Clinical Outcomes of Neoadjuvant Chemotherapy in Locally Advanced Gastric Cancer

Authors
Dr Danson Yeo, AZ Sameera Zeehan

Objectives
Surgical resection with D2 lymphadenectomy is the treatment of choice for most patients with curable gastric cancer, however preoperative chemotherapy may be used to facilitate complete resection in selected cases of locally advanced gastric cancer. Chemotherapy is not without complications. Some studies have suggested that tumor differentiation and tumor size may predict pathological tumor response to chemotherapy. This paper aims to analyse the clinical outcome of patients with locally advanced gastric cancers who underwent neoadjuvant chemotherapy. The outcomes are subsequently categorised as having disease progression, disease regression or no effect.

Methods
Retrospective review of treatment plan and clinical records for patients who were recommended for neoadjuvant chemotherapy by the Gastro-intestinal tumor board (GITB) between Jan 2020 and April 2024 was conducted. Survival statistics and tumor properties were observed across the cases to determine the overall clinical outcome of the neoadjuvant chemotherapy.

Results
A total of 6 patients who underwent neoadjuvant chemotherapy were analysed. Among the 6 cases, 2 of them failed to complete the treatment regime of neoadjuvant chemotherapy followed by surgery where one deferred surgery and one did not complete the recommended cycles of neoadjuvant chemotherapy.

Out of the 6 cases, 3 of the showed evidence of disease progression, 2 of the showed disease regression and 2 of them showed no effect.

Conclusion
Further studies need to be done to predict tumor response to neoadjuvant chemotherapy. Patients who are predicted to have poor tumor response to chemotherapy should undergo upfront surgery instead.