ArticleArquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery2025
Predictive factors for histological response to neoadjuvant therapy in gastric adenocarcinomas.
Article in Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPerioperative chemotherapy is the standard curative treatment for resectable gastric adenocarcinoma, significantly improving both overall and recurrence-free survival. The histological response to neoadjuvant therapy is a critical prognostic factor, commonly assessed through grading systems such as Mandard's tumor regression grade (TRG).
aimsThe aim of the study was to identify predictive factors for histological response to neoadjuvant therapy in gastric adenocarcinoma.
methodsA retrospective study was performed on patients with gastric adenocarcinoma who underwent surgery following neoadjuvant chemotherapy, from 2015 to 2020. The histological response was evaluated using Mandard TRG, which includes five grades (1-5), based on the proportion of residual viable tumor cells and fibrosis. Grades 1-3 were considered a response, and Grades 4 and 5 were considered no response. Students' t-test, chi-squared test, and multivariate logistic regression were used, with significance set at p<0.05.
resultsForty patients were included (male-to-female ratio 2.64, mean age 63 years). Histological response (TRG 1-3) was observed in 48%, while 52% showed no response (TRG 4-5). Univariate analysis showed significant correlations between histological response and tumor size >38 mm (p=0.03), differentiation (p=0.02), parietal wall invasion, absence of nodal involvement (both p<0.001), pathological tumor, node, and metastasis stage (p<0.001), and absence of vascular and perineural invasion (both p=0.001). Multivariate analysis identified parietal wall invasion (odds ratio=2.351, p=0.022) and absence of lymph node metastases (odds ratio=1.491, p=0.01) as independent predictive factors.
conclusionsParietal wall invasion and absence of nodal metastases are predictive of histological response to neoadjuvant therapy in gastric adenocarcinoma.
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