Xing Y, Zhang ZL, Ding ZY, Song WL, Li T. Tumor recurrence after pathological complete response in locally advanced gastric cancer after neoadjuvant therapy: Two case reports. World J Clin Cases 2023; 11(27): 6483-6490 [PMID: 37900239 DOI: 10.12998/wjcc.v11.i27.6483]
Corresponding Author of This Article
Tong Li, MD, PhD, Professor, Department of Surgery, The Third Central Clinical College of Tianjin Medical University, No. 83 Jintang Road, Hedong District, Tianjin 300170, China. litong3zx@sina.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2023; 11(27): 6483-6490 Published online Sep 26, 2023. doi: 10.12998/wjcc.v11.i27.6483
Tumor recurrence after pathological complete response in locally advanced gastric cancer after neoadjuvant therapy: Two case reports
Yu Xing, Zi-Li Zhang, Zhi-Ying Ding, Wei-Liang Song, Tong Li
Yu Xing, Zi-Li Zhang, Zhi-Ying Ding, Wei-Liang Song, Tong Li, Department of Surgery, The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China
Yu Xing, Zi-Li Zhang, Zhi-Ying Ding, Wei-Liang Song, Department of Surgery, The Third Central Hospital of Tianjin, Tianjin 300170, China
Yu Xing, Zi-Li Zhang, Zhi-Ying Ding, Wei-Liang Song, Department of Surgery, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
Author contributions: Xing Y, Zhang ZL, and Ding ZY designed the research plan, compiled and analyzed the data, and drafted the manuscript; Song WL and Li T designed and supervised the research plan, analyzed the data, and completed the manuscript. All authors participated in the writing of the paper and finally approved the submitted and published version.
Supported byThis work was sponsored by Tianjin Key Medical Discipline (Specialty) Construction Project, No. TJYXZDXK-035A; and Tianjin Science and Technology Project, No. 21JCYBJC01590.
Informed consent statement: Consent was obtained from the patient and her family for publication of this report.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tong Li, MD, PhD, Professor, Department of Surgery, The Third Central Clinical College of Tianjin Medical University, No. 83 Jintang Road, Hedong District, Tianjin 300170, China. litong3zx@sina.com
Received: March 30, 2023 Peer-review started: March 30, 2023 First decision: July 3, 2023 Revised: July 8, 2023 Accepted: July 21, 2023 Article in press: July 21, 2023 Published online: September 26, 2023 Processing time: 174 Days and 8.5 Hours
Abstract
BACKGROUND
The pathological complete response (ypCR) rate following neoadjuvant chemotherapy for advanced gastric cancer remains low and lacks a universally accepted treatment protocol. Immunotherapy has achieved breakthrough progress.
CASE SUMMARY
We report two female patients with gastric cancer defined as clinical stage cT4N1-2M0. Detection of mismatch repair protein showed mismatch repair function defect, and perioperative treatment with programmed death protein 1 inhibitor combined with S-1+oxaliplatin achieved ypCR. Surprisingly, the patients underwent clinical observation after surgery but developed different degrees of metastasis at ~6 mo after surgery.
CONCLUSION
PD-1 inhibitor combined with chemotherapy provides a more strategic choice for comprehensive perioperative treatment of gastric cancer.
Core tip: The enhanced antitumor effect of synergistic chemotherapy and immunotherapy has achieved commendable remission rates and survival benefit. We reported two patients who achieved pathological complete remission (ypCR) with perioperative treatment with programmed death protein 1 inhibitor combined with S-1+oxaliplatin. Surprisingly, the patients underwent clinical observation after surgery but developed different degrees of metastasis at ~6 mo after surgery. Achieving ypCR reflects an excellent short-term treatment response but does not necessarily predict long-term survival.
