Predictive Clinical and Pathological Factors for Treatment Response in Locally Advanced Gastric Cancer Patients Receiving Neoadjuvant Chemotherapy

INTRODUCTION: The aim of this study was to identify clinical and pathological factors predicting treatment response among patients with locally advanced gastric cancer who received neoadjuvant chemotherapy.
METHODS: Retrospective data of 106 patients diagnosed with locally advanced gastric carcinoma who presented to Van Yüzüncü Yıl University Faculty of Medicine, Department of Medical Oncology between 2010 and 2023 were analyzed. Patients who received neoadjuvant chemotherapy and subsequently underwent surgery were included. Demographic characteristics, laboratory findings, histopathological features, and treatment response were evaluated.
RESULTS: Compared to the non-response group, patients with pathological response exhibited significantly lower clinical T stage, vascular/perineural invasion, ECOG score, TNM stage, number of metastatic lymph nodes, and CAP-TRG scores (p < 0.05). In the response group, rates of curative surgery, intestinal-type Lauren classification, moderate/well differentiation, CA19-9, and PDW were significantly higher; neuropathy and stomatitis were less frequent. Overall survival and disease-free survival were significantly improved in patients with pathological response (p < 0.05).
DISCUSSION AND CONCLUSION: High T stage, poor differentiation, high ECOG score, and low CA19-9 levels were associated with poor treatment response. A significant survival advantage was observed in patients who responded to neoadjuvant therapy.

Keywords: Gastric adenocarcinoma, neoadjuvant chemotherapy, treatment response, pathological response, prognostic factors