Preop chemosensitivity improves survival in patients with resected gastric adenocarcinoma: JAMA

USA: A new study conducted by Lei Deng and the team showed that in patients with resectable gastric adenocarcinoma who underwent postoperative chemotherapy (PC), preoperative chemosensitivity was related to survival. The findings of this study were published in the Journal of American Medical Association (JAMA) on 19th November 2021.

The goal of this study was to see if preoperative chemosensitivity is related to postoperative survival in patients with resectable gastric adenocarcinoma who are treated with PC. Between 2006 and 2017, this was national, hospital-based cohort research that used data from the National Cancer Database to cover more than 70% of newly diagnosed stomach adenocarcinomas in the United States.

Patients with clinical stage II or III disease who were treated with preoperative chemotherapy and curative-intent resection, excluding radiation, were eligible to participate. Very sensitive (ypT0N0), sensitive (pathological TNM stage less than clinical, except ypT0N0), and refractory (pathological more than or equal to clinical) were the preoperative chemosensitivity classifications. In April 2021, the data was evaluated.

• The results stated that preoperative chemosensitivity was observed to be linked with survival in patients with resectable gastric adenocarcinoma who had PC in this cohort analysis.
• Chemosensitivity before surgery was also linked to postoperative survival. In the overall group, PC was not observed to be related with increased survival. However, the benefit of PC varied depending on the patient's prior chemosensitivity.
• Patients with sensitive illness, defined as pathological less than clinical stage (excluding complete pathological response), showed better survival as compared to those who did not get PC. Patients with particularly sensitive and refractory illness did not have increased survival with PC.

In conclusion, this study discovered that preoperative chemosensitivity is related to survival in patients with clinical stage II to III gastric adenocarcinoma who are treated with PC. Preoperative chemosensitivity may be factored into the PC administration decision-making process.

"These findings suggest that preoperative chemosensitivity may be helpful in making the decision regarding postoperative chemotherapy for patients with resectable gastric adenocarcinoma," wrote the authors. 

Reference:

Deng L, Groman A, Jiang C, et al. Association of Preoperative Chemosensitivity With Postoperative Survival in Patients With Resected Gastric Adenocarcinoma. JAMA Netw Open. 2021;4(11):e2135340. doi:10.1001/jamanetworkopen.2021.35340