CDX2 expression can predict response to neoadjuvant therapy in gastric carcinoma

Vol. 58 No. 4, 2017


Maria Jesus Fernandez Acenero, Maria Luisa Sanchez de Molina, Ana Caso, Peter Vorwald, Damian Garcia Olmo, Jorge Palomar, Lourdes Estrada, Cristina Diaz del Arco

Purpose: Caudal-related homeobox transcription factor 2 (CDX2) has recently been proposed as a prognostic factor for gastric carcinoma. However and to the best of our knowledge, no previous report has analyzed CDX2 expression in patients with gastric adenocarcinoma receiving neoadjuvant therapy (NAT). Patients, Materials and Methods: This is a retrospective cohort study to analyze the potential role of CDX2 expression to predict response to NAT and prognosis. This study has enrolled 57 patients receiving chemotherapy for locally advanced gastric carcinoma. Results: 59.6% of the patients were men; mean age was 64.96 years. Only 8% of the patients showed a complete response to therapy, 10% had grade 1, 28% grade 2, and 54% grade 3 regression, respectively, according to modified Ryan s criteria. On follow-up, 38.6% of the patients showed recurrence of disease (50% distant metastasis) and 28.1% eventually died of it. Twenty-three (40.4%) patients showed intense CDX2 expression. We found a statistically significant association between CDX2 expression and poor regression with NAT, but we found no association with outcome. Discussion: Our study indicates that CDX2 expression can predict lack of response to NAT. Our results have not confirmed the association with prognosis shown in previous reports. Conclusions: Despite these preliminary results, furthermore studies are necessary to define the potential use of CDX2 in gastric carcinoma.

Corresponding author: Maria Jesus Fernandez Acenero, MD, PhD; e-mail:

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