Background Data on the clinicopathological characteristics of mucinous gastric cancer (muc-GC) are limited. This study compares the clinical outcome and response to chemotherapy between patients with resectable muc-GC, intestinal (int-GC) and diffuse (dif-GC) gastric cancer. Methods Patients from the D1/D2 study or the CRITICS trial were included in exploratory surgery-alone (SAtest) or chemotherapy test (CTtest) cohorts. Real-world data from the Netherlands Cancer Registry on patients treated between with surgery-alone (SAvalidation), and receiving preoperative chemotherapy with or without postoperative treatment (CTvalidation) were used for validation. Histopathological subtypes were extracted from pathology reports filed in the Dutch Pathology Registry and correlated with tumor regression grade (TRG) and relative survival (RS). Results In SAtest (n = 549) and SAvalidation (n = 8062) cohorts, muc-GC patients had a five-year RS of 39% and 31%, similar to or slightly better than dif-GC (43% and 29%, p = .52 and p = .011), but worse than int-GC (55% and 42%, p = .11 and p < .001). In CTtest (n = 651) and CTvalidation (n = 2889) cohorts, muc-GC showed favorable TRG (38% and 44% (near-)complete response) compared to int-GC (26% and 35%) and dif-GC (10% and 28%, p < .001 and p = .005). The 5-year RS in CTtest and CTvalidation cohorts for muc-GC (53% and 48%) and int-GC (58% and 59%) was significantly better compared to dif-GC (35% and 38%, p = .004 and p < .001). Conclusion Recognizing and incorporating muc-GC into treatment decision-making of resectable GC can lead to more personalized and effective approaches, given its favorable response to preoperative chemotherapy in relation to int-GC and dif-GC and its favorable prognostic outcomes in relation to dif-GC.

中文翻译：

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粘液型胃癌化疗的组织病理学反应和生存


背景 有关粘液性胃癌（muc-GC）临床病理特征的数据有限。本研究比较了可切除的 muc-GC、肠癌 (int-GC) 和弥漫性 (dif-GC) 胃癌患者的临床结果和化疗反应。方法 来自 D1/D2 研究或 CRITICS 试验的患者被纳入单纯探查手术 (SAtest) 或化疗试验 (CTtest) 队列。使用来自荷兰癌症登记处的真实世界数据进行验证，该数据涉及仅接受手术（SAvalidation）和接受术前化疗加或不加术后治疗（CTvalidation）的患者。组织病理学亚型是从荷兰病理学登记处提交的病理报告中提取的，并与肿瘤消退等级（TRG）和相对生存率（RS）相关。结果 在 SAtest (n = 549) 和 SAvalidation (n = 8062) 队列中，muc-GC 患者的五年 RS 分别为 39% 和 31%，与 diff-GC 相似或略好（43% 和 29%， p = .52 和 p = .011），但比 int-GC 差（55% 和 42%，p = .11 和 p < .001）。在 CTtest (n = 651) 和 CTvalidation (n = 2889) 队列中，与 int-GC（26% 和 35%）和 diff-相比，muc-GC 显示出良好的 TRG（38% 和 44%（接近）完全缓解） GC（10% 和 28%，p < .001 和 p = .005）。 CTtest 和 CTvalidation 队列中 muc-GC（53% 和 48%）和 int-GC（58% 和 59%）的 5 年 RS 明显优于 diff-GC（35% 和 38%，p = . 004 和 p < .001)。结论 认识 muc-GC 并将其纳入可切除 GC 的治疗决策中，可以带来更加个性化和有效的方法，因为它对 int-GC 和 diff-GC 相关的术前化疗有良好的反应，并且与 diff-GC 相关的预后结果良好。 -GC。