Neoadjuvant Chemotherapy Outcomes in Gastric Cancer
Summary
Neoadjuvant chemotherapy has emerged as a pivotal strategy in the management of locally advanced gastric cancer, aiming to downstage tumours, improve resectability and eliminate micrometastatic disease prior to surgery. Clinical trials have established regimens combining fluoropyrimidines, platinum agents and taxanes as standards of care, demonstrating improved rates of R0 resection and modest gains in overall survival. Pathological response, often quantified by tumour regression grading and the incidence of pathological complete response, correlates strongly with long-term outcomes, though interobserver variability and differing grading systems present ongoing challenges. Biomarkers such as serum carcinoembryonic antigen and CA19-9 offer potential for early prediction of response, while ypTNM staging provides refined prognostic stratification post-chemotherapy. Despite advances, heterogeneity in chemotherapy sensitivity and patterns of recurrence—particularly in the central nervous system—highlight the need for personalised approaches, integration of molecular profiling and optimisation of perioperative management across diverse patient populations.
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Neoadjuvant Chemotherapy Outcomes in Gastric Cancer publication trend
The graph below shows the total number of articles in neoadjuvant chemotherapy outcomes in gastric cancer across all publications each year (not limited to Nature Index journals).
Technical terms
Neoadjuvant chemotherapy: Preoperative administration of systemic cytotoxic drugs aimed at shrinking the primary tumour and eradicating micrometastases before surgical resection.
Tumour regression grade (TRG): A histopathological scoring system that quantifies the proportion of residual viable tumour versus treatment-induced fibrosis in resected specimens.
Pathological complete response (pCR): The absence of detectable residual invasive cancer in the primary site and lymph nodes upon pathological examination after preoperative therapy.
ypTNM staging: A post-treatment pathological classification that applies the TNM system to specimens obtained after neoadjuvant therapy, reflecting changes induced by treatment.
References
- Using Normalized Carcinoembryonic Antigen and Carbohydrate Antigen 19 to Predict and Monitor the Efficacy of Neoadjuvant Chemotherapy in Locally Advanced Gastric Cancer. International Journal of Molecular Sciences (2023).
- Interpretation of Tumor Response Grade following Preoperative Therapy for Gastric Cancer: An Overview. Cancers (2023).
- Correlation of pathological complete response with survival after neoadjuvant chemotherapy in gastric or gastroesophageal junction cancer treated with radical surgery: A meta-analysis. PLOS ONE (2018).
- ypTNM staging after neoadjuvant chemotherapy in the Chinese gastric cancer population: an evaluation on the prognostic value of the AJCC eighth edition cancer staging system. Gastric Cancer (2018).
- Prognostic Value of Tumor Regression Grading in Patients Treated With Neoadjuvant Chemotherapy Plus Surgery for Gastric Cancer. Frontiers in Oncology (2021).
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