ABSTRACT
Background: Locoregional gastric cancer presents a significant clinical challenge, often requiring multimodal treatment approaches. Neoadjuvant therapy has emerged as a promising strategy, but its comparative efficacy concerning perioperative and histopathologic outcomes remains underexplored.
Aim: This study aimed to compare the perioperative and histopathologic outcomes of locoregional gastric cancer patients undergoing different neoadjuvant treatment strategies.
Methods: A retrospective analysis was conducted on locoregional gastric cancer patients who underwent neoadjuvant therapy between May 2023 and April 2024. Patients were categorized into groups based on the type of neoadjuvant treatment received, including chemotherapy alone, chemoradiotherapy, and targeted therapy combined with chemotherapy. Perioperative parameters such as operative time, blood loss, and postoperative complications were recorded. Histopathologic outcomes, including tumor regression grade and lymph node status, were also assessed.
Results: A total of 120 patients met the inclusion criteria, with 56 receiving chemotherapy alone, 24 receiving chemoradiotherapy, and 40 receiving targeted therapy combined with chemotherapy. Perioperative analysis revealed comparable operative times across all groups, with slightly lower blood loss observed in the targeted therapy combined with chemotherapy group. Postoperative complication rates were similar among the groups. Histopathologic evaluation demonstrated varying degrees of tumor regression, with the highest rates observed in the chemoradiotherapy group. Lymph node involvement was significantly reduced in patients receiving chemoradiotherapy compared to other treatment modalities.
Conclusion: Neoadjuvant therapy plays a crucial role in improving perioperative and histopathologic outcomes in locoregional gastric cancer patients. While all treatment strategies showed efficacy, chemoradiotherapy appeared to offer superior tumor regression and lymph node control. These findings underscore the importance of tailored neoadjuvant approaches in optimizing outcomes for patients with locoregional gastric cancer.
Keywords: Locoregional gastric cancer, neoadjuvant therapy, perioperative outcomes, histopathologic outcomes, chemoradiotherapy, targeted therapy, tumor regression grade, lymph node status, comparative analysis.