Survival Benefit of Neoadjuvant Chemotherapy with S-1 Plus Docetaxel for Locally Advanced Gastric Cancer: A Propensity Score-Matched Analysis

Kano, Masayuki; Hayano, Koichi; Hayashi, Hideki; Hanari, Naoyuki; Gunji, Hisashi; Toyozumi, Takeshi; Murakami, Kentaro; Uesato, Masaya; Ota, Satoshi; Matsubara, Hisahiro

doi:10.1245/s10434-019-07299-7

Cited by 38 publications

(46 citation statements)

References 33 publications

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“…Excellent outcomes could be expected from surgery alone when gastric cancer is diagnosed at early stage. However, in locally advanced GC patients, operation could not always lead to a satisfactory consequence, even with postoperative therapy [2]. Neoadjuvant chemotherapy (NCT) improves R0 resection rate and prognosis when compared with surgery alone or surgery with postoperative therapy [3], but the outcomes are sometimes unpredictable due to the differences in many factors such as tumor differentiation and Lauren classification.…”

Section: Introductionmentioning

confidence: 99%

CA724 predicts overall survival in locally advanced gastric cancer patients with neoadjuvant chemotherapy

Tong

Zhao

Shan

et al. 2020

Preprint

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Background: Serum tumor markers are of great importance in diagnosis, prognostic predicting and recurrence monitoring in gastrointestinal malignancy, including AFU, AFP, CEA, CA199, CA125 and CA724. However, their significances in gastric cancer (GC) patients with neoadjuvant therapy (NCT) are still uncertain. The aim of this study is to evaluate the predictive value of these six tumor markers in locally advanced GC patients with NCT and curative surgery. Methods: 290 locally advanced GC patients with NCT and D2 radical gastrectomy were retrospectively analyzed. Their tumor markers before (pre-) and after (post-) NCT and pathological characters were exacted from the database in our hospital. The optimal cutoff values of six tumor markers were calculated by ROC and Youden index. Their predictive significances were analyzed and survival curves on overall survival (OS) were obtained by Kaplan-Meier method. Associations between categorical variables were explored by Chi-square test or Fisher's exact method. Multivariate analyses were performed by Cox regression model. Results: Not only the pre- and post- CA199, CA125 and CA724 could predict the OS respectively, but also the changes (diff-) between post- and pre- groups were related to the prognosis (P < 0.05). In multivariable analysis, only pre- (P = 0.016) and post-CA724 (P = 0.033) remained significant, and the significance of diff-CA724 was on borderline (P = 0.085). Besides, pre- and post-CA199, CA125 and CA724 were associated with the metastasis of lymph node (N- vs N+) and pathological stage (Ⅰ-Ⅱ vs Ⅲ) (P < 0.05). Post-CA724 was related to the invasion of vascular or lymphatic vessels (P = 0.019), and pre-CA724 was nearly remarkable (P = 0.082). However, AFU, AFP and CEA showed no association with survival (P > 0.05). Conclusions: CA724 is an independent factor to prognosis, and could be used to predict the ypN and ypTNM stage in locally advanced GC patients undergone NCT and curative resection.

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Section: Introductionmentioning

confidence: 99%

CA724 predicts overall survival in locally advanced gastric cancer patients with neoadjuvant chemotherapy

Tong

Zhao

Shan

et al. 2020

Preprint

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“…It has recently been revealed that the distribution of programmed cell death ligands (PD‐L) differs depending on the type of head and neck squamous cell carcinoma (HNSCC) . In HNSCC patients, PD‐L2 expression has been reported to be greater than that of PD‐L1 .…”

Section: Introductionmentioning

confidence: 99%

Cisplatin‐induced programmed cell death ligand‐2 expression is associated with metastasis ability in oral squamous cell carcinoma

et al. 2020

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Programmed cell death ligands (PD-Ls) are expressed in tumor cells where they bind to programmed cell death-1, an immunocyte co-receptor, resulting in tumor cell evasion from the immune system. Chemotherapeutic drugs have been recently reported to induce the expression of PD-L, such as PD-L1, in some cancer cells. However, little is known regarding PD-L2 expression and its role in oral squamous cell carcinoma (OSCC). In this study, we examined the effect of cisplatin on the expression and regulation of PD-L2 in OSCC cell lines and analyzed malignant behavior in PD-L2-expressing cells using colony, transwell and transformation assays. In addition, we examined PD-L2 expression in the tumor tissues of OSCC patients using cytology and tissue microarray methods. In OSCC cell lines, cisplatin treatment upregulated PD-L2 expression, along with that of the drug efflux transporter ABCG2, via signal transducers and activator of transcription (STAT) 1/3 activation. Moreover, PD-L2positive or PD-L2-overexpressing cells demonstrated upregulation in both invasion and transformation ability but not in proliferation compared with PD-L2-negative or PD-L2-silencing cells. PD-L2 expression was also observed in OSCC cells of cytology samples and tissue from OSCC patients. The intensity of PD-L2 expression was correlated with more malignant morphological features in the histological appearance and an invasive pattern. Our findings indicate that cisplatin-upregulated PD-L2 expression in OSCC via STAT1/3 activation and the expression of PD-L2 are likely to be associated with malignancy in OSCC. The PD-L2 expression in cisplatin-resistant OSCC cells may be a critical factor in prognosis of advanced OSCC patients.

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“…Furthermore, recent studies have demonstrated the prognostic signi cance of conversion surgery after chemotherapy in patients with stage IV gastric cancer [9][10][11][12]. Conversely, neoadjuvant chemotherapy (NAC) has been found as a promising therapeutic strategy in patients with locally advanced gastric cancer, such as those with macroscopic type 4 tumor, large type 3 tumor, bulky lymph node metastasis, and clinically stage III [13][14][15][16][17]. However, the indication and prognostic signi cance of conversion surgery or NAC remain uncertain in patients with type 4 gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of surgery after chemotherapy in patients with type 4 gastric cancer

Arigami

Matsushita

Okubo

et al. 2020

Preprint

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Abstract Background The majority of patients with type 4 gastric cancer have distant metastases with extremely poor prognosis. Consequently, considering a therapeutic strategy that improves the prognosis of these patients is clinically important. The present study aimed to assess the clinical indication and prognostic impact of surgery in patients with type 4 gastric cancer who underwent chemotherapy. Methods A total of 67 patients with type 4 gastric cancer who underwent chemotherapy were retrospectively enrolled. All patients were grouped into progressive disease (PD) and non-PD groups by tumor response to chemotherapy. Results Distant metastases occurred in 58 patients. With regard to tumor response, 16 and 51 patients had PD and non-PD, respectively. The prognosis was significantly poorer in patients with PD than in those with non-PD (p < 0.0001). Among 23 patients who underwent surgery after chemotherapy, 21 had a R0 resection. The presence or absence of surgery was significantly correlated with age, first-line chemotherapeutic regimen, lymph node metastasis, clinical stage, number of distant metastatic sites, peritoneal dissemination, and tumor response (p = 0.0412, p = 0.0096, p = 0.0024, p = 0.0059, p = 0.0128, and p = 0.0020, and p = 0.0066, respectively). Multivariate analysis selected tumor response and surgery as an independent prognostic factor (p = 0.0001 and p = 0.0009, respectively). Moreover, multivariate analysis for the surgery group demonstrated that metastatic nodal status (N0-1 vs N2-3) and residual tumor status (R0 vs R1-2) were significant independent prognostic factors (p = 0.0258 and p = 0.0458, respectively). Conclusion Our retrospective study suggests that surgery after chemotherapy for type 4 gastric cancer may improve the prognosis of responders with N0-1 status and a curative R0 resection.

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Survival Benefit of Neoadjuvant Chemotherapy with S-1 Plus Docetaxel for Locally Advanced Gastric Cancer: A Propensity Score-Matched Analysis

Cited by 38 publications

References 33 publications

CA724 predicts overall survival in locally advanced gastric cancer patients with neoadjuvant chemotherapy

CA724 predicts overall survival in locally advanced gastric cancer patients with neoadjuvant chemotherapy

Cisplatin‐induced programmed cell death ligand‐2 expression is associated with metastasis ability in oral squamous cell carcinoma

Prognostic significance of surgery after chemotherapy in patients with type 4 gastric cancer

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