Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2878-2892
Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2878
Perioperative chemotherapy improves survival of patients with locally advanced diffuse gastric cancer
Ze-Feng Li, Zheng Li, Xiao-Jie Zhang, Chong-Yuan Sun, He Fei, Chun-Xia Du, Chun-Guang Guo, Dong-Bing Zhao
Ze-Feng Li, Zheng Li, Xiao-Jie Zhang, Chong-Yuan Sun, He Fei, Chun-Guang Guo, Dong-Bing Zhao, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Chun-Xia Du, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Co-first authors: Ze-Feng Li and Zheng Li.
Co-corresponding authors: Chun-Xia Du and Dong-Bing Zhao.
Author contributions: Du CX, Guo CG, Zhao DB designed the study, initiated the collaborations, and provided the framework and structure to the article; Li ZF, Li Z, Zhang XJ, Sun CY, Fei H cleaned and analyzed the data, created the figures and tables, interpreted the results, and led one section of the manuscript; Li ZF, Li Z, Du CX, Guo CG, Zhao DB undertook the final editing, and all authors approved the final version; All authors have read and agreed to the published version of the manuscript.
Supported by the Beijing Hope Run Special Fund of Cancer Foundation of China, No. LC2022L03; and CAMS Innovation Fund for Medical Sciences (CIFMS), No. 2021-I2M-C&T-A-014.
Institutional review board statement: The data in this study obtained from SEER database was in accordance with the SEER data use agreement. The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. This study is approved by the ethics committee of the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Informed consent statement: As a study based on SEER dataset, informed consent statement is not appliable.
Conflict-of-interest statement: The authors have no disclosures or relevant conflicts of interest.
Data sharing statement: The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Xia Du, PhD, Professor, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuannanli, Chaoyang District, Beijing 10021, China, Beijing 100021, China. retinadcx@vip.163.com
Received: May 29, 2024
Revised: July 21, 2024
Accepted: July 26, 2024
Published online: September 27, 2024
Processing time: 112 Days and 10.2 Hours
Abstract
BACKGROUND

Whether patients with diffuse gastric cancer, which is insensitive to chemotherapy, can benefit from neoadjuvant or adjuvant chemotherapy has long been controversial.

AIM

To investigate whether perioperative chemotherapy can improve survival of patients with locally advanced diffuse gastric cancer.

METHODS

A total of 2684 patients with locally advanced diffuse gastric cancer from 18 population-based cancer registries in the United States were analyzed.

RESULTS

Compared with surgery alone, perioperative chemotherapy improved the prognosis of patients with locally advanced gastric cancer. Before stabilized inverse probability of treatment weighting (IPTW), the median overall survival (OS) times were 40.0 months and 13.0 months (P < 0.001), respectively. After IPTW, the median OS times were 33.0 months and 17.0 months (P < 0.001), respectively. Neoadjuvant chemotherapy did not improve the prognosis of patients with locally advanced gastric cancer compared with adjuvant chemotherapy after IPTW. After IPTW, the median OS times were 38.0 months in the neoadjuvant chemotherapy group and 42.0 months in the adjuvant chemotherapy group (P = 0.472).

CONCLUSION

Patients with diffuse gastric cancer can benefit from perioperative chemotherapy. There was no significant difference in survival between patients who received neoadjuvant chemotherapy and those who received adjuvant chemotherapy.

Keywords: Gastric cancer; Neoadjuvant chemotherapy; Adjust chemotherapy; Prognosis; Survival

Core Tip: Patients with diffuse gastric cancer can benefit from perioperative chemotherapy. As there was no significant difference in survival between patients who received neoadjuvant chemotherapy and those who received adjuvant chemotherapy. Clinicians should personalize the selection of neoadjuvant chemotherapy or adjuvant chemotherapy for different patients.