The optimal approach for treating cytology-positive (Cy1) gastric cancer (GC) patients without additional non-curative factors remains uncertain. While neoadjuvant chemotherapy followed by gastrectomy shows promise, its suitability for Western patients is not well supported by existing data. To address this knowledge gap, a cohort study was conducted across four major GC treatment centers in Lithuania, Estonia, and Ukraine. Forty-three consecutive Cy1 GC patients who underwent neoadjuvant chemotherapy between 2016 and 2020 were enrolled. The study evaluated overall survival (OS), progression-free survival (PFS), cytology status conversion, and major pathological response rates, along with the factors influencing these outcomes. All patients underwent surgery post-neoadjuvant chemotherapy, with 53.5% experiencing cytological status conversion and 23.3% achieving a major pathological response. The median OS and PFS were 20 (95% CI: 16–25) and 19 (95% CI: 11–20) months, respectively. Conversion to negative cytology significantly reduced the relative risk of peritoneal progression (RR: 0.11; 95% CI: 0.03–0.47,p= 0.002). The study suggests that neoadjuvant chemotherapy followed by gastrectomy holds promise as a treatment option for Cy1 GC without additional non-curative factors, associating cytology status conversion with improved long-term outcomes and reduced peritoneal relapse risk.
对于无其他非治愈性因素的细胞学阳性（Cy1）胃癌患者，最佳治疗方案仍不明确。新辅助化疗联合胃切除术虽显示出潜力，但现有数据未能充分支持其在西方患者中的适用性。为填补这一知识空白，本研究在立陶宛、爱沙尼亚和乌克兰的四个主要胃癌治疗中心开展了一项队列研究。研究连续纳入2016年至2020年间接受新辅助化疗的43例Cy1胃癌患者，评估了总生存期（OS）、无进展生存期（PFS）、细胞学状态转化率及主要病理缓解率，并分析了影响这些结果的因素。所有患者在新辅助化疗后均接受手术治疗，其中53.5%实现细胞学状态转化，23.3%达到主要病理缓解。中位OS和PFS分别为20个月（95% CI：16-25）和19个月（95% CI：11-20）。细胞学转阴显著降低腹膜进展的相对风险（RR：0.11；95% CI：0.03-0.47，p=0.002）。研究表明，对于无其他非治愈性因素的Cy1胃癌患者，新辅助化疗联合胃切除术可能是一种有前景的治疗选择，细胞学状态转化与长期预后改善及腹膜复发风险降低相关。
肿瘤(癌症)患者之家