The relationship between Lauren classification and pathological response after preoperative chemoradiotherapy for locally advanced gastric cancer
Fang Yi1, Zhang Yujing1, Li Nai1, Ling Yihong2, Zhou Zhiwei3
1Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China; 2Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China; 3Department of Gastric Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China
Abstract：Objective To investigate the correlation between Lauren classification and pathological response after preoperative chemoradiotherapy in patients with locally advanced gastric cancer. Methods From 2013 to 2019,98 patients with definite Lauren classification who were enrolled in Sun Yat-sen University Cancer Center 5010 Phase Ⅲ clinical trials. Among them, 46 patients received preoperative chemoradiotherapy (CRT), and the remaining 52 cases received preoperative chemotherapy (ChT) and radical surgery. After preoperative therapy, the correlation between pathological responseincluding the tumor regression grade (NCCN-TRG0-3) and the lymph node stage (ypN0-3) and Lauren classification was analyzed. A favorable pathological response (FPR) was defined as TRG0-2 and ypN0. Results In the CRT group, patients with intestinal type (IT) tumors had a higher rate of ypN0(OR=6.8,95%CI:1.8-25.0,P=0.004) and FPR (OR=8.0,95%CI:2.2-29.9,P=0.002) than their counterparts with diffuse or mixed type tumors. However, Lauren classification was not significantly correlated withpathological responsein the ChT group (P>0.05). For patients with IT tumors, those receiving CRT had a higher likelihood of achieving a TRG0-2 response (P=0.033), an ypN0 nodal regression (P<0.001), and a FPR (P<0.001) than their counterparts receiving ChT, whereas pathological response was not significantly associated with preoperative therapeutic method in patients with diffuse or mixed tumors (P>0.05). Conclusion Lauren classification may be a reliable predictor of the clinical efficacy of preoperative chemoradiotherapy for locally advanced gastric cancer, which can be utilized to select and optimize preoperative treatment.
Fang Yi,Zhang Yujing,Li Nai et al. The relationship between Lauren classification and pathological response after preoperative chemoradiotherapy for locally advanced gastric cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(5): 349-353.
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