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©The Author(s) 2024.
World J Gastrointest Surg. Feb 27, 2024; 16(2): 396-408
Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.396
Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.396
Table 1 Characteristics of patients in the primary and P value of univariate analysis
| Characteristics | Obvious response (grade 0/grade 1), n = 95 (%) | Poor response (grade 2/grade 3), n = 135 (%) | t/χ2 | P value |
| Age | 59.88 ± 10.00 | 59.00 ± 11.03 | -0.62 | 0.535 |
| Sex, n | ||||
| Male | 70 (73.68) | 84 (62.22) | 3.31 | 0.069 |
| Female | 25 (26.32) | 51 (37.78) | ||
| BMI, kg/m2 | 22.90 ± 3.55 | 22.85 ± 2.99 | -0.12 | 0.907 |
| Location | ||||
| Esophagogastric junction | 53 (55.79) | 30 (22.22) | 27.24 | < 0.001 |
| Non-esophagogastric junction | 42 (44.21) | 105 (77.78) | ||
| Tumor size, cm | 5.65 ± 2.51 | 5.97 ± 2.97 | 0.86 | 0.393 |
| Tumor differentiation | ||||
| Well + moderately differentiated | 47 (49.47) | 38 (28.15) | 10.88 | 0.001 |
| Poorly differentiated + Signet ring cell | 48 (50.53) | 97 (71.85) | ||
| cT stage | ||||
| T2 | 6 (6.32) | 4 (2.96) | 9.64 | 0.008 |
| T3 | 34 (35.79) | 27 (20.00) | ||
| T4 | 55 (57.89) | 104 (77.04) | ||
| cN stage | ||||
| N0 | 26 (27.37) | 24 (17.78) | 3.02 | 0.083 |
| N+ | 69 (72.63) | 111 (82.22) | ||
| Blood type | ||||
| Type A | 25 (26.32) | 42 (31.11) | 0.84 | 0.840 |
| Type B | 27 (28.42) | 39 (28.89) | ||
| Type AB | 11 (11.58) | 13 (9.63) | ||
| Type O | 32 (33.68) | 41 (30.37) | ||
| CA724, U/mL | ||||
| ≤ 6.5 | 71 (74.74) | 78 (57.78) | 7.03 | 0.008 |
| > 6.5 | 24 (25.26) | 57 (42.22) | ||
| CEA, ng/mL | ||||
| ≤ 5 | 76 (80.00) | 102 (75.56) | 0.63 | 0.428 |
| > 5 | 19 (20.00) | 33 (24.44) | ||
| CA125, U/mL | ||||
| ≤ 24 | 82 (86.32) | 123 (91.11) | 1.32 | 0.250 |
| > 24 | 13 (13.68) | 12 (8.89) | ||
| CA199, U/mL | ||||
| ≤ 30 | 79 (83.16) | 112 (82.96) | 0.01 | 0.969 |
| > 30 | 16 (16.84) | 23 (17.04) | ||
| Serum albumin, g/L | 41.77 (41.01-42.52) | 41.64 (40.98-42.29) | -0.25 | 0.803 |
| PLT, 109/L | 224.56 ± 95.13 | 214.83 ± 73.90 | -0.87 | 0.384 |
| Lymphocyte, 109/L | 1.57 ± 0.51 | 1.59 ± 0.44 | 0.25 | 0.806 |
| PLR | 153.65 ± 70.73 | 144.45 ± 64.21 | -1.03 | 0.306 |
| Neutrophil cell, 109/L | 3.65 ± 1.43 | 3.57 ± 1.36 | -0.47 | 0.637 |
| Monocyte, 109/L | 0.43 ± 0.16 | 0.41 ± 0.14 | -1.19 | 0.235 |
| NMR | 9.07 ± 3.98 | 9.24 ± 3.50 | 0.346 | 0.730 |
| NLR | 2.29 (2.26-2.73) | 2.41 (2.21-2.62) | -0.48 | 0.629 |
| Smoking history | ||||
| Yes | 36 (37.89) | 50 (37.04) | 0.02 | 0.895 |
| No | 59 (62.11) | 85 (62.96) |
Table 2 Toxicity of neoadjuvant chemotherapy
| Feature | Grade 1/2, n = 120 (%) | Grade 3/4, n = 77 (%) | Total, n = 197 |
| Anemia | 107 (89.17) | 36 (46.75) | 143 (72.59) |
| Leukopenia | 33 (27.50) | 20 (25.97) | 53 (26.90) |
| Neutropenia | 25 (20.83) | 6 (7.79) | 31 (15.74) |
| Thrombocytopenia | 27 (22.50) | 17 (22.08) | 44 (22.34) |
| Nausea/vomiting | 57 (47.50) | 12 (15.58) | 69 (35.03) |
| Diarrhea | 12 (10.00) | 1 (1.30) | 13 (6.60) |
| Hepatic impairment | 21 (17.50) | 10 (13.00) | 31 (15.74) |
| Hand-foot syndrome | 39 (32.50) | 0 | 39 (19.80) |
| Cardiotoxicity | 1 (0.83) | 0 | 1 (0.51) |
Table 3 Comparison of toxicity between the obvious response group and the poor response group
| System | Total, n = 230 (%) | Obvious response, n = 95 (%) | Poor response, n = 135 (%) | χ2 | P value |
| Gastrointestinal | 91 (39.57) | 41 (43.16) | 50 (37.04) | 0.874 | 0.350 |
| Hematological | 169 (73.48) | 71 (74.74) | 98 (72.59) | 0.132 | 0.717 |
| Neurological | 39 (16.96) | 19 (20.00) | 20 (14.81) | 1.065 | 0.302 |
| Cardiac | 1 (0.43) | 1 (1.05) | 0 | 1.385 | 0.239 |
Table 4 Postoperative complications after neoadjuvant chemotherapy (Clavien-Dindo classification)
| Complication | Grade 1, n = 2 (%) | Grade 2, n = 43 (%) | Grade 3a, n = 5 (%) | Grade 3b, n = 0 (%) | Grade 4a, n = 0 (%) | Grade 4b, n = 0 (%) | Grade 5, n = 1 (%) |
| Pulmonary infection/pleural effusion | 0 | 31 (72.09) | 4 (80.00) | 0 | 0 | 0 | 0 |
| Incision infection | 2 (100) | 0 | 0 | 0 | 0 | 0 | 0 |
| Intraperitoneal hemorrhage | 0 | 0 | 0 | 0 | 0 | 0 | 1 (100) |
| Digestive tract hemorrhage | 0 | 2 (4.65) | 0 | 0 | 0 | 0 | 0 |
| Anastomotic leakage | 0 | 0 | 1 (20.00) | 0 | 0 | 0 | 1 (100) |
| Duodenal stump fistula | 0 | 2 (4.65) | 0 | 0 | 0 | 0 | 0 |
| Gastroplegia | 0 | 3 (6.98) | 0 | 0 | 0 | 0 | 0 |
| Intestinal obstruction | 0 | 3 (6.98) | 0 | 0 | 0 | 0 | 0 |
| Peritoneal effusion/abscess formation | 0 | 4 (9.30) | 0 | 0 | 0 | 0 | 1 (100) |
| Lymphatic leakage | 0 | 1 (2.33) | 0 | 0 | 0 | 0 | 0 |
| Urinary tract infection | 0 | 3 (6.98) | 0 | 0 | 0 | 0 | 0 |
Table 5 Comparison of postoperative complications between the obvious response group and the poor response group
| Complication | Obvious-response, n = 95 (%) | Poor response, n = 135 (%) | χ2 | P value |
| Pulmonary infection/pleural effusion | 17 (17.89) | 18 (13.33) | 0.899 | 0.343 |
| Incision infection | 0 | 1 (0.74) | 0.00 | > 0.990 |
| Intraperitoneal hemorrhage | 1 (1.05) | 0 | 0.031 | 0.860 |
| Digestive tract hemorrhage | 2 (2.11) | 0 | 0.945 | 0.331 |
| Anastomotic leakage | 1 (1.05) | 1 (0.74) | 0.000 | > 0.990 |
| Duodenal stump fistula | 0 | 2 (1.48) | 0.221 | 0.638 |
| Gastroplegia | 1 (1.05) | 2 (1.48) | 0.095 | 0.758 |
| Intestinal obstruction | 1 (1.05) | 2 (1.48) | 0.000 | > 0.990 |
| Peritoneal effusion/abscess formation | 1 (1.05) | 4 (2.96) | 0.269 | 0.604 |
| Lymphatic leakage | 0 | 1 (0.74) | 0.000 | > 0.990 |
| Urinary tract infection | 2 (2.11) | 1 (0.74) | 0.095 | 0.758 |
- Citation: Liu B, Xu YJ, Chu FR, Sun G, Zhao GD, Wang SZ. Development of a clinical nomogram for prediction of response to neoadjuvant chemotherapy in patients with advanced gastric cancer. World J Gastrointest Surg 2024; 16(2): 396-408
- URL: https://www.wjgnet.com/1948-9366/full/v16/i2/396.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v16.i2.396