Factors predictioning the treatment response and prognosis in patients with local advanced stomach cancer receiving neoadjuvan chemotherapy

Objective: The standard treatment approach in locally advanced gastric cancer is surgery after neoadjuvant chemotherapy. In this study, it was aimed to investigate the factors that predict treatment response and prognosis in patients with locally advanced gastric cancer receiving neoadjuvant chemotherapy. Materials and Methods: A total of 71 patients with locally advanced gastric adenocarcinoma who applied to the Dicle University Medical Faculty Medical Oncology outpatient clinic between January 01, 2014 and December 01, 2022 and received neoadjuvant chemotherapy were included in this study. Demographic data, clinicopathological characteristics and various laboratory parameters of the patients were examined in accordance with the information in the hospital records. Results: When the responses of 71 patients to neoadjuvant chemotherapy according to their demographic and clinicopathological characteristics were evaluated in our study; It was observed that the response rates from neoadjuvant chemotherapy in patients with stage 2 disease were higher than those with stage 3 disease ((X2=9.963; p<0.05), and the rates of response from neoadjuvant chemotherapy treatment in patients with negative clinical N(nodal) stage were found to be higher than those with stage 3 disease), clinical N(nodal) stage is higher than patients with positive (X2=7.278; p<0.05), the rate of response from neoadjuvant chemotherapy in patients with clinical T3-T4 disease is higher than those without clinical T3-T4 disease ((X2=6.852) ; p<0.05), it was determined that the PIV (pan immune inflammation value) values before chemotherapy in patients who responded to neoadjuvant chemotherapy were lower than those who did not respond to neoadjuvant chemotherapy (t=2.130; p<0.05) and potential prognostic factors affecting overall survival (OS) were examined by univariate and multivariate analysis, no prognostic factor was found to predict DFS. In univariate analysis, clinical stage, ECOG performance score and neoadjuvant chemotherapy regimen predicted OS. However, in multivariate analysis, no independent prognostic factors were found to predict overall survival. Conclusion: In our study, it was determined that disease stage, presence of T3-T4 disease, nodal stage and PIV value before neoadjuvant chemotherapy were parameters that predicted neoadjuvant chemotherapy response in patients with locally advanced gastric cancer. Key words: Locally advanced gastric cancer, neoadjuvant chemotherapy, pan inflammation value(PIV), treatment response, prognosis