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Clinical implications and chemo-sensitivity of adjuvant chemotherapy in patients with poorly cohesive cells-gastric cancer

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Abstract

Purpose

Poorly cohesive cells-gastric cancer (PCC-GC) represents distinct features within the GC spectrum. The present study investigated the clinicopathologic characteristics and chemo-sensitivity for a relatively large cohort of PCC-GC patients.

Materials and methods

A total of 268 patients diagnosed with stage II or III PCC-GC were included. GC cell lines were also analyzed for drug sensitivity to 5-fluorouracil (5-FU) and oxaliplatin in vitro.

Results

One hundred fifteen (42.9%) patients were stage II and 153 (57.1%) were stage III. Two hundred twenty-three (83.2%) patients received adjuvant therapy. Among these patients, 139 (62.3%) received CAPOX and 84 (37.7%) received S-1. With a median follow-up of 38.9 (1.6–137.8) months, the estimated 5-year disease-free survival (DFS) and overall survival (OS) rates were 52.3% and 61.0%, respectively. In the univariate analysis, survival was significantly better in the adjuvant chemotherapy group than in the surgery only group. In the subgroup analysis, there was no significant difference in DFS or OS between the types of adjuvant chemotherapy for either disease stage. In vitro cell line analysis, different responses to 5-FU and oxaliplatin were observed in SRC and non-SRC, where the treatment in KATOIII cell lines with oxaliplatin had less effect at a higher concentration compared to non-SRC cell lines.

Conclusion

The current study found that adjuvant chemotherapy was not significantly associated with survival benefit for patients with resected stage II and III PCC-GC. Plus, S-1 showed numerically longer DFS and OS compared to CAPOX in PCC-GC patients, although no significant in the multivariate analysis.

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Data availability

All data generated or analyzed during this study are included in this published article [and its supplementary information files]. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This research was supported by (1) a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant No. HR22C1832) and (2) a grant of the National Research Foundation of Korea (Grant No. 2022R1I1A2066092).

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Author notes

  1. ** Ho Baek and Byung Woog Kang have contributed equally to this work as first authors.

Authors and Affiliations

  1. Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, 807 Hoguk-ro, Buk-gu, Daegu, 41404, Republic of Korea

    ** Ho Baek, Byung Woog Kang & Jong Gwang Kim

  2. College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of Korea

    Hyojeung Kang & Miyeon Cho

  3. Department of Surgery, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, Republic of Korea

    Oh Kyoung Kwon, Ji Yeon Park & Ki Bum Park

  4. Department of Pathology, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, Republic of Korea

    An Na Seo

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  1. ** Ho Baek
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Contributions

Conceived and designed the analysis: JHB, BWK and JGK. Collected the data: HK, MC, OKK, JYP, KBP and ANS. Analysis and interpretation of data: JHB, BWK and JGK. Wrote the paper: JHB, BWK and JGK.

Corresponding author

Correspondence to Jong Gwang Kim.

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Conflict of interest

Conflict of interest relevant to this article was not reported.

Ethical approval

This study was conducted in accordance with the International Conference on Harmonization Good Clinical Practice guidelines and the Declaration of Helsinki. This study protocol was reviewed and approved by the Institutional Review Board of Kyungpook National University Chilgok Hospital. Written informed consent was obtained from all patients participating in the study.

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Baek, J.H., Kang, B.W., Kang, H. et al. Clinical implications and chemo-sensitivity of adjuvant chemotherapy in patients with poorly cohesive cells-gastric cancer. Cancer Chemother Pharmacol 92, 279–290 (2023). https://doi.org/10.1007/s00280-023-04564-1

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