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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

3348 - Can preoperative diagnosis select therapeutic target of neoadjuvant chemotherapy for gastric cancer?

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Targeted Therapy

Tumour Site

Gastric Cancer

Presenters

Kentaro Hara

Citation

Annals of Oncology (2018) 29 (suppl_8): viii205-viii270. 10.1093/annonc/mdy282

Authors

K. Hara1, T. Hayashi2, Y. Shimoda2, M. Nakazono2, S. Nagasawa2, Y. Kumazu2, T. Yamada2, Y. Rino3, M. Masuda3, T. Ogata2, T. Oshima2, T. Yoshikawa4

Author affiliations

  • 1 Gastroenterological Surgery, Kanagawa Cancer Center, 2410815 - Yokohama/JP
  • 2 Gastrointestinal Surgery, Kanagawa Cancer Center, 2410815 - Yokohama/JP
  • 3 Surgery, Yokohama City University, Yokohama/JP
  • 4 Gastric Surgery Division, National Cancer Center Hospital, Tokyo/JP
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Resources

Abstract 3348

Background

Precise clinical staging by diagnostic imaging is essential for determination of initial treatment for gastric cancer. Indeed, cT3 and T4 diseases with lymph node metastasis (T3-4/N+) were candidate of neoadjuvant chemotherapy (NAC) followed by gastrectomy, defined as cStageIII in 8th edition of AJCC/UICC TNM classification. However, pathological T3-4/N+ diseases could contain some cases that were underestimated as cStage I/II and excluded from target of NAC. This study aims to examine the accuracy of preoperative diagnosis and the prognosis from each cStage in pathological T3-4/N+ gastric cancers.

Methods

The study analyzed gastric cancer patients who received gastrectomy and diagnosed as pathological T3-4/N+ deseases between Jun 2000 and Jun 2012 at Kanagawa Cancer Center. The clinical and pathological data were analyzed retrospectively. Patients who received preoperative chemotherapy were excluded. The proportion of each cStage was investigated based on the 8th edition of AJCC/UICC, and 5-year overall survival rate (5yOS) for each cStage was calculated using the Kaplan-Meier method.

Results

In total, 337 patients were diagnosed as pathological T3-4/N+ diseases and included in this study. In clinical staging, 48 patients (14.2%) were diagnosed as cStageI, 10 patients (3.0%) as cStageIIA, 109 patients (32.3%) as cStageIIB, 159 patients (47.2%) as cStageIII, 6 patients (1.8%) as cStageIVA, and 5 patients (1.5%) as cStageIVB. 5yOS stratified by cStage was 77.0% in cStageI, 90.0% in cStageIIA, 52.2% in cStageIIB, 49.0% in cStageIII, and 0% in cStageIVA/IVB. Furthermore, survival curve of cStageIIB and cStageIII were approximately overlapped.

Conclusions

Among pathological T3-4/N+ diseases, the underestimation as cStageI and cStageIIA was acceptable, because of relative low frequency and good prognosis without NAC. Meanwhile, the underestimation as cStageIIB could not be ignored, because patients diagnosed as cStageIIB occupied one third of pathological T3-4/N+ disease and had poor prognosis comparable to cStageIII. We need to consider underestimation of preoperative diagnosis, when we determine target of NAC for advanced gastric cancer.

Clinical trial identification

Legal entity responsible for the study

Kentaro Hara.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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