TY - JOUR
T1 - Sexual difference matters
T2 - Females with high microsatellite instability show increased survival after neoadjuvant chemotherapy in gastric cancer
AU - Kohlruss, Meike
AU - Ott, Katja
AU - Grosser, Bianca
AU - Jesinghaus, Moritz
AU - Slotta-Huspenina, Julia
AU - Novotny, Alexander
AU - Hapfelmeier, Alexander
AU - Schmidt, Thomas
AU - Gaida, Matthias M.
AU - Weichert, Wilko
AU - Keller, Gisela
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - We aimed to investigate patients with gastric/gastro-esophageal adenocarcinomas for sex-and age-specific differences regarding overall survival (OS) and response to neoadjuvant chemotherapy (CTx) under consideration of tumor specific molecular subtypes. Overall, 717 patients were analyzed, including 426 patients treated with and 291 treated without neoadjuvant CTx. Microsatel-lite instability (MSI) and Epstein-Barr virus positivity (EBV+) were determined previously. Females demonstrated a significantly increased OS (p = 0.035), particularly in the subgroup treated with CTx (p = 0.054). No significant differences regarding age were found. In the molecular subgroups, no sex-related differences were observed in the non-CTx group. However in the CTx group, females with MSI-high (H) tumors showed the best OS (p = 0.043), followed by the male MSI-H (p = 0.198) and female MSS (p = 0.114) compared to the male MSS group as reference. The interaction between sex and MSI in this patient group was noticeable (p = 0.053) and was included as a relevant factor in multivariable analyses. In conclusion, our results show an effect of sex on OS in gastric/gastro-esophageal cancer specifically for patients treated with neoadjuvant CTx. The superior survival of women with MSI-H tumors after neoadjuvant CTx implies that combined consideration of these factors could contribute to an individualized treatment of the patients.
AB - We aimed to investigate patients with gastric/gastro-esophageal adenocarcinomas for sex-and age-specific differences regarding overall survival (OS) and response to neoadjuvant chemotherapy (CTx) under consideration of tumor specific molecular subtypes. Overall, 717 patients were analyzed, including 426 patients treated with and 291 treated without neoadjuvant CTx. Microsatel-lite instability (MSI) and Epstein-Barr virus positivity (EBV+) were determined previously. Females demonstrated a significantly increased OS (p = 0.035), particularly in the subgroup treated with CTx (p = 0.054). No significant differences regarding age were found. In the molecular subgroups, no sex-related differences were observed in the non-CTx group. However in the CTx group, females with MSI-high (H) tumors showed the best OS (p = 0.043), followed by the male MSI-H (p = 0.198) and female MSS (p = 0.114) compared to the male MSS group as reference. The interaction between sex and MSI in this patient group was noticeable (p = 0.053) and was included as a relevant factor in multivariable analyses. In conclusion, our results show an effect of sex on OS in gastric/gastro-esophageal cancer specifically for patients treated with neoadjuvant CTx. The superior survival of women with MSI-H tumors after neoadjuvant CTx implies that combined consideration of these factors could contribute to an individualized treatment of the patients.
KW - Adenocarcinoma
KW - Age
KW - Gastric
KW - Gastroesophageal junction
KW - Microsatellite instability
KW - Molecular subtype
KW - Neoadjuvant chemotherapy
KW - Prognosis
KW - Sex
UR - http://www.scopus.com/inward/record.url?scp=85101715150&partnerID=8YFLogxK
U2 - 10.3390/cancers13051048
DO - 10.3390/cancers13051048
M3 - Article
AN - SCOPUS:85101715150
SN - 2072-6694
VL - 13
SP - 1
EP - 13
JO - Cancers
JF - Cancers
IS - 5
M1 - 1048
ER -