When and where: A study on gastric cancer recurrence after neoadjuvant/perioperative chemotherapy

Table 1 Baseline patient characteristics (n = 91), n (%)

	A: 4 DOC + surgery (n = 46)	B: 2 DOC + surgery + 2 DOC (n = 45)	Overall
Median age, years (range)	63 (39-74)	66 (33-75)	64 (33-75)
Gender
Male	32 (69.6)	32 (71.1)	64 (70.3)
Female	14 (30.4)	13 (28.9)	27 (29.7)
ECOG performance status
0	42 (91.3)	43 (95.6)	85 (93.4)
1	4 (8.7)	2 (4.4)	6 (6.6)
cTN
T2N+	2 (4.3)	1 (2.2)	3 (3.3)
T3N0	8 (17.4)	5 (11.1)	13 (14.2)
T3N+	18 (39.1)	16 (35.6)	34 (37.4)
T4aN0	4 (8.7)	3 (6.7)	7 (7.7)
T4aN+	13 (28.3)	18 (40.0)	31 (34.1)
T4bN+	1 (2.2)	2 (4.4)	3 (3.3)
cT
T2	2 (4.3)	1 (2.2)	3 (3.3)
T3	26 (56.5)	21 (46.7)	47 (51.6)
T4a	17 (37.0)	21 (46.7)	38 (41.8)
T4b	1 (2.2)	2 (4.4)	3 (3.3)
cN
N0	12 (26.1)	8 (17.8)	20 (22.0)
N1	14 (30.4)	16 (35.6)	30 (33.0)
N2	4 (8.7)	7 (15.6)	11 (12.0)
N3	3 (6.5)	3 (6.7)	6 (6.6)
N+	13 (28.3)	11 (24.3)	24 (26.4)
Response to treatment (Becker + lymph nodes)
Poor response	27 (62.8)	32 (78.1)	59 (70.2)
Good response	16 (37.2)	9 (21.9)	25 (29.8)
Unknown	3	4	7
Lauren histotype
Diffuse	22 (50.0)	13 (29.5)	35 (39.8)
Intestinal	18 (40.9)	23 (52.3)	41 (46.6)
Other	4 (9.1)	8 (18.2)	12 (13.6)
Unknown	2	1	3

ECOG: Eastern Cooperative Oncology Group; DOC: Docetaxel, oxaliplatin, capecitabine.

Table 2 Sites of first recurrence during the first seven years of follow-up (n = 41)

Site of recurrence	Time
	< 1 year	1-2 years	2-3 years	3-4 years	4-5 years	7-8 years	Total
Peritoneal metastases or carci/carcinosis (n)	6	0	3	1	1	0	11
Column (%)	37.5	0.0	42.9	33.3	33.3	0.0	26.8
Local metastases (n)	2	3	0	0	0	0	5
Column (%)	12.5	27.3	0.0	0.00	0.0	0.0	12.2
Distant metastases (n)	6	8	3	1	2	1	21
Column (%)	37.5	72.7	42.9	33.3	66.7	100.0	51.2
Multiple metastases (n)	2	0	1	1	0	0	4
Column (%)	12.5	0.0	14.2	33.34	0.0	0.0	9.8
Total (n)	16	11	7	3	3	1	41
Row (%)	39.0	26.8	17.1	7.3	7.3	2.5	100.00

Table 3 Multivariable analysis for relapse-free survival

	Multivariable model
	HR (95%CI)	P value
cT
2-3	1.00
4	1.92 (1.03-3.56)	0.038
Response to treatment (Becker + lymph nodes)
Poor response	1.00
Good response	0.36 (0.15-0.85)	0.020
Lauren histotype (main effect)
Diffuse	1.00
Intestinal	1.26 (0.44-3.64)	0.665
Other	0.54 (0.15-1.90)	0.335
Lauren histotype (time-dependent effect)
Diffuse	1.00
Intestinal	0.95 (0.91-0.99)	0.034
Other	1.01 (0.98-1.04)	0.462

HR: Hazard ratio; CI: Confidence interval.

Table 4 Univariable overall survival

Variable	Number of patients	Number of events	5 years OS (95%CI)	Median OS in months (95%CI)	P value (log-rank test)
Overall patients	86	45	57.1 (45.5-67.1)	69.6 (44.2-115.1)
BMI
Underweight or normal (< 25)	32	24	42.9 (25.5-59.1)	41.6 (20.7-78.3)	0.008
Overweight or obesity (≥ 25.0)	53	21	64.8 (49.4-76.6)	115.1 (59.9-NE)
Unknown	1	0
cT
T2	3	2
T3	45	18	63.4 (47.2-75.8)	NR	0.045
T4	38	25	48.0 (30.5-63.5)	59.9 (39.1-89.4)
Lauren histotype
Diffuse	34	24	37.8 (21.3-54.3)	40.6 (21.3-69.6)	0.001
Intestinal	38	13	72.7 (54.5-84.1)	NR
Other	14	7
Unknown	2	1
Treatment
Arm A	44	21	58.7 (41.9-72.2)	78.2 (40.5-NE)	0.806
Arm B	42	24	55.0 (38.4-68.9)	65.0 (41.1-115.1)
Response (Becker + lymph nodes)
Poor responders	57	32	50.4 (36.4-62.8)	60.5 (40.5-NE)	0.034
Good responders	24	8	85.7 (61.7-95.2)	115.1 (65.0-NE)

Strata with fewer than 15 patients were excluded from the log-rank test calculation. OS: Overall survival; CI: Confidence interval; BMI: Body mass index; NE: Not estimable from statistical software; NR: Median not reached.