Staging I in a Gastric Adenocarcinoma Cohort Description of Clinical, Imaging and Pathological Findings

Background: Gastric cancer was the fourth cause of cancer-related deaths in 2020 in the world. The aim of this study was to describe the characteristics of patients with gastric adenocarcinoma Stage I describing clinical, pathological, and neoadjuvant staging in a prospective cohort at A.C. Camargo Cancer Center (ACCCC). Methods: Sixty-three patients with Stage I gastric adenocarcinoma treated at ACCCC were evaluated for clinical, pathological, and clinical Stages. For the comparison between the clinical staging and the post-treatment one (surgical and neoadjuvant): tumor (T) and lymph nodes (N) were evaluated. Results: Of the 63 patients, 29/63 (46%) were clinical Stage I, and 34/63 (54%) were initially staged as clinical Stage II and III that migrated to Stage I after surgical and neoadjuvant treatment. As for the clinical aspects, 36/63 patients (57%) were men with an average age of 58.7 years, 63% patients were Caucasian and 83% (52) had private medical insurance. In the endoscopic reports, 68.3% (n=43) of the lesions were ulcerated and the histological type, 55.6% (n=35) were diffuse. Patients treated with neoadjuvant therapy had a 100% reduction of tumors T3/T4 to T1/T2 (p<0.001) and 78.5% of the regional lymph nodes, N+ to N0. (p=0.001). Conclusion: The neoadjuvant therapy on patients with gastric adenocarcinoma led to significant tumor (T) and regional lymph nodes (N) regressions, thus, increasing the migration of cases from T3/T4 to T1 /T2 and N+ to N0 in this cohort.