New data raises the question of whether surgery can be skipped for certain gastric and gastroesophageal junction cancers with high pathologic complete response rates.
- Patients with mismatch-repair deficient tumors have a 60% pathologic complete response to neoadjuvant immunotherapy.
- Those with mismatch repair intact tumors show about 20% pathologic complete response with chemo-immunotherapy.
Surgeons should consider omitting surgery in select patients while emphasizing shared decision-making, especially given the high morbidity and mortality associated with surgical procedures.
- Long-term data supporting surgery omission remains limited.
Journal Article by Gunder MA, Badgwell BD and Kelly KJ in Ann Surg Oncol
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