scholarly journals ENDOSCOPIC CHARACTERISTICS OF PATIENTS WITH COMPLETE PATHOLOGICAL RESPONSE AFTER NEOADJUVANT CHEMOTHERAPY FOR GASTRIC AND ESOPHAGOGASTRIC JUNCTION ADENOCARCINOMAS

2021 ◽  
Vol 34 (3) ◽  
Author(s):  
Juliana Silveira Lima de CASTRO ◽  
Adriane Graicer PELOSOF ◽  
João Guilherme Guerra de ANDRADE-CABRAL ◽  
Alvaro Moura SERAPHIM ◽  
Eloy TAGLIERI ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Esophagogastric Junction ◽  
Pathological Response ◽  
Gastric Body ◽  
Time Interval ◽  
Significant Finding ◽  
Complete Pathological Response ◽  
Term Survival ◽  
Endoscopic Findings ◽  
Additional Surgery

ABSTRACT Background: Gastric and esophagogastric junction adenocarcinoma are responsible for approximately 13.5% of cancer-related deaths. Given the fact that these tumors are not typically detected until they are already in the advanced stages, neoadjuvancy plays a fundamental role in improving long-term survival. Identification of those with complete pathological response (pCR) after neoadjuvant chemotherapy (NAC) is a major challenge, with effects on organ preservation, extent of resection, and additional surgery. There is little or no information in the literature about which endoscopic signs should be evaluated after NAC, or even when such re-evaluation should occur. Aim: To describe the endoscopic aspects of patients with gastric and esophagogastric junction adenocarcinomas who underwent NAC and achieved pCR, and to determine the accuracy of esophagogastroduodenoscopy (EGD) in predicting the pCR. Methods: A survey was conducted of the medical records of patients with these tumors who were submitted to gastrectomy after NAC, with anatomopathological result of pCR. Results: Twenty-nine patients were identified who achieved pCR after NAC within the study period. Endoscopic responses were used to classify patients into two groups: G1-endoscopic findings consistent with pCR and G2-endoscopic findings not consistent with pCR. Endoscopic evaluation in G1 was present in an equal percentage (47.4%; p=0.28) in Borrmann classification II and III. In this group, the predominance was in the gastric body (57.9%; p=0.14), intestinal subtype with 42.1% (p=0.75), undifferentiated degree, 62.5% (p=0.78), Herb+ in 73.3% (p=0.68). The most significant finding, however, was that the time interval between NAC and EGD was longer for G1 than G2 (24.4 vs. 10.2 days, p=0.008). Conclusion: EGD after NAC seems to be a useful tool for predicting pCR, and it may be possible to use it to create a reliable response classification. In addition, the time interval between NAC and EGD appears to significantly influence the predictive power of endoscopy for pCR.

Long-term follow-up of advanced gastric cancer patients who achieved a pathologic complete response with neoadjuvant chemotherapy.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 133-133
Author(s):  
Haruhiko Cho ◽  
Takaki Yoshikawa
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Pathological Response ◽  
Term Survival ◽  
Gastric Cancer Patients ◽  
The Impact

133 Background: Adjuvant chemotherapy (AC) after D2 gastrectomy has become a standard treatment for stage 2/3 gastric cancer in Japan and Korea; however, the results remain unsatisfactory due to insufficient risk reduction in patients with stage 3 disease and low compliance. Although the administration of neoadjuvant chemotherapy (NAC) is a promising approach associated with a high rate of compliance and a downstage effect, the long-term survival benefits of this modality are unclear. Moreover, the impact of the pathological response on survival has not been evaluated. Based on the hypothesis that the pathological response grade is associated with survival, we conducted a search for reports of a pathological complete response (pCR) obtained with NAC. Methods: A total of 27 gastric cancer patients who achieved a pCR following NAC therapy were identified using PubMed and the Japanese medical search engine “Ichu-shi,” with the search words “gastric cancer,” “NAC,” and “pCR.” A questionnaire regarding the patients’ prognoses was posted in 23 institutions in Japan in July 2013. Results: Answers regarding 22 patients were obtained from 20 institutions. The subjects included 13 males and nine females. The mean age was 67.5 years. Tumors with stage 3/4 (95.4%: 21/22) and a diffuse-type histology (61.9%: 13/21) were dominant. S1/CDDP was the most frequently selected NAC regimen. A total of 77.2% (17/22) of the patients required combined resection of adjacent organs, and all patients underwent R0 resection and D2 lymphadenectomy. At present, 86.3% (19/22) of the patients are alive without recurrence; none of the ten patients who received postoperative AC demonstrated any recurrence, while three of twelve patients who did not receive postoperative AC developed recurrence, and two patients died of the disease after surgery (at 71 months and nine months, respectively). The overall and recurrence-free survival rates at three/five years were 95.5%/85.1% and 90.9%/75.1%, respectively. Conclusions: Patients with gastric cancer who achieve a pCR with NAC are rare; however, their prognoses are excellent. It is therefore important to develop a NAC regimen focusing on a high pCR rate.

P136. Does complete radiological response correlate with a complete pathological response following neoadjuvant chemotherapy?

2019 ◽  
Vol 45 (5) ◽  
pp. 919-920
Author(s):  
Alexander Frost Younger ◽  
Ross McLean ◽  
Petros Amorginos ◽  
Andrew Pieri ◽  
Henry Cain ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Pathological Response ◽  
Complete Pathological Response ◽  
Radiological Response

767 Magnetic Resonance Imaging in the Assessment of Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy: Evaluation of the Prognostic Value of Mid-Chemotherapy and Post-Chemotherapy Scans

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Davenport ◽  
R Okhiria ◽  
E Barrett ◽  
L Highton
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Neoadjuvant Chemotherapy ◽  
Prognostic Value ◽  
Breast Tissue ◽  
Complete Response ◽  
Pathological Response ◽  
Resonance Imaging ◽  
Complete Pathological Response ◽  
Radiological Response

Abstract Introduction Magnetic Resonance Imaging (MRI) is used to assess the response to Neoadjuvant Chemotherapy (NAC) when used in patients with breast cancer. Method This retrospective observational study compared patterns of tumour response at mid-chemotherapy and post-chemotherapy MRIs to histological outcomes. 118 cases of breast cancer, from a local database, were included. Results There was a significant association between complete pathological response in resected breast tissue and complete radiological response on both mid-chemotherapy MRI (p = 0.007) and post-chemotherapy MRI (p < 0.001). In patients who had both scans,100% of those with complete response at mid-chemotherapy scan maintained this response pattern. In those who had both scans, complete response at the mid-chemotherapy scan had a PPV for complete pathological response in resected breast tissue of 92% compared to 64% in those with complete response that was not achieved until the post-chemotherapy scan. There was a trend towards an association between early complete radiological response and complete pathological response (p = 0.124). Conclusions Both scans have significant prognostic value. A mid-chemotherapy scan may have superior prognostic value when complete response is achieved, though larger studies are needed to determine the significance. 100% maintenance of complete radiological response after the mid-chemotherapy scan highlights the possibility that some post-chemotherapy scan could be avoided.

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