The aim of this study is to develop a CT scan-based radiomics predictive model about tumor regression grade (TRG) in patients with esophago-gastric junction (EGJ) ang gastric cancer undergoing perioperative chemotherapy. The molecular expression of the neoplasms will be evaluated to assess its association with the TRG and the radiomic features.
• To compare the radiomic features of the CT scans at the time of diagnosis (T0) and at the end of the preoperative chemotherapy (T1) in order to predict the TRG with the texture analysis on the first CT scan. A non-good response (non-GR) has shown to be predictable with texture analysis on the pre-treatment CT scan. Therefore, we hypothesize that texture analysis could let to identify the good response patients. • To find correlation between the molecular expression of the tumor and the radiomics features. Texture analysis on the pre-chemotherapy CT scan founded that entropy and compactness were higher and uniformity lower in responders. Nonetheless the association between radiomics features and molecular expression has not been investigated yet. Therefore, we hypothesize to add some others radiomics signatures to the analysis and to find an association with the molecular expression. • To find correlation between the molecular expression of the tumor and the TRG. MSI gastric cancer has been shown to be less responsive to preoperative chemotherapy. Therefore, we hypothesize to confirm this result.
Study Type
OBSERVATIONAL
Enrollment
138
Patients undergoing CT scan staging for gastric and EJ junction cancer + perioperative chemotherapy (FLOT regimen) , CT scan re-staging and radical gastrectomy or esophagogastrectomy will be enrolled in the study
University of Padova
Padua, Italy
Link Campus University
Roma, Italy
Giovanni Maria Garbarino
Roma, Italy
University of Verona
Verona, Italy
Amsterdam UMC location University of Amsterdam
Predictive performance of radiomics analysis on the pre-treatment CT scan.
Comparing the radiomic features of the CT scans at the time of diagnosis (T0) and at the end of the preoperative chemotherapy (T1) in order to predict the TRG with the texture analysis on the first CT scan.
Time frame: 2 months
Association of the radiomics features with the molecular expression of the tumor.
Texture analysis on the pre-chemotherapy CT scan founded that entropy and compactness were higher and uniformity lower in responders. Nonetheless the association between radiomics features and molecular expression has not been investigated yet. Therefore, we hypothesize to add some others radiomics signatures to the analysis and to find an association with the molecular expression.
Time frame: 2 months
Evaluation of the association between TRG and the molecular expression of the tumor.
Investigate if the molecular expression of the tumor can influence the TRG
Time frame: 2 months
Association between radiomics and molecular expression in regards to long-term outcomes
Analysis of the 3 and 5y DFS and OS of patients with the radiomics and molecular expression profile
Time frame: 5 years
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Amsterdam, North Holland, Netherlands