{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:26:47Z","timestamp":1786706807876,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100018904","name":"Beijing Xisike Clinical Oncology Research Foundation","doi-asserted-by":"publisher","award":["Y\u20102019Roche\u2010157"],"award-info":[{"award-number":["Y\u20102019Roche\u2010157"]}],"id":[{"id":"10.13039\/100018904","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2025A1515012334"],"award-info":[{"award-number":["2025A1515012334"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neoadjuvant therapies, including chemotherapy (NACT), chemoradiotherapy (NACRT), and chemoimmunotherapy (NACIT), are standard for locally advanced gastric cancer (LAGC). Pathological response is a key surrogate for treatment effectiveness, but its correlation with long\u2010term outcomes across modalities remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study analyzed 256 LAGC patients receiving neoadjuvant therapy (NACT\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009162; NACRT\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948; NACIT\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946) from January 2017 to December 2022. Pathological responses, disease\u2010free survival (DFS), and overall survival (OS) were evaluated using Kaplan\u2013Meier estimates and Cox models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to NACT, NACIT was associated with significantly improved DFS (HR\u2009=\u20090.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035), though no OS difference was observed. Although NACRT enhanced pathological response rates, this was not accompanied by a survival benefit. Crucially, major pathological response (MPR) strongly correlated with improved survival in the NACT and NACIT groups, but no significant association was observed in the NACRT group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NACIT is associated with improved DFS for patients with LAGC, whereas NACRT suggests a \u2018pathology\u2010prognosis mismatch,\u2019 where improved pathological response may not reliably predict a survival advantage. These findings challenge the uniform application of pathological response as a surrogate endpoint and highlight the critical need for modality\u2010specific interpretation when evaluating neoadjuvant therapy efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71619","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T07:37:24Z","timestamp":1770881844000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness and Modality\u2010Dependent Prognostic Value of Pathological Response Following Neoadjuvant Therapy for Locally Advanced Gastric Cancer"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7734-9429","authenticated-orcid":false,"given":"Yongfeng","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenchong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minju","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoucheng","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6382-7521","authenticated-orcid":false,"given":"Yi","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1821-6147","authenticated-orcid":false,"given":"Jianrong","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukai","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, State Key Laboratory of Oncology 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