{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:14:14Z","timestamp":1787764454480,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pathologic complete response (pCR) after neoadjuvant therapy has been associated with improved survival in several malignancies, but its prognostic value in gastric cancer remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the National Cancer Database, we identified non\u2010metastatic gastric adenocarcinoma patients diagnosed 2004\u20132021 treated with neoadjuvant chemotherapy followed by curative\u2010intent resection. Patients receiving neoadjuvant radiation were excluded. We analyzed pCR rates, overall survival (OS), and factors associated with pCR using a generalized estimating equations model. Kaplan\u2013Meier and Cox proportional hazards models were used to assess OS. Trends in pCR over time were evaluated with time\u2010trend analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 7258 patients, 672 (9.3%) achieved pCR. Median OS was significantly higher in patients with pCR compared to those without (167.9 vs. 65.8 months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Subgroup analysis of cT2N1 or higher stage patients revealed the highest survival in patients with both tumor and nodal pCR (median OS 181.8 months). Patients diagnosed after 2018 were more likely to achieve pCR (OR: 1.26, 95% CI: 1.07\u20131.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), correlating with the adoption of the FLOT regimen. Completion of adjuvant therapy in patients who achieved pCR did not significantly improve OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>pCR is associated with significantly improved OS in gastric cancer, especially when both tumoral and nodal pCR are achieved. Increasing pCR rates in recent years may reflect the uptake of modern chemotherapy regimens, underscoring the value of neoadjuvant strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70251","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T07:02:50Z","timestamp":1778482970000},"page":"1105-1115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pathologic Response and Outcomes After Neoadjuvant Chemotherapy in Gastric Cancer: A NCDB Analysis"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8875-8699","authenticated-orcid":false,"given":"Jennifer","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Surgery, Huntsman Cancer Institute University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaina","family":"Hunt","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine Temple University Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Papai","sequence":"additional","affiliation":[{"name":"Department of Surgery Temple University Health System Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4132-9382","authenticated-orcid":false,"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics and Biostatistics Fox Chase Cancer Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill S.","family":"Hasler","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics and Biostatistics Fox Chase Cancer Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea S.","family":"Porpiglia","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony M.","family":"Villano","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Farma","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie H.","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-1057"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i16.2452"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101404"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-320234"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0022"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32557-1"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34511"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62422-8"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.11.001"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-025-14548-4"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2024.07.026"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-023-11508-8"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2025.110528"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.5812\/ijcm-139026"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.6905"},{"key":"e_1_2_10_17_1","unstructured":"American College of Surgeons. 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