Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Периоперационная химиотерапия и морфологический ответ в лечении рака желудка
Периоперационная химиотерапия и морфологический ответ в лечении рака желудка
Киселев Н.М., Климин С.А., Колесник Я.И., Кокорин Р.С., Ашимов Э.А., Елагина В.Ю., Шумская И.С., Загайнов В.Е., Гамаюнов С.В. Периоперационная химиотерапия и морфологический ответ в лечении рака желудка. Современная Онкология. 2024;26(3):276–283. DOI: 10.26442/18151434.2024.3.202978
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Цель. Проанализировать результаты комбинированного лечения пациентов с целью поиска предикторов лечебного патоморфоза, оценки влияния лекарственной терапии на непосредственные и отдаленные результаты лечения, выявления других факторов, статистически достоверно влияющих на результаты лечения.
Материалы и методы. В анализ включены 119 пациентов, которым проведена периоперационная химиотерапия в сочетании с оперативным пособием в 2023 г. на базе ГАУЗ НО НИИКО НОКОД. Настоящее исследование представляло собой два блока: выявление взаимосвязей между анализируемыми параметрами и патоморфологическим ответом, развитием послеоперационных осложнений; анализ общей (ОВ) и безрецидивной выживаемости (БРВ). В анализе номинальных показателей I этапом использовался χ2 Пирсона, точный критерий Фишера. Вторым этапом при достижении статистической значимости для переменных с двумя уровнями фактора рассчитывались сила связи – V Крамера по шкале Rea&Parker, отношение шансов с 95% доверительным интервалом (ДИ), для переменных с более чем двумя факторами выполнялся post-hoc-анализ с поправкой на множественные сравнения Бенджамини–Хохберга. Все количественные показатели в публикуемой выборке имеют распределение, отличное от нормального. Мера центральной тенденции – медиана с 25 и 75-м процентилями. При сравнении двух групп количественных показателей использовался критерий Манна–Уитни, при сравнении большего числа групп – Краскела–Уоллиса с post-hoc-анализом критерием Данна (при достижении статистически значимых различий на I этапе).
Результаты. При анализе связи между неоадъювантной полихимиотерапией (НАПХТ) по схеме FLOT и наличием ответа (TRG I–II) выявлено отсутствие респондентов в подгруппе получавших НАПХТ по отличным от FLOT схемам (p=0,019). У пациентов с I стадией заболевания сравнительно больше частота ответов на лечение в сравнении с ≥III стадией заболевания (post-hoc p-value 0,006). В группе респондентов отмечено меньшее число пациентов с метастатически пораженными лимфатическими узлами по сравнению с группой, не ответившей на проведенное лечение, – 8,7 и 91%, результат является статистически значимым (p-value<0,001). Наличие ответа (TRG I–II) статистически значимо уменьшает шанс позитивных лимфоузлов в 7,30 раза – отношение шансов 0,137 (95% ДИ 0,044–0,421). При проведении подгруппового анализа медиана возраста пациентов с осложнениями I–IIIa типов по Clavien–Dindo статистически значимо меньше в сравнении с осложнениями IIIb–V типов. Не выявлено статистически значимой взаимосвязи между дифференцировкой опухоли и наличием ответа на проведенное лечение (p=0,3). При анализе ОВ отмечалось статистически значимое увеличение рисков наступления летального исхода при увеличении количества послеоперационных дней на 1 в 1,134 раза, или на 13,4% (p=0,004). Увеличение количества метастатических лимфатических узлов на 1 повышало риск летального исхода в 1,091 раза, или на 9,1% (p=0,017). При анализе БРВ выявлено статистически значимое увеличение рисков наступления прогрессии при увеличении степени лечебного патоморфоза по Mandard на 1-й степени (начиная с I) в 1,423 раза, или на 42,3% (p=0,042), увеличении степени pN-статуса на 1 (начиная с N1) в 1,290 раза, или на 29,0% (p=0,011), увеличении количества послеоперационных дней на 1 в 1,099 раза, или на 9,9% (p=0,025). При анализе ОВ подгруппы, получившей адъювантную полихимиотерапию (АПХТ), отмечалось статистически значимое увеличение рисков наступления летального исхода при увеличении количества метастатических узлов на 1 в 1,087 раза, или на 8,7% (95% ДИ 1,009–1,172; p=0,029). При анализе БРВ подгруппы получивших АПХТ отмечалось статистически значимое увеличение рисков наступления прогрессии при увеличении степени pN-статуса на 1 (начиная с N1) в 1,252 раза, или на 25,2% (p=0,040). При определении влияния АПХТ на ОВ и БРВ методом регрессии Кокса не получено статистически значимых результатов. Однако, учитывая p-value, приближенное к 0,05, величину коэффициента регрессии и большую часть 95% ДИ (<1), можно предположить, что проведение АПХТ уменьшает риски наступления летального исхода и прогрессии заболевания, а для достижения статистически значимых результатов требуются большее количество и время наблюдений, количество исходов.
Заключение. Проведение периоперационной терапии в режиме FLOT ассоциировано с большим количеством лечебных патоморфозов 1 и 2-й степени у пациентов с ранней стадией заболевания в сравнении с распространенными формами заболевания. Не выявлено влияния дифференцировки опухоли, ее гистологического подтипа на степень патоморфоза. Периоперационная химиотерапия не увеличивает частоту и тяжесть послеоперационных осложнений. Метастатическое поражения лимфатических узлов достоверно ухудшает ОВ и БРВ, в группе пациентов с 1–2-й степенью патоморфоза частота метастатического поражения лимфоузлов меньше в сравнении с пациентами с 3–5-й степенью патоморфоза. Не получено однозначных данных о необходимости проведения АПХТ при наличии или отсутствии патоморфоза, однако с большей долей вероятности можно предположить, что проведение АПХТ уменьшает риски наступления летального исхода и прогрессии заболевания.
Ключевые слова: рак желудка, химиотерапия, патоморфоз, морфологический ответ, периоперационная химиотерапия, неоадъювантная полихимиотерапия, режим FLOT
Materials and methods. Included 119 patients who underwent perioperative chemotherapy (FLOT) in combination with surgery in 2023 on the basis of the Nizhny Novgorod Regional Clinical Oncological Dispensary. This study consisted of two blocks: Identification of relationships between the analyzed parameters and the pathomorphological response, the development of postoperative complications. Analysis of overall and disease-free survival (DFS). In the analysis of nominal indicators, the first step was to use χ2 Pearson and Fisher's exact test. At the second stage, when statistical significance was achieved, the strength of the relationship was calculated for variables with two levels of the factor – Cramer’s V on the Rea & Parker scale, odds ratio (OR) with a 95% confidence interval (CI), for variables with more than two factors, post-hoc analysis was performed with Benjamini–Hochberg correction for multiple comparisons. All quantitative indicators in the published sample have a distribution other than normal. The measure of central tendency is the median with 25th and 75th percentiles. When comparing two groups of quantitative indicators, the Mann–Whitney test was used; when comparing a larger number of groups, the Kruskal–Wallis test was used with post-hoc analysis using the Dunn test (if statistically significant differences were achieved at the first stage).
Results. Analyzing the relationship between neo-adjuvant chemotherapy according to the FLOT regimen and the presence of response (TRG I–II), there was a lack of respondents in the subgroup who received neo-adjuvant chemotherapy according to regimens other than FLOT (p=0.019). Patients with stage I disease have a comparatively higher response rate to treatment compared with patients with ≥ stage III disease (post-hoc p-value=0.006). In the group of respondents there are fewer patients with positive lymph nodes compared to the group that did not respond to treatment (8.7% and 91%), the result is statistically significant (p-value <0.001). The presence of a response (TRG I–II) statistically significantly reduces the chance of positive tests by 7.30 times – OR 0.137 (95% CI 0.044–0.421). When conducting a subgroup analysis, the median age of patients with complications of types I–IIIa by Clavien–Dindo is statistically significantly lower compared to complications of types IIIb–V. There was no statistically significant relationship between tumor differentiation and response to treatment (p=0.3). When analyzing overall survival, there was a statistically significant increase in the risk of death with an increase in the number of postoperative days by 1 by 1.134 times or 13.4% (p=0.004). An increase in the number of metastatic lymph nodes by 1 increased the risk of death by 1.091 times or 9.1% (p=0.017). When analyzing DFS, a statistically significant increase in the risk of progression was revealed with an increase in the degree of pathomorphosis according to Mandard by 1 degree (starting from I) by 1.423 times or by 42.3% (p=0.042), an increase in the degree of pN-status by 1 (starting from N1) by 1.290 times or by 29.0% (p=0.011), an increase in the number of postoperative days by 1 by 1.099 times or by 9.9% (p=0.025). When analyzing the overall survival of the subgroup who received adjuvant chemo, there was a statistically significant increase in the risk of death in the subgroup of patients with adjuvant cgemo with an increase in the number of metastatic nodes by 1 by 1.087 times or by 8.7% (95% CI 1.009–1.172; p=0.029). When analyzing DFS of the subgroup who received adjuvant chemo, there was a statistically significant increase in the risk of progression in the subgroup of patients who received adjuvant chemo with an increase in the degree of pN status by 1 (starting from N1) by 1.252 times or 25.2% (p=0.040). When determining the effect of adjuvant chemo on overall survival and DFS using the Cox regression method, no statistically significant results were obtained. However, taking into account the p-value close to 0.05, the regression coefficient and most of the 95% CI (less than 1), it can be assumed that conducting adjuvant chemo reduces the risks of death and disease progression, and to achieve statistically significant results, a larger number of and observation time, number of outcomes.
Conclusion. Neo-adjuvant FLOT is associated with a large number of TRG I–II in patients with an early stage of the disease in comparison with advanced forms of the disease. There was no effect of tumor differentiation or its histological subtype on the degree of TRG. Perioperative chemotherapy does not increase the incidence or severity of postoperative complications. Metastatic lesions of the lymph nodes significantly worsen overall survival and DFS; in the group of patients with TRG grade I–II, the frequency of metastatic lymph node lesions is lower compared to patients with TRG III–V. There is no significant data on the need for adjuvant chemo in the presence or absence of pathomorphosis, however, it can be assumed that performing adjuvant chemo reduces the risks of death and disease progression.
Keywords: gastric cancer, chemotherapy, pathomorphosis, morphological response, perioperative chemotherapy, neoadjuvant polychemotherapy, FLOT regimen
Материалы и методы. В анализ включены 119 пациентов, которым проведена периоперационная химиотерапия в сочетании с оперативным пособием в 2023 г. на базе ГАУЗ НО НИИКО НОКОД. Настоящее исследование представляло собой два блока: выявление взаимосвязей между анализируемыми параметрами и патоморфологическим ответом, развитием послеоперационных осложнений; анализ общей (ОВ) и безрецидивной выживаемости (БРВ). В анализе номинальных показателей I этапом использовался χ2 Пирсона, точный критерий Фишера. Вторым этапом при достижении статистической значимости для переменных с двумя уровнями фактора рассчитывались сила связи – V Крамера по шкале Rea&Parker, отношение шансов с 95% доверительным интервалом (ДИ), для переменных с более чем двумя факторами выполнялся post-hoc-анализ с поправкой на множественные сравнения Бенджамини–Хохберга. Все количественные показатели в публикуемой выборке имеют распределение, отличное от нормального. Мера центральной тенденции – медиана с 25 и 75-м процентилями. При сравнении двух групп количественных показателей использовался критерий Манна–Уитни, при сравнении большего числа групп – Краскела–Уоллиса с post-hoc-анализом критерием Данна (при достижении статистически значимых различий на I этапе).
Результаты. При анализе связи между неоадъювантной полихимиотерапией (НАПХТ) по схеме FLOT и наличием ответа (TRG I–II) выявлено отсутствие респондентов в подгруппе получавших НАПХТ по отличным от FLOT схемам (p=0,019). У пациентов с I стадией заболевания сравнительно больше частота ответов на лечение в сравнении с ≥III стадией заболевания (post-hoc p-value 0,006). В группе респондентов отмечено меньшее число пациентов с метастатически пораженными лимфатическими узлами по сравнению с группой, не ответившей на проведенное лечение, – 8,7 и 91%, результат является статистически значимым (p-value<0,001). Наличие ответа (TRG I–II) статистически значимо уменьшает шанс позитивных лимфоузлов в 7,30 раза – отношение шансов 0,137 (95% ДИ 0,044–0,421). При проведении подгруппового анализа медиана возраста пациентов с осложнениями I–IIIa типов по Clavien–Dindo статистически значимо меньше в сравнении с осложнениями IIIb–V типов. Не выявлено статистически значимой взаимосвязи между дифференцировкой опухоли и наличием ответа на проведенное лечение (p=0,3). При анализе ОВ отмечалось статистически значимое увеличение рисков наступления летального исхода при увеличении количества послеоперационных дней на 1 в 1,134 раза, или на 13,4% (p=0,004). Увеличение количества метастатических лимфатических узлов на 1 повышало риск летального исхода в 1,091 раза, или на 9,1% (p=0,017). При анализе БРВ выявлено статистически значимое увеличение рисков наступления прогрессии при увеличении степени лечебного патоморфоза по Mandard на 1-й степени (начиная с I) в 1,423 раза, или на 42,3% (p=0,042), увеличении степени pN-статуса на 1 (начиная с N1) в 1,290 раза, или на 29,0% (p=0,011), увеличении количества послеоперационных дней на 1 в 1,099 раза, или на 9,9% (p=0,025). При анализе ОВ подгруппы, получившей адъювантную полихимиотерапию (АПХТ), отмечалось статистически значимое увеличение рисков наступления летального исхода при увеличении количества метастатических узлов на 1 в 1,087 раза, или на 8,7% (95% ДИ 1,009–1,172; p=0,029). При анализе БРВ подгруппы получивших АПХТ отмечалось статистически значимое увеличение рисков наступления прогрессии при увеличении степени pN-статуса на 1 (начиная с N1) в 1,252 раза, или на 25,2% (p=0,040). При определении влияния АПХТ на ОВ и БРВ методом регрессии Кокса не получено статистически значимых результатов. Однако, учитывая p-value, приближенное к 0,05, величину коэффициента регрессии и большую часть 95% ДИ (<1), можно предположить, что проведение АПХТ уменьшает риски наступления летального исхода и прогрессии заболевания, а для достижения статистически значимых результатов требуются большее количество и время наблюдений, количество исходов.
Заключение. Проведение периоперационной терапии в режиме FLOT ассоциировано с большим количеством лечебных патоморфозов 1 и 2-й степени у пациентов с ранней стадией заболевания в сравнении с распространенными формами заболевания. Не выявлено влияния дифференцировки опухоли, ее гистологического подтипа на степень патоморфоза. Периоперационная химиотерапия не увеличивает частоту и тяжесть послеоперационных осложнений. Метастатическое поражения лимфатических узлов достоверно ухудшает ОВ и БРВ, в группе пациентов с 1–2-й степенью патоморфоза частота метастатического поражения лимфоузлов меньше в сравнении с пациентами с 3–5-й степенью патоморфоза. Не получено однозначных данных о необходимости проведения АПХТ при наличии или отсутствии патоморфоза, однако с большей долей вероятности можно предположить, что проведение АПХТ уменьшает риски наступления летального исхода и прогрессии заболевания.
Ключевые слова: рак желудка, химиотерапия, патоморфоз, морфологический ответ, периоперационная химиотерапия, неоадъювантная полихимиотерапия, режим FLOT
________________________________________________
Materials and methods. Included 119 patients who underwent perioperative chemotherapy (FLOT) in combination with surgery in 2023 on the basis of the Nizhny Novgorod Regional Clinical Oncological Dispensary. This study consisted of two blocks: Identification of relationships between the analyzed parameters and the pathomorphological response, the development of postoperative complications. Analysis of overall and disease-free survival (DFS). In the analysis of nominal indicators, the first step was to use χ2 Pearson and Fisher's exact test. At the second stage, when statistical significance was achieved, the strength of the relationship was calculated for variables with two levels of the factor – Cramer’s V on the Rea & Parker scale, odds ratio (OR) with a 95% confidence interval (CI), for variables with more than two factors, post-hoc analysis was performed with Benjamini–Hochberg correction for multiple comparisons. All quantitative indicators in the published sample have a distribution other than normal. The measure of central tendency is the median with 25th and 75th percentiles. When comparing two groups of quantitative indicators, the Mann–Whitney test was used; when comparing a larger number of groups, the Kruskal–Wallis test was used with post-hoc analysis using the Dunn test (if statistically significant differences were achieved at the first stage).
Results. Analyzing the relationship between neo-adjuvant chemotherapy according to the FLOT regimen and the presence of response (TRG I–II), there was a lack of respondents in the subgroup who received neo-adjuvant chemotherapy according to regimens other than FLOT (p=0.019). Patients with stage I disease have a comparatively higher response rate to treatment compared with patients with ≥ stage III disease (post-hoc p-value=0.006). In the group of respondents there are fewer patients with positive lymph nodes compared to the group that did not respond to treatment (8.7% and 91%), the result is statistically significant (p-value <0.001). The presence of a response (TRG I–II) statistically significantly reduces the chance of positive tests by 7.30 times – OR 0.137 (95% CI 0.044–0.421). When conducting a subgroup analysis, the median age of patients with complications of types I–IIIa by Clavien–Dindo is statistically significantly lower compared to complications of types IIIb–V. There was no statistically significant relationship between tumor differentiation and response to treatment (p=0.3). When analyzing overall survival, there was a statistically significant increase in the risk of death with an increase in the number of postoperative days by 1 by 1.134 times or 13.4% (p=0.004). An increase in the number of metastatic lymph nodes by 1 increased the risk of death by 1.091 times or 9.1% (p=0.017). When analyzing DFS, a statistically significant increase in the risk of progression was revealed with an increase in the degree of pathomorphosis according to Mandard by 1 degree (starting from I) by 1.423 times or by 42.3% (p=0.042), an increase in the degree of pN-status by 1 (starting from N1) by 1.290 times or by 29.0% (p=0.011), an increase in the number of postoperative days by 1 by 1.099 times or by 9.9% (p=0.025). When analyzing the overall survival of the subgroup who received adjuvant chemo, there was a statistically significant increase in the risk of death in the subgroup of patients with adjuvant cgemo with an increase in the number of metastatic nodes by 1 by 1.087 times or by 8.7% (95% CI 1.009–1.172; p=0.029). When analyzing DFS of the subgroup who received adjuvant chemo, there was a statistically significant increase in the risk of progression in the subgroup of patients who received adjuvant chemo with an increase in the degree of pN status by 1 (starting from N1) by 1.252 times or 25.2% (p=0.040). When determining the effect of adjuvant chemo on overall survival and DFS using the Cox regression method, no statistically significant results were obtained. However, taking into account the p-value close to 0.05, the regression coefficient and most of the 95% CI (less than 1), it can be assumed that conducting adjuvant chemo reduces the risks of death and disease progression, and to achieve statistically significant results, a larger number of and observation time, number of outcomes.
Conclusion. Neo-adjuvant FLOT is associated with a large number of TRG I–II in patients with an early stage of the disease in comparison with advanced forms of the disease. There was no effect of tumor differentiation or its histological subtype on the degree of TRG. Perioperative chemotherapy does not increase the incidence or severity of postoperative complications. Metastatic lesions of the lymph nodes significantly worsen overall survival and DFS; in the group of patients with TRG grade I–II, the frequency of metastatic lymph node lesions is lower compared to patients with TRG III–V. There is no significant data on the need for adjuvant chemo in the presence or absence of pathomorphosis, however, it can be assumed that performing adjuvant chemo reduces the risks of death and disease progression.
Keywords: gastric cancer, chemotherapy, pathomorphosis, morphological response, perioperative chemotherapy, neoadjuvant polychemotherapy, FLOT regimen
Полный текст
Список литературы
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. Cancer J Clin. 2018;68(6):394-424. DOI:10.3322/caac.21492
2. American Cancer Society (2024) Cancer Facts & Fig. 2024. Atlanta: American Cancer Society.
3. Kuijper SC, Pape M, Vissers PA, et al. Trends in Best-case, typical and worst-case survival scenarios of patients with non-metastatic esophagogastric cancer between 2006 and 2020: A population-based study. Int J Cancer. 2023;153:33-43. DOI:10.1002/ijc.34488
4. van Putten M, Nelen SD, Lemmens VE, et al. Overall survival before and after centralization of Gastric Cancer Surgery in the Netherlands. Br J Surg.
2018;105:1807-15. DOI:10.1002/bjs.10931
5. Cunningham D, Allum WH, Stenning SP. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med.
2006;355(1):11-20. DOI:10.1056/NEJMoa055531
6. Al-Batran S-E, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019;393:1948-57. DOI:10.1016/S0140-6736(18)32557-1
7. Al-Batran S-E, Hofheinz RD, Pauligk C, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol. 2016;17:1697-708. DOI:10.1016/S1470-2045(16)30531-9
8. Ychou M, Boige V, Pignon J-P, et al. Perioperative Chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD Multicenter Phase III Trial. JCO. 2011;29:1715-21. DOI:10.1200/JCO.2010.33.0597
9. Yamada T, Yoshikawa T, Taguri M, et al. The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors. Gastric Cancer. 2016;19(2):479-89. DOI:10.1007/s10120-015-0480-5
10. Graziosi L, Marino E, Donini A. Survival comparison in gastric cancer patients between 7th and 8th edition of the AJCC TNM staging system: the first western single center experience. Eur J Surg Oncol. 2019;45(6):1105-8. DOI:10.1016/j.ejso.2018.12.010
11. Lu J, Zheng Z-F, Xie J-W, et al. Is the 8th Edition of the AJCC TNM staging System sufficiently reasonable for all patients with Noncardia Gastric Cancer? A 12,549-Patient International Database Study. Ann Surg Oncol. 2018;25:2002-11. DOI:10.1245/s10434-018-6447-0
12. Lu J, Zheng Z-F, Wang W, et al. A novel TNM staging system for gastric cancer based on the metro-ticket paradigm: a comparative study with the AJCC-TNM staging system. Gastric Cancer. 2019;22:759-68. DOI:10.1007/s10120-018-00904-w
13. Bria E, De Manzoni G, Beghelli S, et al. A clinical-biological risk stratification model for resected gastric cancer: prognostic impact of Her2, Fhit, and APC expression status. Ann Oncol. 2013;24:693-701. DOI:10.1093/annonc/mds506
14. Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual 2017. Springer Publishing.
15. Songun I, Putter H, Kranenbarg EM-K, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol.
2010;11:439-49. DOI:10.1016/S1470-2045(10)70070-X
16. Wang X, Liu F, Li Y, et al. Comparison on clinicopathological features, treatments and prognosis between proximal gastric Cancer and distal gastric Cancer: a National Cancer Data Base Analysis. J Cancer. 2019;10:3145-53. DOI:10.7150/jca.30371
17. Wanebo HJ, Kennedy BJ, Chmiel J, et al. Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg. 1993;218:583-92.
DOI:10.1097/00000658-199321850-00002
18. Giommoni E, Lavacchi D, Tirino G, et al. Results of the observational prospective RealFLOT study. BMC Cancer. 2021;21:1086. DOI:10.1186/s12885-021-08768-7
19. The Cancer Genome Atlas Research Network Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513:202-9. DOI:10.1038/nature13480
20. Taghavi S, Jayarajan SN, Davey A, et al. Prognostic significance of Signet Ring gastric Cancer. J Clin Oncol. 2012;30:3493-8. DOI:10.1200/JCO.2012.42.6635
21. Mandard AM, Dalibard F, Mandard JC, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer. 1994;73(11):2680-6. DOI:10.1002/1097-0142(19940601)73:11<2680::AID-CNCR2820731105>3.0.CO;2-C
22. Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer. 2003;98:1521-30. DOI:10.1002/cncr.11660
23. Abboretti F, Mantziari S, Didisheim L, et al. Prognostic value of tumor regression grade (TRG) after oncological gastrectomy for gastric cancer. Langenbecks Arch Surg. 2024;409(1):199. DOI:10.1007/s00423-024-03388-8
24. Achilli P, Martini PD, Ceresoli M, et al. Tumor response evaluation after neoadjuvant chemotherapy in locally advanced gastric adenocarcinoma: a prospective, multi-center cohort study. J Gastrointest Oncol. 2017;8(6):1018-25. DOI:10.21037/jgo.2017.08.13
25. Blackham AU, Greenleaf E, Yamamoto M, et al. Tumor regression grade in gastric cancer: predictors and impact on outcome. J Surg Oncol. 2016;114:434-9. DOI:10.1002/jso.24307
26. Schmidt T, Sicic L, Blank S, et al. Prognostic value of histopathological regression in 850 neoadjuvantly treated oesophagogastric adenocarcinomas. Br J Cancer. 2014;110:1712-20. DOI:10.1038/bjc.2014.94
27. Lombardi PM, Mazzola M, Achilli P, et al. Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: new perspectives from a single-center experience. J Surg Oncol. 2021;123:923-31. DOI:10.1002/jso.26391
28. Ассоциация онкологов России. Общероссийская общественная организация «Российское общество клинической онкологии». Клинические рекомендации «Рак желудка». М., 2020 [Assotsiatsiia onkologov Rossii. Obshcherossiiskaia obshchestvennaia organizatsiia “Rossiiskoie obshchestvo klinicheskoi onkologii”. Klinicheskiie rekomendatsii “Rak zheludka”. Moscow, 2020 (in Russian)].
29. Состояние онкологической помощи населению России в 2022 году. Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена − филиал ФГБУ “НМИЦ радиологии” Минздрава России, 2022 [Sostoianiie onkologicheskoi pomoshchi naseleniiu Rossii v 2022 godu. Pod red. AD Kaprina, VV Starinskogo, AO Shakhzadovoi. Moscow: MNIOI im. PA Gertsena − filial FGBU “NMITS radiologii” Minzdrava Rossii, 2022 (in Russian)].
30. Lombardi PM, Mazzola M, Achilli P, et al. Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: new perspectives from a single-center experience. J Surg Oncol. 2021;123:923-31. DOI:10.1002/jso.26391
31. Becker K, Langer R, Reim D, et al. Significance of histopathological tumor regression after neoadjuvant chemotherapy in gastric adenocarcinomas: a summary of 480 cases. Ann Surg. 2011;253:934-9. DOI:10.1097/SLA.0b013e318216f449
32. Drubay V, Nuytens F, Renaud F, et al. Poorly cohesive cells gastric carcinoma including signet-ring cell cancer: updated review of definition, classification and therapeutic management. World J Gastrointest Oncol. 2022;14:1406-28. DOI:10.4251/wjgo.v14.i8.1406
33. Xie J-W, Lu J, Xu B, et al. Prognostic value of Tumor Regression Grading in patients treated with neoadjuvant chemotherapy plus surgery for gastric Cancer. Front Oncol. 2021;11:587856. DOI:10.3389/fonc.2021.587856
2. American Cancer Society (2024) Cancer Facts & Fig. 2024. Atlanta: American Cancer Society.
3. Kuijper SC, Pape M, Vissers PA, et al. Trends in Best-case, typical and worst-case survival scenarios of patients with non-metastatic esophagogastric cancer between 2006 and 2020: A population-based study. Int J Cancer. 2023;153:33-43. DOI:10.1002/ijc.34488
4. van Putten M, Nelen SD, Lemmens VE, et al. Overall survival before and after centralization of Gastric Cancer Surgery in the Netherlands. Br J Surg.
2018;105:1807-15. DOI:10.1002/bjs.10931
5. Cunningham D, Allum WH, Stenning SP. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med.
2006;355(1):11-20. DOI:10.1056/NEJMoa055531
6. Al-Batran S-E, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019;393:1948-57. DOI:10.1016/S0140-6736(18)32557-1
7. Al-Batran S-E, Hofheinz RD, Pauligk C, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol. 2016;17:1697-708. DOI:10.1016/S1470-2045(16)30531-9
8. Ychou M, Boige V, Pignon J-P, et al. Perioperative Chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD Multicenter Phase III Trial. JCO. 2011;29:1715-21. DOI:10.1200/JCO.2010.33.0597
9. Yamada T, Yoshikawa T, Taguri M, et al. The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors. Gastric Cancer. 2016;19(2):479-89. DOI:10.1007/s10120-015-0480-5
10. Graziosi L, Marino E, Donini A. Survival comparison in gastric cancer patients between 7th and 8th edition of the AJCC TNM staging system: the first western single center experience. Eur J Surg Oncol. 2019;45(6):1105-8. DOI:10.1016/j.ejso.2018.12.010
11. Lu J, Zheng Z-F, Xie J-W, et al. Is the 8th Edition of the AJCC TNM staging System sufficiently reasonable for all patients with Noncardia Gastric Cancer? A 12,549-Patient International Database Study. Ann Surg Oncol. 2018;25:2002-11. DOI:10.1245/s10434-018-6447-0
12. Lu J, Zheng Z-F, Wang W, et al. A novel TNM staging system for gastric cancer based on the metro-ticket paradigm: a comparative study with the AJCC-TNM staging system. Gastric Cancer. 2019;22:759-68. DOI:10.1007/s10120-018-00904-w
13. Bria E, De Manzoni G, Beghelli S, et al. A clinical-biological risk stratification model for resected gastric cancer: prognostic impact of Her2, Fhit, and APC expression status. Ann Oncol. 2013;24:693-701. DOI:10.1093/annonc/mds506
14. Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual 2017. Springer Publishing.
15. Songun I, Putter H, Kranenbarg EM-K, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol.
2010;11:439-49. DOI:10.1016/S1470-2045(10)70070-X
16. Wang X, Liu F, Li Y, et al. Comparison on clinicopathological features, treatments and prognosis between proximal gastric Cancer and distal gastric Cancer: a National Cancer Data Base Analysis. J Cancer. 2019;10:3145-53. DOI:10.7150/jca.30371
17. Wanebo HJ, Kennedy BJ, Chmiel J, et al. Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg. 1993;218:583-92.
DOI:10.1097/00000658-199321850-00002
18. Giommoni E, Lavacchi D, Tirino G, et al. Results of the observational prospective RealFLOT study. BMC Cancer. 2021;21:1086. DOI:10.1186/s12885-021-08768-7
19. The Cancer Genome Atlas Research Network Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513:202-9. DOI:10.1038/nature13480
20. Taghavi S, Jayarajan SN, Davey A, et al. Prognostic significance of Signet Ring gastric Cancer. J Clin Oncol. 2012;30:3493-8. DOI:10.1200/JCO.2012.42.6635
21. Mandard AM, Dalibard F, Mandard JC, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer. 1994;73(11):2680-6. DOI:10.1002/1097-0142(19940601)73:11<2680::AID-CNCR2820731105>3.0.CO;2-C
22. Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer. 2003;98:1521-30. DOI:10.1002/cncr.11660
23. Abboretti F, Mantziari S, Didisheim L, et al. Prognostic value of tumor regression grade (TRG) after oncological gastrectomy for gastric cancer. Langenbecks Arch Surg. 2024;409(1):199. DOI:10.1007/s00423-024-03388-8
24. Achilli P, Martini PD, Ceresoli M, et al. Tumor response evaluation after neoadjuvant chemotherapy in locally advanced gastric adenocarcinoma: a prospective, multi-center cohort study. J Gastrointest Oncol. 2017;8(6):1018-25. DOI:10.21037/jgo.2017.08.13
25. Blackham AU, Greenleaf E, Yamamoto M, et al. Tumor regression grade in gastric cancer: predictors and impact on outcome. J Surg Oncol. 2016;114:434-9. DOI:10.1002/jso.24307
26. Schmidt T, Sicic L, Blank S, et al. Prognostic value of histopathological regression in 850 neoadjuvantly treated oesophagogastric adenocarcinomas. Br J Cancer. 2014;110:1712-20. DOI:10.1038/bjc.2014.94
27. Lombardi PM, Mazzola M, Achilli P, et al. Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: new perspectives from a single-center experience. J Surg Oncol. 2021;123:923-31. DOI:10.1002/jso.26391
28. Assotsiatsiia onkologov Rossii. Obshcherossiiskaia obshchestvennaia organizatsiia “Rossiiskoie obshchestvo klinicheskoi onkologii”. Klinicheskiie rekomendatsii “Rak zheludka”. Moscow, 2020 (in Russian).
29. Sostoianiie onkologicheskoi pomoshchi naseleniiu Rossii v 2022 godu. Pod red. AD Kaprina, VV Starinskogo, AO Shakhzadovoi. Moscow: MNIOI im. PA Gertsena − filial FGBU “NMITS radiologii” Minzdrava Rossii, 2022 (in Russian).
30. Lombardi PM, Mazzola M, Achilli P, et al. Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: new perspectives from a single-center experience. J Surg Oncol. 2021;123:923-31. DOI:10.1002/jso.26391
31. Becker K, Langer R, Reim D, et al. Significance of histopathological tumor regression after neoadjuvant chemotherapy in gastric adenocarcinomas: a summary of 480 cases. Ann Surg. 2011;253:934-9. DOI:10.1097/SLA.0b013e318216f449
32. Drubay V, Nuytens F, Renaud F, et al. Poorly cohesive cells gastric carcinoma including signet-ring cell cancer: updated review of definition, classification and therapeutic management. World J Gastrointest Oncol. 2022;14:1406-28. DOI:10.4251/wjgo.v14.i8.1406
33. Xie J-W, Lu J, Xu B, et al. Prognostic value of Tumor Regression Grading in patients treated with neoadjuvant chemotherapy plus surgery for gastric Cancer. Front Oncol. 2021;11:587856. DOI:10.3389/fonc.2021.587856
2. American Cancer Society (2024) Cancer Facts & Fig. 2024. Atlanta: American Cancer Society.
3. Kuijper SC, Pape M, Vissers PA, et al. Trends in Best-case, typical and worst-case survival scenarios of patients with non-metastatic esophagogastric cancer between 2006 and 2020: A population-based study. Int J Cancer. 2023;153:33-43. DOI:10.1002/ijc.34488
4. van Putten M, Nelen SD, Lemmens VE, et al. Overall survival before and after centralization of Gastric Cancer Surgery in the Netherlands. Br J Surg.
2018;105:1807-15. DOI:10.1002/bjs.10931
5. Cunningham D, Allum WH, Stenning SP. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med.
2006;355(1):11-20. DOI:10.1056/NEJMoa055531
6. Al-Batran S-E, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019;393:1948-57. DOI:10.1016/S0140-6736(18)32557-1
7. Al-Batran S-E, Hofheinz RD, Pauligk C, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol. 2016;17:1697-708. DOI:10.1016/S1470-2045(16)30531-9
8. Ychou M, Boige V, Pignon J-P, et al. Perioperative Chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD Multicenter Phase III Trial. JCO. 2011;29:1715-21. DOI:10.1200/JCO.2010.33.0597
9. Yamada T, Yoshikawa T, Taguri M, et al. The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors. Gastric Cancer. 2016;19(2):479-89. DOI:10.1007/s10120-015-0480-5
10. Graziosi L, Marino E, Donini A. Survival comparison in gastric cancer patients between 7th and 8th edition of the AJCC TNM staging system: the first western single center experience. Eur J Surg Oncol. 2019;45(6):1105-8. DOI:10.1016/j.ejso.2018.12.010
11. Lu J, Zheng Z-F, Xie J-W, et al. Is the 8th Edition of the AJCC TNM staging System sufficiently reasonable for all patients with Noncardia Gastric Cancer? A 12,549-Patient International Database Study. Ann Surg Oncol. 2018;25:2002-11. DOI:10.1245/s10434-018-6447-0
12. Lu J, Zheng Z-F, Wang W, et al. A novel TNM staging system for gastric cancer based on the metro-ticket paradigm: a comparative study with the AJCC-TNM staging system. Gastric Cancer. 2019;22:759-68. DOI:10.1007/s10120-018-00904-w
13. Bria E, De Manzoni G, Beghelli S, et al. A clinical-biological risk stratification model for resected gastric cancer: prognostic impact of Her2, Fhit, and APC expression status. Ann Oncol. 2013;24:693-701. DOI:10.1093/annonc/mds506
14. Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual 2017. Springer Publishing.
15. Songun I, Putter H, Kranenbarg EM-K, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol.
2010;11:439-49. DOI:10.1016/S1470-2045(10)70070-X
16. Wang X, Liu F, Li Y, et al. Comparison on clinicopathological features, treatments and prognosis between proximal gastric Cancer and distal gastric Cancer: a National Cancer Data Base Analysis. J Cancer. 2019;10:3145-53. DOI:10.7150/jca.30371
17. Wanebo HJ, Kennedy BJ, Chmiel J, et al. Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg. 1993;218:583-92.
DOI:10.1097/00000658-199321850-00002
18. Giommoni E, Lavacchi D, Tirino G, et al. Results of the observational prospective RealFLOT study. BMC Cancer. 2021;21:1086. DOI:10.1186/s12885-021-08768-7
19. The Cancer Genome Atlas Research Network Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513:202-9. DOI:10.1038/nature13480
20. Taghavi S, Jayarajan SN, Davey A, et al. Prognostic significance of Signet Ring gastric Cancer. J Clin Oncol. 2012;30:3493-8. DOI:10.1200/JCO.2012.42.6635
21. Mandard AM, Dalibard F, Mandard JC, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer. 1994;73(11):2680-6. DOI:10.1002/1097-0142(19940601)73:11<2680::AID-CNCR2820731105>3.0.CO;2-C
22. Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer. 2003;98:1521-30. DOI:10.1002/cncr.11660
23. Abboretti F, Mantziari S, Didisheim L, et al. Prognostic value of tumor regression grade (TRG) after oncological gastrectomy for gastric cancer. Langenbecks Arch Surg. 2024;409(1):199. DOI:10.1007/s00423-024-03388-8
24. Achilli P, Martini PD, Ceresoli M, et al. Tumor response evaluation after neoadjuvant chemotherapy in locally advanced gastric adenocarcinoma: a prospective, multi-center cohort study. J Gastrointest Oncol. 2017;8(6):1018-25. DOI:10.21037/jgo.2017.08.13
25. Blackham AU, Greenleaf E, Yamamoto M, et al. Tumor regression grade in gastric cancer: predictors and impact on outcome. J Surg Oncol. 2016;114:434-9. DOI:10.1002/jso.24307
26. Schmidt T, Sicic L, Blank S, et al. Prognostic value of histopathological regression in 850 neoadjuvantly treated oesophagogastric adenocarcinomas. Br J Cancer. 2014;110:1712-20. DOI:10.1038/bjc.2014.94
27. Lombardi PM, Mazzola M, Achilli P, et al. Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: new perspectives from a single-center experience. J Surg Oncol. 2021;123:923-31. DOI:10.1002/jso.26391
28. Ассоциация онкологов России. Общероссийская общественная организация «Российское общество клинической онкологии». Клинические рекомендации «Рак желудка». М., 2020 [Assotsiatsiia onkologov Rossii. Obshcherossiiskaia obshchestvennaia organizatsiia “Rossiiskoie obshchestvo klinicheskoi onkologii”. Klinicheskiie rekomendatsii “Rak zheludka”. Moscow, 2020 (in Russian)].
29. Состояние онкологической помощи населению России в 2022 году. Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена − филиал ФГБУ “НМИЦ радиологии” Минздрава России, 2022 [Sostoianiie onkologicheskoi pomoshchi naseleniiu Rossii v 2022 godu. Pod red. AD Kaprina, VV Starinskogo, AO Shakhzadovoi. Moscow: MNIOI im. PA Gertsena − filial FGBU “NMITS radiologii” Minzdrava Rossii, 2022 (in Russian)].
30. Lombardi PM, Mazzola M, Achilli P, et al. Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: new perspectives from a single-center experience. J Surg Oncol. 2021;123:923-31. DOI:10.1002/jso.26391
31. Becker K, Langer R, Reim D, et al. Significance of histopathological tumor regression after neoadjuvant chemotherapy in gastric adenocarcinomas: a summary of 480 cases. Ann Surg. 2011;253:934-9. DOI:10.1097/SLA.0b013e318216f449
32. Drubay V, Nuytens F, Renaud F, et al. Poorly cohesive cells gastric carcinoma including signet-ring cell cancer: updated review of definition, classification and therapeutic management. World J Gastrointest Oncol. 2022;14:1406-28. DOI:10.4251/wjgo.v14.i8.1406
33. Xie J-W, Lu J, Xu B, et al. Prognostic value of Tumor Regression Grading in patients treated with neoadjuvant chemotherapy plus surgery for gastric Cancer. Front Oncol. 2021;11:587856. DOI:10.3389/fonc.2021.587856
________________________________________________
2. American Cancer Society (2024) Cancer Facts & Fig. 2024. Atlanta: American Cancer Society.
3. Kuijper SC, Pape M, Vissers PA, et al. Trends in Best-case, typical and worst-case survival scenarios of patients with non-metastatic esophagogastric cancer between 2006 and 2020: A population-based study. Int J Cancer. 2023;153:33-43. DOI:10.1002/ijc.34488
4. van Putten M, Nelen SD, Lemmens VE, et al. Overall survival before and after centralization of Gastric Cancer Surgery in the Netherlands. Br J Surg.
2018;105:1807-15. DOI:10.1002/bjs.10931
5. Cunningham D, Allum WH, Stenning SP. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med.
2006;355(1):11-20. DOI:10.1056/NEJMoa055531
6. Al-Batran S-E, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019;393:1948-57. DOI:10.1016/S0140-6736(18)32557-1
7. Al-Batran S-E, Hofheinz RD, Pauligk C, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol. 2016;17:1697-708. DOI:10.1016/S1470-2045(16)30531-9
8. Ychou M, Boige V, Pignon J-P, et al. Perioperative Chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD Multicenter Phase III Trial. JCO. 2011;29:1715-21. DOI:10.1200/JCO.2010.33.0597
9. Yamada T, Yoshikawa T, Taguri M, et al. The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors. Gastric Cancer. 2016;19(2):479-89. DOI:10.1007/s10120-015-0480-5
10. Graziosi L, Marino E, Donini A. Survival comparison in gastric cancer patients between 7th and 8th edition of the AJCC TNM staging system: the first western single center experience. Eur J Surg Oncol. 2019;45(6):1105-8. DOI:10.1016/j.ejso.2018.12.010
11. Lu J, Zheng Z-F, Xie J-W, et al. Is the 8th Edition of the AJCC TNM staging System sufficiently reasonable for all patients with Noncardia Gastric Cancer? A 12,549-Patient International Database Study. Ann Surg Oncol. 2018;25:2002-11. DOI:10.1245/s10434-018-6447-0
12. Lu J, Zheng Z-F, Wang W, et al. A novel TNM staging system for gastric cancer based on the metro-ticket paradigm: a comparative study with the AJCC-TNM staging system. Gastric Cancer. 2019;22:759-68. DOI:10.1007/s10120-018-00904-w
13. Bria E, De Manzoni G, Beghelli S, et al. A clinical-biological risk stratification model for resected gastric cancer: prognostic impact of Her2, Fhit, and APC expression status. Ann Oncol. 2013;24:693-701. DOI:10.1093/annonc/mds506
14. Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual 2017. Springer Publishing.
15. Songun I, Putter H, Kranenbarg EM-K, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol.
2010;11:439-49. DOI:10.1016/S1470-2045(10)70070-X
16. Wang X, Liu F, Li Y, et al. Comparison on clinicopathological features, treatments and prognosis between proximal gastric Cancer and distal gastric Cancer: a National Cancer Data Base Analysis. J Cancer. 2019;10:3145-53. DOI:10.7150/jca.30371
17. Wanebo HJ, Kennedy BJ, Chmiel J, et al. Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg. 1993;218:583-92.
DOI:10.1097/00000658-199321850-00002
18. Giommoni E, Lavacchi D, Tirino G, et al. Results of the observational prospective RealFLOT study. BMC Cancer. 2021;21:1086. DOI:10.1186/s12885-021-08768-7
19. The Cancer Genome Atlas Research Network Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513:202-9. DOI:10.1038/nature13480
20. Taghavi S, Jayarajan SN, Davey A, et al. Prognostic significance of Signet Ring gastric Cancer. J Clin Oncol. 2012;30:3493-8. DOI:10.1200/JCO.2012.42.6635
21. Mandard AM, Dalibard F, Mandard JC, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer. 1994;73(11):2680-6. DOI:10.1002/1097-0142(19940601)73:11<2680::AID-CNCR2820731105>3.0.CO;2-C
22. Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer. 2003;98:1521-30. DOI:10.1002/cncr.11660
23. Abboretti F, Mantziari S, Didisheim L, et al. Prognostic value of tumor regression grade (TRG) after oncological gastrectomy for gastric cancer. Langenbecks Arch Surg. 2024;409(1):199. DOI:10.1007/s00423-024-03388-8
24. Achilli P, Martini PD, Ceresoli M, et al. Tumor response evaluation after neoadjuvant chemotherapy in locally advanced gastric adenocarcinoma: a prospective, multi-center cohort study. J Gastrointest Oncol. 2017;8(6):1018-25. DOI:10.21037/jgo.2017.08.13
25. Blackham AU, Greenleaf E, Yamamoto M, et al. Tumor regression grade in gastric cancer: predictors and impact on outcome. J Surg Oncol. 2016;114:434-9. DOI:10.1002/jso.24307
26. Schmidt T, Sicic L, Blank S, et al. Prognostic value of histopathological regression in 850 neoadjuvantly treated oesophagogastric adenocarcinomas. Br J Cancer. 2014;110:1712-20. DOI:10.1038/bjc.2014.94
27. Lombardi PM, Mazzola M, Achilli P, et al. Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: new perspectives from a single-center experience. J Surg Oncol. 2021;123:923-31. DOI:10.1002/jso.26391
28. Assotsiatsiia onkologov Rossii. Obshcherossiiskaia obshchestvennaia organizatsiia “Rossiiskoie obshchestvo klinicheskoi onkologii”. Klinicheskiie rekomendatsii “Rak zheludka”. Moscow, 2020 (in Russian).
29. Sostoianiie onkologicheskoi pomoshchi naseleniiu Rossii v 2022 godu. Pod red. AD Kaprina, VV Starinskogo, AO Shakhzadovoi. Moscow: MNIOI im. PA Gertsena − filial FGBU “NMITS radiologii” Minzdrava Rossii, 2022 (in Russian).
30. Lombardi PM, Mazzola M, Achilli P, et al. Prognostic value of pathological tumor regression grade in locally advanced gastric cancer: new perspectives from a single-center experience. J Surg Oncol. 2021;123:923-31. DOI:10.1002/jso.26391
31. Becker K, Langer R, Reim D, et al. Significance of histopathological tumor regression after neoadjuvant chemotherapy in gastric adenocarcinomas: a summary of 480 cases. Ann Surg. 2011;253:934-9. DOI:10.1097/SLA.0b013e318216f449
32. Drubay V, Nuytens F, Renaud F, et al. Poorly cohesive cells gastric carcinoma including signet-ring cell cancer: updated review of definition, classification and therapeutic management. World J Gastrointest Oncol. 2022;14:1406-28. DOI:10.4251/wjgo.v14.i8.1406
33. Xie J-W, Lu J, Xu B, et al. Prognostic value of Tumor Regression Grading in patients treated with neoadjuvant chemotherapy plus surgery for gastric Cancer. Front Oncol. 2021;11:587856. DOI:10.3389/fonc.2021.587856
Авторы
Н.М. Киселев1,2, С.А. Климин*1,2, Я.И. Колесник1,2, Р.С. Кокорин1,2, Э.А. Ашимов1,2, В.Ю. Елагина1, И.С. Шумская1,2, В.Е. Загайнов1,2, С.В. Гамаюнов1,2
1ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России, Нижний Новгород, Россия;
2ГАУЗ НО НИИКО «Нижегородский областной клинический онкологический диспансер», Нижний Новгород, Россия
*kliminsergey7@gmail.com
1Privolzhsky Research Medical University, Nizhny Novgorod, Russia;
2Nizhny Novgorod Regional Clinical Oncological Dispensary, Nizhny Novgorod, Russia
*kliminsergey7@gmail.com
1ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России, Нижний Новгород, Россия;
2ГАУЗ НО НИИКО «Нижегородский областной клинический онкологический диспансер», Нижний Новгород, Россия
*kliminsergey7@gmail.com
________________________________________________
1Privolzhsky Research Medical University, Nizhny Novgorod, Russia;
2Nizhny Novgorod Regional Clinical Oncological Dispensary, Nizhny Novgorod, Russia
*kliminsergey7@gmail.com
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.