Survival outcomes according to neoadjuvant chemotherapy status in pathological stage IIIC gastric cancer: a single-center institutional experience
Aytac Selman, Cebrail Akyuz, Meryem Gunay GurleyikAbstract
Objectives
Neoadjuvant chemotherapy (NACT) is commonly incorporated into the management of resectable locally advanced gastric cancer. However, survival outcomes in patients who remain classified as pathological stage IIIC after surgery, particularly when analyzed according to NACT exposure, are not well characterized. This study compares overall survival (OS) according to prior NACT exposure among patients who ultimately remained classified as pathological stage IIIC after curative surgery.
Methods
This retrospective study included patients who underwent curative surgery between 2010 and 2022 and were diagnosed with pathological stage IIIC gastric cancer on postoperative histopathological examination. Patients were grouped according to whether they received NACT. OS was measured from surgery to death from any cause or last follow-up. Survival was analyzed using the Kaplan–Meier method and Cox proportional hazards regression.
Results
The study cohort comprised 75 patients, of whom 24.0 % (18/75) received NACT. OS did not differ significantly between patients who received NACT and those who did not, as assessed by the log-rank test (p=0.749). In multivariable Cox regression analysis, NACT was not identified as an independent factor associated with OS (HR: 0.96; 95 % CI: 0.50–1.84; p=0.902).
Conclusions
Within the limitations of this retrospective study, overall survival was comparable according to neoadjuvant chemotherapy status among patients who ultimately remained classified as pathological stage IIIC after curative surgery. These findings should be interpreted cautiously because the compared groups represent biologically distinct populations and the study was not designed to evaluate the therapeutic efficacy of neoadjuvant chemotherapy.