Neoadjuvant intra-arterial chemoembolization improves tumor pathological regression and survival in Borrmann type IV gastric cancer

doi:10.5306/wjco.123351

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World Journal of Clinical Oncology

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2218-4333

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Oncol. Aug 24, 2026; 17(8): 123351
Published online Aug 24, 2026. doi: 10.5306/wjco.123351

Neoadjuvant intra-arterial chemoembolization improves tumor pathological regression and survival in Borrmann type IV gastric cancer

Xiao-Xing Wu, Hou-Dun Yang, Jiang Min, Chao Yuan, Lian-Shuo Li, Wei Zhang, Yue Tong

Xiao-Xing Wu, Hou-Dun Yang, Jiang Min, Chao Yuan, Lian-Shuo Li, Wei Zhang, Yue Tong, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Co-first authors: Xiao-Xing Wu and Hou-Dun Yang.

Co-corresponding authors: Wei Zhang and Yue Tong.

Author contributions: Wu XX, Yang HD, Min J, Yuan C, Li LS, Zhang W, and Tong Y contributed to the data collection, analysis, and drafting or revision of the manuscript; Wu XX and Yang HD contributed equally to this manuscript as co-first authors; Zhang W and Tong Y contributed equally to this manuscript as co-corresponding authors. All authors have read and approved the final version of the manuscript.

AI contribution statement: During the preparation of this work, the author(s) did not use any generative AI or AI-assisted tools for literature search, data analysis, figure generation, or writing. All content was solely created by the author(s).

Supported by Chongqing Municipal Science and Technology Bureau, No. CSTB2025NSCQ-GPX1134.

Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (approval No. 2025-560-01).

Informed consent statement: Written informed consent for treatment was obtained from all patients. The institutional review board waived the requirement for additional informed consent for this retrospective analysis of anonymized data.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.

Corresponding author: Yue Tong, Academic Fellow, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. natual101@gmail.com

Received: May 18, 2026
Revised: July 27, 2026
Accepted: August 20, 2026
Published online: August 24, 2026
Processing time: 101 Days and 6.7 Hours

Core Tip

Core Tip: Borrmann type IV gastric cancer has a poor prognosis because of its diffuse and infiltrative growth pattern. In this retrospective of 70 patients, neoadjuvant intra-arterial chemoembolization followed by gastrectomy achieved an objective response rate of 40.0% with manageable toxicity. Primary-tumor pathological response was associated with better survival in unadjusted analyses, whereas N-stage regression remained independently associated with improved overall survival and disease-free survival after multivariable adjustment. Postoperative complications were associated with worse outcomes. These findings support N-stage regression as a clinically relevant prognostic marker and warrant prospective evaluation of intra-arterial chemoembolization as a therapeutic strategy for Borrmann type IV gastric cancer.