Impact of tumor regression grade on recurrence after preoperative chemoradiation and gastrectomy for gastric cancer

Background and Objectives It is unknown whether the degree of response to preoperative therapy correlates with locoregional recurrence (LR) or distant recurrence (DR) after resection of gastric cancer. Methods Patients who underwent resection of gastric adenocarcinoma following chemotherapy and chem...

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Published in:Journal of surgical oncology 2020-09, Vol.122 (3), p.422-432
Main Authors: Stark, Alexander P., Estrella, Jeannelyn S., Chiang, Yi‐Ju, Das, Prajnan, Minsky, Bruce D., Blum Murphy, Mariela A., Ajani, Jaffer A., Mansfield, Paul, Badgwell, Brian D., Ikoma, Naruhiko
Format: Article
Language:English
Subjects:
Gastric cancer
neoadjuvant
radiation therapy
recurrence
tumor regression grade
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Summary:Background and Objectives It is unknown whether the degree of response to preoperative therapy correlates with locoregional recurrence (LR) or distant recurrence (DR) after resection of gastric cancer. Methods Patients who underwent resection of gastric adenocarcinoma following chemotherapy and chemoradiation (1995‐2015) were reviewed. The tumor regression grade (TRG) was defined by the percentage of viable tumor cells in the specimen (TRG0 = 0%; TRG1 = 1%‐2%; TRG2 = 3%‐50%; TRG3 ≥ 50%). The relationships among TRG, recurrence‐free survival (RFS), LR, and DR were examined. Results Two hundred forty‐seven patients met the inclusion criteria (TRG0, 52 [21%]; TRG1, 49 [20%]; TRG2, 98 [40%]; TRG3, 48 [19%]). LR and DR occurred in 6.1% and 32.0% of patients, respectively. No patient with TRG0 experienced LR. R1 resection (6%‐15%) and LR (6%‐8%) rates were similar among TRG1‐3 patients. R1 resection was associated with LR (hazard ratio [HR], 17.85; P 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.25984