ASO Author Reflections: In Gastric Cancer Patients with Primary Tumor Pathologic Complete Response, Treatment-Refractory Nodal Disease is an Ominous Sign

Abstract

Preoperative therapy is frequently used for resectable gastric and gastroesophageal adenocarcinoma, and patients who achieve pathologic complete response to preoperative therapy have longer overall survival (OS) than those with persistent viable disease. However, pathologic complete response is not synonymous with cure. At 5 years after resection, patients with pathologic complete response are reported to have a mortality rate of 15% and a recurrence rate of 25–27%. The reasons why one patient with pathologic complete response experiences prolonged survival whereas another does not are not well understood. This study therefore examined a cohort of ypT0 patients (n =77) to describe these patients clinically and pathologically and to determine factors associated with prognosis in this unique patient population.