Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;9(12):7384-7393.
doi: 10.21037/tcr-20-2426.

ypT0 gastric carcinoma after preoperative chemotherapy: a unique status according to AJCC 8th edition cancer staging system

Kankai Zhu  1 , Hailong Jin  1 , Qing Zhang  1 , Chunhui Shou  1 , Fang Chen  1 , Jiren Yu  1
Affiliations

ypT0 gastric carcinoma after preoperative chemotherapy: a unique status according to AJCC 8th edition cancer staging system

Kankai Zhu et al. Transl Cancer Res. 2020 Dec.

Abstract

Background: American Joint Committee on Cancer (AJCC) recently had published 8th edition staging system, in which a separate staging system was proposed for gastric cancers those received preoperative therapy (ypStage), however ypT0 was not included. The aim of this study was to propose the inclusion of ypT0 into the new staging classification.

Methods: We collected data of gastric cancer patients who underwent gastrectomy after preoperative chemotherapy in the First Affiliated Hospital of Zhejiang University (2004-2015). Kaplan-Meier survival estimations and log-rank tests were performed to compare survival.

Results: 314 patients were enrolled in this study according to inclusion and exclusion criteria. The 5-year overall survival (OS) rate of all patients was 53.5% and the survival estimation was well discriminated by ypstage (P<0.001). Twenty-five patients were identified achieving pathological complete regression in primary lesion (ypT0), in which there were 16 pCR patients and 9 ypT0N+ patients. The 5-year OS of pCR patients was 93.8%, which was not better than ypstage I with 5-year OS of 97.5% (P=0.507). Meanwhile, ypT0N+ patients' 5-year OS was 66.7%, which was significantly shorter than those with ypstage I (P=0.002), but no statistical difference from ypstage II with 5-year OS of 71.6% (P=0.583).

Conclusions: Complete pathological regression of primary lesion (ypT0) was a predictor for long-term outcomes. pCR and ypT0N+ patients might be considered for inclusion in the ypstage I and ypstage II group respectively.

Keywords: Preoperative chemotherapy; TNM staging; stomach neoplasms.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr-20-2426). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow-chart of patients’ inclusion and exclusion process.
Figure 2
Figure 2
(A) Kaplan-Meier estimates for overall survival (OS) of all enrolled patients. (B) Kaplan-Meier estimates for OS according to whether residual tumor was observed in primary lesion or not (P=0.001).
Figure 3
Figure 3
(A) Kaplan-Meier estimates for overall survival (OS) of patients with pCR, ypT0N+, ypstage I and II (P<0.001); (B) Kaplan–Meier estimates for OS according to whether residual tumor was observed in primary lesion (ypT0 and ypT1-4) and the lymph nodes status (N0 and N+) (P<0.001).
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. 10.3322/caac.21492 - DOI - PubMed
    1. Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual. 8th ed. New York (NY): Springer; 2016.
    1. Lorenzen S, Thuss-Patience P, Al-Batran SE, et al. Impact of pathological complete response on disease-free survival in patients with esophagogastric adenocarcinoma receiving preoperative docetaxel-based chemotherapy. Ann Oncol 2013;24:2068-73. 10.1093/annonc/mdt141 - DOI - PubMed
    1. Brenner B, Shah MA, Karpeh MS, et al. A phase II trial of neoadjuvant cisplatin-fluorouracil followed by postoperative intraperitoneal floxuridine-leucovorin in patients with locally advanced gastric cancer. Ann Oncol 2006;17:1404-11. 10.1093/annonc/mdl133 - DOI - PubMed
    1. Sano T., Kodera Y. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 2011;14:113-23. 10.1007/s10120-011-0042-4 - DOI - PubMed