Analysis of the therapeutic effect and influencing factors on unresectable gastric cancer treated with conversion therapy.

Résumé

BACKGROUND: Gastric cancer (GC) is one of the leading causes of cancer-related death in China, and with the extensive development of conversion therapy, the treatment of advanced unresectable gastric cancer (AUGC) patients has ushered in a new dawn. This study aimed to analyze the efficacy of conversion therapy in AUGC patients and explored the relevant factors affecting the efficacy.METHOD: We collected information from GC patients who received conversion therapy from this center and designed a retrospective study.RESULTS: We collected relevant clinical data from 160 patients with AUGC. A total of 120 patients who underwent routine R0 resection were identified as conversion cases. A total of 25 patients (15.6%) achieved pCR, 92 patients (57.5%) achieved objective response rate (ORR), 140 patients (87.5%) achieved disease control rate (DCR), and 20 cases (12.5%) observed tumor progression. There were 86 patients who achieved pathological downgrading, with a total downgrading rate of 53.8%. Among the 160 patients, 37 patients (23.1%) had postoperative complications of varying degrees. A total of 72 patients (45.0%) had tumor recurrence/progression at the end of follow-up. The last chemotherapy and surgery (CST) (OR = 1.046, 95% CI 1.013-1.081, = 0.006), tumor invasion (OR = 32.096, 95% CI 5.091-202.349, < 0.001), and distant metastasis (OR = 7.050, 95% CI 1.888-26.323, = 0.004) were independent factors influencing the efficacy of conversion therapy.CONCLUSION: Conversion therapy may have a good therapeutic efficacy for AUGC, and some clinical factors affect the efficacy response.