Survival analysis of a prospective multicenter observational study on surgical palliation among patients with malignant bowel obstruction caused by peritoneal dissemination of gastric cancer

2021 ◽  
Author(s):  
Ryohei Kawabata ◽  
Kazumasa Fujitani ◽  
Kentaro Sakamaki ◽  
Masahiko Ando ◽  
Yuichi Ito ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Analysis ◽  
Observational Study ◽  
Bowel Obstruction ◽  
Peritoneal Dissemination ◽  
Malignant Bowel Obstruction ◽  
Multicenter Observational Study ◽  
Surgical Palliation ◽  
Prospective Multicenter Observational Study

scholarly journals A Prospective Multicenter Observational Study of Venous Thromboembolism after Gastric Cancer Surgery (SHISA-1601)

2021 ◽  
pp. 1-10
Author(s):  
Sachiko Kaida ◽  
Toru Miyake ◽  
Satoshi Murata ◽  
Tsuyoshi Yamaguchi ◽  
Takeshi Tatsuta ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Venous Thromboembolism ◽  
Blood Transfusion ◽  
Observational Study ◽  
Characteristic Curve ◽  
Cancer Surgery ◽  
Gastric Cancer Surgery ◽  
Multicenter Observational Study ◽  
Prospective Multicenter Observational Study ◽  
D Dimer

Introduction: This study aimed to clarify the frequency and risk factors of intercurrent venous thromboembolism (VTE) in patients undergoing major curative gastric cancer surgery. Methods: This prospective, multicenter, observational study included patients with gastric cancer who underwent radical gastrectomy at 5 hospitals between June 2016 and May 2018. Patients who were preoperatively administered anticoagulants were excluded. Results: A total of 126 patients were eligible to participate. VTE occurred within 9 days postoperatively in 5 cases (4.0%; 2 symptomatic and 3 asymptomatic). Postoperative day (POD) 1 plasma D-dimer and soluble fibrin (SF) levels were significantly higher in the VTE group than in the non-VTE group. Receiver-operating characteristic curve (ROC) analysis indicated a statistically significant ability of POD 1 D-dimer and SF levels to predict postoperative VTE development after gastrectomy; this finding was reflected by an area under the curve (AUC) of 0.97 (95% CI 0.92–1.0) and 0.87 (95% CI 0.74–1.0), respectively. Cutoff values of D-dimer (24.6 µg/mL) and SF (64.1 µg/mL) were determined. Intraoperative blood transfusion (odds ratio [OR] 7.86), POD 1 D-dimer ≥24.6 µg/mL (OR 17.35), and POD 1 SF ≥64.1 µg/mL (OR 19.5) were independent predictive factors for postoperative VTE (p < 0.05). Conclusion: VTE occurred in 4.0% patients (1.6% symptomatic and 2.4% asymptomatic) after gastric cancer surgery; however, with an early diagnosis and anticoagulant therapy, no patients experienced progression. Careful observation of patients with a high risk for VTE, including intraoperative blood transfusion and high POD 1 D-dimer or SF levels, would contribute to the early detection of VTE.

scholarly journals Metronomic chemotherapy with 5-fluorouracil and cisplatin for inoperable malignant bowel obstruction because of peritoneal dissemination from gastric cancer

2016 ◽  
Vol 23 (3) ◽  
pp. 248 ◽  
Author(s):  
S. Yang ◽  
S. Li ◽  
H. Yu ◽  
S. Li ◽  
W. Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Bowel Obstruction ◽  
Combination Chemotherapy ◽  
Peritoneal Dissemination ◽  
Symptom Control ◽  
Metronomic Chemotherapy ◽  
Medical Problem ◽  
Malignant Bowel Obstruction ◽  
Full Diet

Background Gastric cancer is the 2nd leading cause of cancer death worldwide. Malignant bowel obstruction (MBO) is a common complication in advanced gastric cancer because of peritoneal dissemination. A multicentre prospective study reported that patients with peritoneal dissemination of gastric origin survive for a median of 3.1 months. The aim of the present study was therefore to evaluate the efficacy and safety of metronomic combination chemotherapy with 5-fluorouracil and cisplatin in inoperable MBO from peritoneal dissemination in gastric cancer.Methods Gastric cancer patients diagnosed with inoperable MBO because of peritoneal dissemination were treated with infusional 5-fluorouracil 300 mg/m2 daily on days 1–5 and 8–12, and cisplatin 5 mg/m2 daily on days 1–4 and 8–11 every 3 weeks. The primary endpoint was symptom control (remission of obstruction); the secondary endpoint was symptom control time and survival; the tertiary endpoint was adverse effects.Results Between January 2013 and December 2014, 26 patients received the study treatment. Before treatment, 18 patients (69.2%) were nil per os, and 8 (30.8%) could consume liquids. After a mean of 3.3 cycles of the study treatment, just 4 patients (15.4%) was still nil per os. Of the remaining 22 patients, 3 (11.5%) could consume liquids, 7 (26.9%) could consume soft solids, and 12 (46.2%) ate a full diet. The improved ability to eat was statistically significant (p < 0.0001). Median duration of remission from MBO was 105 days. Median survival was 182 days. The 3-month survival rate was 69.2%, and the 6-month survival rate was 53.8%. Treatment was well tolerated, with grade iii toxicities consisting of thrombocytopenia in 1 patient (3.84%) and mucositis in 2 patients (7.7%). No abnormalities in serum creatinine were observed.Conclusions Metronomic combination chemotherapy with 5-fluorouracil and cisplatin is well tolerated and shows activity in inoperable MBO because of peritoneal dissemination in gastric cancer. Metronomic combination chemotherapy with 5-fluorouracil and cisplatin provides a rationale for exploring this medical problem in the future.

scholarly journals Serum levels of ANOS1 serve as a diagnostic biomarker of gastric cancer: a prospective multicenter observational study

2019 ◽  
Vol 23 (2) ◽  
pp. 203-211 ◽  
Author(s):  
Mitsuro Kanda ◽  
Yun-Suhk Suh ◽  
Do Joong Park ◽  
Chie Tanaka ◽  
Sang-Hoon Ahn ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Observational Study ◽  
Serum Levels ◽  
Diagnostic Biomarker ◽  
Multicenter Observational Study ◽  
Prospective Multicenter Observational Study
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