PMID- 23715160
OWN - NLM
STAT- MEDLINE
DCOM- 20130815
LR  - 20130618
IS  - 1532-0979 (Electronic)
IS  - 0147-5185 (Linking)
VI  - 37
IP  - 7
DP  - 2013 Jul
TI  - Postoperative nodal status and diffuse-type histology are independent prognostic 
      factors in resectable advanced gastric carcinomas after preoperative 
      chemotherapy.
PG  - 1022-9
LID - 10.1097/PAS.0b013e31828778fd [doi]
AB  - Surgical resection of primary gastric lesions after neoadjuvant or palliative 
      chemotherapy is performed for curative or palliative purpose in locally advanced 
      (LA) or initially metastatic (IM) gastric cancer. We investigated which 
      histomorphologic features were associated with patient prognosis. We examined 143 
      patients (57 LA and 86 IM) who underwent gastrectomy after chemotherapy between 
      2000 and 2009. The tumor regression grade (TRG)-determined by examining the 
      residual neoplastic cells and background stromal changes-was evaluated. 
      Progression-free (PFS) and overall survival (OS) were evaluated according to 
      pretherapeutic and posttherapeutic clinicopathologic factors using univariate and 
      multivariate analyses. Because both the LA and the IM groups showed similar 
      trends of PFS and OS according to TRG, the 2 groups were analyzed together. 
      Patients with TRG1 (no residual primary tumor) showed a superior PFS and OS than 
      the remaining TRGs. We defined pathologic complete regression (pCR) as TRG1 with 
      negative lymph nodes (LN) and the others as non-pCR. Sixteen patients (11.1%) had 
      pCR with better PFS (P=0.007) and OS (P=0.006). Initial disease status (LA or IM) 
      remained as independent prognostic factors for PFS (P=0.021) but not for OS 
      (P=0.109). The postoperative negative LN status correlated with good outcome and 
      postoperative diffuse-type histology correlated with poor outcome after 
      multivariate analysis. This study showed that pCR, but not partial regression, 
      provides meaningful prognostic information in gastrectomy after chemotherapy. In 
      addition, postoperative LN positivity and diffuse-type histology were independent 
      poor prognostic factors for PFS and OS.
FAU - Koh, Young Wha
AU  - Koh YW
AD  - Department of Pathology, Asan Medical Center, University of Ulsan College of 
      Medicine, Seoul, Republic of Korea.
FAU - Park, Young Soo
AU  - Park YS
FAU - Ryu, Min-Hee
AU  - Ryu MH
FAU - Ryoo, Baek-Yeol
AU  - Ryoo BY
FAU - Park, Hye Jin
AU  - Park HJ
FAU - Yook, Jeong Hwan
AU  - Yook JH
FAU - Kim, Byung Sik
AU  - Kim BS
FAU - Kang, Yoon-Koo
AU  - Kang YK
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Surg Pathol
JT  - The American journal of surgical pathology
JID - 7707904
SB  - IM
MH  - Adenocarcinoma/mortality/*secondary/therapy
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Chemotherapy, Adjuvant/*methods
MH  - Disease-Free Survival
MH  - Female
MH  - Gastrectomy
MH  - Humans
MH  - Lymph Nodes/*pathology
MH  - Male
MH  - Middle Aged
MH  - Neoadjuvant Therapy/*methods
MH  - Postoperative Period
MH  - Prognosis
MH  - Republic of Korea/epidemiology
MH  - Retrospective Studies
MH  - Stomach Neoplasms/mortality/*pathology/therapy
MH  - Survival Rate
EDAT- 2013/05/30 06:00
MHDA- 2013/08/16 06:00
CRDT- 2013/05/30 06:00
PHST- 2013/05/30 06:00 [entrez]
PHST- 2013/05/30 06:00 [pubmed]
PHST- 2013/08/16 06:00 [medline]
AID - 10.1097/PAS.0b013e31828778fd [doi]
PST - ppublish
SO  - Am J Surg Pathol. 2013 Jul;37(7):1022-9. doi: 10.1097/PAS.0b013e31828778fd.