do Nascimento, Catarina NetoMascarenhas-Lemos, LuísSilva, João RicardoMarques, Diogo SousaGouveia, Catarina FerreiraFaria, AnaVelho, SóniaGarrido, RitaMaio, RuiCosta, AndreiaPontes, PatríciaWen, XiaogangGullo, IreneCravo, MaríliaCarneiro, Fátima2023-05-232023-05-232022Cancers (Basel) . 2022 Dec 22;15(1):74http://hdl.handle.net/10451/57529© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).We investigated the impactof microsatellite instability (MSI) and Epstein-Barr virus (EBV) status in gastric cancer (GC), regarding response to perioperative chemotherapy (POPChT), overall survival (OS), and progression-free survival (PFS). We included 137 cases of operated GC, 51 of which were submitted to POPChT. MSI status was determined by multiplex PCR and EBV status by EBV-encoded RNA in situ hybridization. Thirty-seven (27%) cases presented as MSI-high, and seven (5.1%) were EBV+. Concerning tumor regression after POPChT, no differences were observed between the molecular subtypes, but females were more likely to respond (p = 0.062). No significant differences were found in OS or PFS between different subtypes. In multivariate analysis, age (HR 1.02, IC 95% 1.002-1.056, p = 0.033) and positive lymph nodes (HR 1.82, IC 95% 1.034-3.211, p = 0.038) were the only prognostic factors for OS. However, females with MSI-high tumors treated with POPChT demonstrated a significantly increased OS compared to females with MSS tumors (p = 0.031). In conclusion, we found a high proportion of MSI-high cases. MSI and EBV status did not influence OS or PFS either in patients submitted to POPChT or surgery alone. However, superior survival of females with MSI-high tumors suggests that sex disparities and molecular classification may influence treatment options in GC.engEpstein–Barr virusFemalesGastric cancerGenderMicrosatellite instabilityMolecular subtypeNeoadjuvant chemotherapyPerioperative chemotherapy predictorPrognosisjournal article10.3390/cancers150100742072-6694