Emotional Distress and Pathologic Response in Locally Advanced Gastric/GEJ Adenocarcinoma

Inclusion criteria

• Willing to participate in this study.
• Age >18 years; both sexes are eligible.
• Histologically confirmed gastric adenocarcinoma or gastroesophageal junction adenocarcinoma.
• Resectable locally advanced disease as assessed by imaging and/or multidisciplinary team evaluation, generally corresponding to AJCC 8th edition stage II-III disease, including cT3-4a with any N category or any T with node-positive disease, without distant metastasis.
• Planned to receive neoadjuvant therapy followed by curative-intent surgery.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
• No prior systemic antitumor treatment for the current tumor at baseline.
• Able to understand and complete questionnaire assessments.
• Able and willing to provide written informed consent.

Exclusion criteria

• Presence of distant metastasis, peritoneal metastasis, or loss of curative treatment opportunity as determined by clinical evaluation.
• Prior neoadjuvant chemotherapy, immunotherapy, radiotherapy, or other systemic antitumor treatment for the current tumor.
• Severe cognitive impairment, acute psychiatric disorder, or any condition that precludes completion of questionnaire assessments.
• Current treatment with antidepressants, anxiolytics, or other psychotropic medications with any of the following within 4 weeks before baseline assessment: initiation, discontinuation, change in medication type, dose adjustment of 50% or more, or addition of a second or more psychotropic medication.
• Any other condition judged by the investigator to make the participant unsuitable for enrollment.