THE STUDY OF THE ROLE OF COMPUTED TOMOGRAPHY IN EVALUATING THE RESPONSE OF STAGE II-III GASTRIC CANCER AFTER NEOADJUVANT CHEMOTHERAPY
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Abstract
Background: Neoadjuvant chemotherapy for locally advanced gastric cancer (LAGC) has been shown to improve overall survival (OS) and disease-free survival (DFS) compared with surgery alone. The role of computed tomography (CT) in assessing response after neoadjuvant chemotherapy for GC has not received much attention at present. Methods: Retrospective, descriptive case series. All patients with confirmed diagnosis of LAGC, were consulted and treated with NAC regimen FLOT before surgery, then underwent radical surgery, at Binh Dan Hospital, Ho Chi Minh City from January 2019 to September 2024. Computed tomography characteristics were recorded on pre-chemotherapy and pre-surgery films, compared with postoperative histopathological results. Results: From January 2019 to September 2024, there were 32 cases (average age 56.9, male: female ratio = 1.7:1) of stage II-III GC treated with preoperative FLOT chemotherapy. Postoperative histopathological results showed 4 cases (12,5%) with pCR. After NAC, the accuracy of CT in assessing T stage was 69%, and that of lymph node stage was 47%. Comparing CT between the two groups with pCR and non-pCR, recorded statistically significant differences in characteristics including: tumor thickness after chemotherapy, tumor density after chemotherapy, percentage of tumor thickness reduction, and percentage of tumor density reduction after chemotherapy. Conclusions: After neoadjuvant chemotherapy for locally advanced gastric cancer, CT scan has medium accuracy in tumor stage reassessment, low accuracy in lymph node stage reassessment. Some characteristics of CT scan that can predict pathological complete response are tumor thickness after chemotherapy, tumor intensity after chemotherapy, % reduction in tumor thickness, and % reduction in tumor intensity after chemotherapy.
Article Details
Keywords
Locally advanced gastric cancer, Computed tomography, Neoadjuvant chemotherapy, Pathological complete response
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