Clinical value of SDI test for predicting effect of postoperative chemotherapy for patients with gastric cancer

PurposePatients with locally advanced gastric cancer benefit from combined pre- and postoperative chemotherapy, although fewer than 50% could receive postoperative chemotherapy. We examined the value of purely preoperative chemotherapy in a phase III trial with strict preoperative staging and surgical resection guidelines.Patients and MethodsPatients with locally advanced adenocarcinoma of the stomach or esophagogastric junction (AEG II and III) were randomly assigned to preoperative chemotherapy followed by surgery or to surgery alone. To detect with 80% power an improvement in median survival from 17 months with surgery alone to 24 months with neoadjuvant, 282 events were required.ResultsThis trial was stopped for poor accrual after 144 patients were randomly assigned (72:72); 52.8% patients had tumors located in the proximal third of the stomach, including AEG type II and III. The International Union Against Cancer R0 resection rate was 81.9% after neoadjuvant chemotherapy as compared with 66.7% with surgery alone (P = .036). The surgery-only group had more lymph node metastases than the neoadjuvant group (76.5% v 61.4%; P = .018). Postoperative complications were more frequent in the neoadjuvant arm (27.1% v 16.2%; P = .09). After a median follow-up of 4.4 years and 67 deaths, a survival benefit could not be shown (hazard ratio, 0.84; 95% CI, 0.52 to 1.35; P = .466).ConclusionThis trial showed a significantly increased R0 resection rate but failed to demonstrate a survival benefit. Possible explanations are low statistical power, a high rate of proximal gastric cancer including AEG and/or a better outcome than expected after radical surgery alone due to the high quality of surgery with resections of regional lymph nodes outside the perigastic area (celiac trunc, hepatic ligament, lymph node at a. lienalis; D2).

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Gallbladder perforation: a rare complication of postoperative chemotherapy of gastric cancer

World Journal of Surgical Oncology ◽

10.1186/s12957-015-0659-6 ◽

2015 ◽

Vol 13 (1) ◽

Cited By ~ 3

Author(s):

Yanlai Sun ◽

Wentao Song ◽

Qingsheng Hou ◽

Jianning Li ◽

Hongliang Guo

Keyword(s):

Gastric Cancer ◽

Rare Complication ◽

Postoperative Chemotherapy ◽

Gallbladder Perforation

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Clinical Value of Energy Spectrum Curves of Dual-energy CT in Evaluating Pathological Grading of Gastric Adenocarcinoma

10.21203/rs.2.12786/v1 ◽

2019 ◽

Author(s):

Zhihua Lu ◽

Suying Wu ◽

Jianwei Chen ◽

Chuan Yan ◽

Yueming Li

Keyword(s):

Gastric Cancer ◽

Energy Spectrum ◽

Gastric Adenocarcinoma ◽

Dual Energy ◽

Dual Energy Ct ◽

Clinical Value ◽

Pathological Differentiation ◽

Dual Source ◽

Venous Phase ◽

Poorly Differentiated

Abstract Backgroud: Accurate diagnosis of cancer staging and pathological differentiation are critical for the formulation of individualized treatment and prognosis of gastric cancer. It is vital to explore non-invasive preoperative imaging techniques to evaluate the pathological differentiation degree of gastric cancer tissues, and provide better diagnostic basis and decision-making reference for treatment. The purpose of this study was to explore the clinical value of energy spectrum curves of dual-source dual-energy CT in the quantitative evaluation of different pathological grades of gastric adenocarcinoma. Methods: A total of 62 patients with 1 well, 25 moderately and 36 poorly differentiated gastric adenocarcinomas pathologically confirmed by surgery were collected, and they underwent dual-source dual-energy CT plain scanning and enhanced scanning before operation. Dual-Energy software was used to measure the slope of the energy spectrum curves (λ) in arterial and venous phases after image reconstruction. Patients were divided into two groups according to the pathological results, including well and moderately differentiated gastric adenocarcinoma group and poorly differentiated gastric adenocarcinoma group. Data of each group were analyzed by independent sample t-test. The receiver operating characteristic curve was plotted to evaluate the diagnostic efficiency of the corresponding parameters. Results: There were significant differences in λ values of 40-50keV, 40-60keV, 40-80keV, 40-90keV, 40-100keV, 40-120keV, 40-130keV, 40-140keV and 40-150keV energy ranges in venous phase between the well and moderately differentiated group and poorly differentiated group (P<0.05), but no significant differences in λ values of different energy ranges in arterial phase between the two groups (P>0.05). And the area under curve in 40-120keV energy range was the largest in venous phase. K40-120keV =2.69 was selected as the diagnostic threshold with the maximum Youden index, the sensitivity and specificity were 61.1% and 76%, respectively. Conclusion: The energy spectrum curve of dual-energy CT had certain diagnostic value in the quantitative evaluation of pathological grading of gastric adenocarcinoma.

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Identifying Novel Cell Glycolysis-Related Gene Signature Predictive of Overall Survival in Gastric Cancer

BioMed Research International ◽

10.1155/2021/9656947 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Xin Zhao ◽

Jiaxuan Zou ◽

Ziwei Wang ◽

Ge Li ◽

Yi Lei

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

High Risk ◽

Risk Score ◽

Malignant Tumors ◽

Single Gene ◽

Univariate Analysis ◽

The Cancer Genome Atlas ◽

Clinical Value ◽

Specificity And Sensitivity

Background. Gastric cancer (GC) is believed to be one of the most common digestive tract malignant tumors. The prognosis of GC remains poor due to its high malignancy, high incidence of metastasis and relapse, and lack of effective treatment. The constant progress in bioinformatics and molecular biology techniques has given rise to the discovery of biomarkers with clinical value to predict the GC patients’ prognosis. However, the use of a single gene biomarker can hardly achieve the satisfactory specificity and sensitivity. Therefore, it is urgent to identify novel genetic markers to forecast the prognosis of patients with GC. Materials and Methods. In our research, data mining was applied to perform expression profile analysis of mRNAs in the 443 GC patients from The Cancer Genome Atlas (TCGA) cohort. Genes associated with the overall survival (OS) of GC were identified using univariate analysis. The prognostic predictive value of the risk factors was determined using the Kaplan-Meier survival analysis and multivariate analysis. The risk scoring system was built in TCGA dataset and validated in an independent Gene Expression Omnibus (GEO) dataset comprising 300 GC patients. Based on the median of the risk score, GC patients were grouped into high-risk and low-risk groups. Results. We identified four genes (GMPPA, GPC3, NUP50, and VCAN) that were significantly correlated with GC patients’ OS. The high-risk group showed poor prognosis, indicating that the risk score was an effective predictor for the prognosis of GC patients. Conclusion. The signature consisting of four glycolysis-related genes could be used to forecast the GC patients’ prognosis.

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Clinical value of multidetector row computed tomography in detecting lymph node metastasis of early gastric cancer

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2005.03.005 ◽

2005 ◽

Vol 31 (7) ◽

pp. 743-748 ◽

Cited By ~ 25

Author(s):

T. Shinohara ◽

S. Ohyama ◽

T. Yamaguchi ◽

T. Muto ◽

A. Kohno ◽

...

Keyword(s):

Gastric Cancer ◽

Computed Tomography ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Early Gastric Cancer ◽

Multidetector Row Computed Tomography ◽

Clinical Value ◽

Multidetector Row ◽

Node Metastasis

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Effect of Preoperative CT Angiography Examination on the Clinical Outcome of Patients With BMI≥25.0kg/m2 Undergoing Laparoscopic Gastrectomy: Study Protocol for a Multicenter Randomized Controlled Trial

10.21203/rs.3.rs-470896/v1 ◽

2021 ◽

Author(s):

Cheng Meng ◽

Shougen Cao ◽

Xiaodong Liu ◽

Leping Li ◽

Qingsi He ◽

...

Keyword(s):

Gastric Cancer ◽

Clinical Outcome ◽

Ct Angiography ◽

Laparoscopic Gastrectomy ◽

Financial Burden ◽

Controlled Trial ◽

Second Primary ◽

Clinical Value ◽

Multicenter Randomized Controlled Trial ◽

Hospitalization Costs

Abstract Background Gastric cancer, which ranks the fifth most common malignant and causes the third oncological death, especially in east Asian countries, such as China, Japan and Korea, is still a serious global healthy issue that caused heavy financial burden for the government and family. To our knowledge, there is seldom reports of multicenter randomized control trial on the utilization of CT angiography (CTA)for the patients who are diagnosed histological gastric cancer before surgery. Therefore, we conduct this RCT to verify whether the utilization of CTA can possibly change the short- and long-term clinical outcome or not. Method: The GISSG 20 − 01 study is a multicenter, prospective, open-lable clinical study that emphasis on the application of the CTA for the patients who will undergo the laparoscopic gastrectomy to prove the clinical outcome of it. 382 patients that meet the inclusion criteria and not in accordance with exclusion criteria will be recruited in the study and randomly divided into two groups with a 1:1 ratio: CTA group(n = 191) and Non-CTA group (n = 191). Apart from both of the two groups receive the examination of upper abdomen enhanced CT, the CTA group receive the examination of CT angiography. The primary endpoint of this trial is the volume of blood loss, the second primary endpoints are retrieved number of lymph nodes, postoperative recovery course, hospitalization costs, length of hospitalization days, postoperative complications, 3 years OS and 3 years DFS. Discussion It is anticipated that the result of this trial can provide high-level evidence and have clinical value on the application of CTA in laparoscopic gastrectomy. Trial registration: ClinicalTrials.gov, NCT04636099, Registered November 19, 2020

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The functional role of oncogenic lncRNA BCAR4 for cancer outcome

Current Pharmaceutical Design ◽

10.2174/1381612827666210604114955 ◽

2021 ◽

Vol 27 ◽

Author(s):

Bei Wang ◽

Wen Xu ◽

Yuxuan Cai ◽

Kai Liu ◽

Jiacheng Wu ◽

...

Keyword(s):

Breast Cancer ◽

Gastric Cancer ◽

Molecular Mechanisms ◽

Clinical Value ◽

Non Coding Rna ◽

Entry Points ◽

Multiple Processes ◽

Cancer Outcome ◽

Long Non Coding Rna

Background: Long non-coding RNA (lncRNA) breast cancer anti-estrogen resistance 4 (BCAR4) is a characterized oncogenic lncRNA in different cancers. This review is dedicated to summarize various molecular mechanisms of BCAR4 and demonstrate that the biological functions exerted by BCAR4 are good entry points for therapy. Methods: The molecular mechanism of BCAR4 acting on tumors is summarized by reviewing PubMed. Results: The expression of lncRNA BCAR4 is abnormally increased in all kinds of tumors, including colorectal cancer, prostate cancer, bladder cancer, gastric cancer, chondrosarcoma, glioma, breast cancer, glioma, gastric cancer, liver cancer, cervical cancer, lung cancer, etc. Besides, BCAR4 mediates multiple processes involved in carcinogenesis, including proliferation, invasion, anti-apoptosis, migration. Conclusion: BCAR4 may show great clinical value in this direction as a therapeutic cancer target.

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Efficacy of Postoperative FOLFOX Versus XELOX Chemotherapy for Gastric Cancer and Prognostic Value of Platelet–Lymphocyte Ratio in Patients Receiving XELOX

Frontiers in Oncology ◽

10.3389/fonc.2020.584772 ◽

2020 ◽

Vol 10 ◽

Author(s):

Xin Yin ◽

Tianyi Fang ◽

Yimin Wang ◽

Chunfeng Li ◽

Yufei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Tumor Size ◽

Prognostic Value ◽

Cox Regression ◽

Postoperative Chemotherapy ◽

Chinese Patients ◽

Cox Regression Analysis ◽

Lymphocyte Ratio ◽

Platelet Lymphocyte Ratio ◽

Ptnm Stage

BackgroundSurgery combined with postoperative chemotherapy is an effective method for treating patients with gastric cancer (GC) in Asia. The important roles of systemic inflammatory response in chemotherapy have been gradually verified. The purpose of this study was to assess the difference in clinical effectiveness of FOLFOX (oxaliplatin + leucovorin + 5-fluorouracil) and XELOX (oxaliplatin + capecitabine), and the prognostic value of postoperative platelet–lymphocyte ratio (PLR) in the XELOX group.MethodsPatients who received radical gastrectomy combined with postoperative chemotherapy between 2004 and 2014 were consecutively selected into the FOLFOX and XELOX groups. Group bias was reduced through propensity score matching, which resulted in 278 patients in each group. Cut-off values of systemic immune inflammation (SII) score and PLR were obtained by receiver operating characteristic curve. Kaplan–Meier and Log-rank tests were used to analyze overall survival. The chi-square test was used to analyze the association between clinical characteristics and inflammatory indexes. Univariate and multivariate analyses based on Cox regression analysis showed independent risk factors for prognosis. The nomogram was made by R studio.ResultsPatients receiving XELOX postoperative chemotherapy had better survival than those receiving FOLFOX (P < 0.001), especially for stage III GC (P = 0.002). Preoperative SII was an independent risk factor for prognosis in the FOLFOX group, and PLR of the second postoperative chemotherapy regimen in the XELOX group, combined with tumor size and pTNM stage, could construct a nomogram for evaluating recurrence and prognosis.ConclusionXELOX is better than FOLFOX for treatment of GC in Chinese patients, and a nomogram constructed by PLR, tumor size and pTNM stage can predict recurrence and prognosis.

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