The impact of ‘two week’ referral guidelines on the stage of resected disease and overall survival for patients with oesophago-gastric cancer

2007 ◽  
Vol 33 (9) ◽  
pp. 1108-1108
Author(s):  
R NIJJAR ◽  
A PARNHAM ◽  
C ROBERTSON ◽  
M WADLEY
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
The Impact

scholarly journals Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 198
Author(s):  
Ji Yeon Park ◽  
Byunghyuk Yu ◽  
Ki Bum Park ◽  
Oh Kyoung Kwon ◽  
Seung Soo Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Tumor Resection ◽  
Palliative Resection ◽  
Primary Tumors ◽  
Palliative Intent ◽  
Palliative Gastrectomy ◽  
Gastric Cancer Patients ◽  
The Impact

Background and Objectives: The prognosis of metastatic or unresectable gastric cancer is dismal, and the benefits of the palliative resection of primary tumors with noncurative intent remain controversial. This study aimed to evaluate the impact of palliative gastrectomy (PG) on overall survival in gastric cancer patients. Materials and Methods: One hundred forty-eight gastric cancer patients who underwent PG or a nonresection (NR) procedure between January 2011 and 2017 were retrospectively reviewed to select and analyze clinicopathological factors that affected prognosis. Results: Fifty-five patients underwent primary tumor resection with palliative intent, and 93 underwent NR procedures owing to the presence of metastatic or unresectable disease. The PG group was younger and more female dominant. In the PG group, R1 and R2 resection were performed in two patients (3.6%) and 53 patients (96.4%), respectively. The PG group had a significantly longer median overall survival than the NR group (28.4 vs. 7.7 months, p < 0.001). Multivariate analyses revealed that the overall survival was significantly better after palliative resection (hazard ratio (HR), 0.169; 95% confidence interval (CI), 0.088–0.324; p < 0.001) in patients with American Society of Anesthesiologists Physical Status (ASA) scores ≤1 (HR, 0.506; 95% CI, 0.291–0.878; p = 0.015) and those who received postoperative chemotherapy (HR, 0.487; 95% CI, 0.296–0.799; p = 0.004). Among the patients undergoing palliative resection, the presence of <15 positive lymph nodes was the only significant predictor of better overall survival (HR, 0.329; 95% CI, 0.121–0.895; p = 0.030). Conclusions: PG might lead to the prolonged survival of certain patients with incurable gastric cancer, particularly those with less-extensive lymph-node metastasis.

Effects of prognostic nutrition index on side effects and prognosis of radiotherapy and chemotherapy after radical gastrectomy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16002-e16002
Author(s):  
Jiyu Liu ◽  
Hongmin Dong ◽  
Wenling Wang ◽  
Gang Wang ◽  
Huan Pan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Side Effects ◽  
Nutritional Support ◽  
Gastrointestinal Surgery ◽  
Prognostic Nutritional Index ◽  
Survival Prognosis ◽  
The Impact ◽  
Prognostic Nutrition Index ◽  
Support Treatment

e16002 Background: To investigate the impact of preoperative prognostic nutritional index (PNI) on the severity of radiotherapy and chemotherapy toxicity and survival prognosis in patients with gastric cancer through retrospective analysis and research in order to guide clinical nutritional support treatment for patients with gastric cancer. Methods: Through a retrospective cohort study，we analyzed the data of 191 patients with gastric cancer in the Department of Gastrointestinal Surgery of the Affiliated Hospital of Guizhou Medical University and Guizhou Cancer Hospital from January 2008 to December 2018. According to the cut-off value, the patients were divided into high PNI group (PNI≥47.7) and low PNI group (PNI < 47.7). We Compared the incidences of severe radiotherapy and chemotherapy toxicities and overall survival in high PNI group and low PNI group. and make Analysis of prognostic factors. Results: The low PNI group was more prone to severe radiochemotherapy hematological side effects than the high PNI group, and the postoperative survival time was shorter. Multivariate analysis showed that: TNM stage (P = 0.000) and PNI (P = 0.001) were Independent risk factors in predicting overall survival rate. Conclusions: The preoperative prognostic nutrition index is a useful factor for predicting the incidence of radiotherapy and chemotherapy toxicities in patients after gastric cancer surgery.It is one of the important factors affecting the prognosis of gastric cancer and helps to guide the nutritional support treatment of gastric cancer patients.

Abstract 1796: The impact of adjuvant immunochemotherapy using protein-bound polysaccharide-K on overall survival of gastric cancer

2011 ◽  
Author(s):  
Hiroaki Tanaka ◽  
Masaichi Ohira ◽  
Kazuya Muguruma ◽  
Naoshi Kubo ◽  
Hisashi Nagahara ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Adjuvant Immunochemotherapy ◽  
Polysaccharide K ◽  
The Impact

Impact of intramuscular fat accumulation on survival in stage II/III gastric cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 19-19
Author(s):  
Yuhei Waki ◽  
Rie Makuuchi ◽  
Tomoyuki Irino ◽  
Satoshi Kamiya ◽  
Yutaka Tanizawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Subcutaneous Fat ◽  
Lumbar Vertebra ◽  
Intramuscular Fat ◽  
Stage Ii ◽  
Youden Index ◽  
Fat Accumulation ◽  
The Impact

19 Background: Intramuscular fat accumulation of skeletal muscle has been reported to be a prognostic factor in various cancers. To evaluate the intramuscular steatosis, intramuscular adipose tissue content (IMAC) measured by CT scan is thought to be an ideal method. However, this kind of study is very limited in curatively resected gastric cancer. So, this study was aimed to clarify the impact of IMAC on survival in stage II/III gastric cancer (GC). Methods: A total of 383 patients with pathological stage II/III GC after curative gastrectomy between January 2009 and December 2013 were included. IMAC was calculated by dividing the CT value of the multifidus muscles with that of the subcutaneous fat at the level of third lumbar vertebra. The IMAC cut-off values associated with cancer-specific survival (CSS) were separated by sex based on the maximum values of Youden index (sensitivity + specificity -1). Patients were classified into normal or high IMAC group according to this cut-off value. Clinicopathological factors and survival outcomes were compared between the two groups. Results: The median values of IMAC were -0.327 (IQR: -0.404- -0.250) in male and -0.239 (IQR: -0.335- -0.114) in female. The cut-off values of IMAC were -0.345 in male and -0.126 in female. Patients were classified into normal IMAC group (n = 204) and high IMAC group (n = 179). Patients in the high IMAC group were elderly, male, obese, having many comorbidities and with poor ECOG-PS compared to those in the normal IMAC group. Interestingly, despite the fact that no significant differences were observed in the pathological findings between the groups, the overall survival and CSS were significantly worse in the high IMAC group than in the normal IMAC group (p < 0.001 and p = 0.035). Moreover, the high IMAC was identified as an independent prognostic factor not only for overall survival but also for CSS (HR: 1.440, p = 0.021, HR: 1.646, p = 0.008, respectively). Conclusions: The high IMAC was significantly associated with worse survival, suggesting that IMAC represents certain oncological implications in patients with GC. Therefore, IMAC could be used as a new prognostic factor in curatively resected GC.

scholarly journals Necessity of prophylactic No.10 lymph node clearance for middle and upper third gastric cancer: a network meta-analysis

2019 ◽  
Author(s):  
Gaozan Zheng ◽  
Jinqiang Liu ◽  
Yinghao Guo ◽  
Fei Wang ◽  
Shushang Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Survival Rate ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Overall Survival Rate ◽  
The Impact

Abstract Background It remains controversial whether prophylactic No.10 lymph node clearance is necessary for gastric cancer. Thus, the present study aims to investigate the impact of prophylactic No.10 lymph node clearance on the perioperative complications and prognosis of upper and middle third gastric cancer.Methods A network meta-analysis to identify both direct and indirect evidence with respect to the comparison of gastrectomy alone (G-A), gastrectomy combination with splenectomy (G+S) and gastrectomy combination with spleen-preserving splenic hilar dissection (G+SPSHD) was conducted. We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies published before September 2018. Perioperative complications and overall survival were analyzed. Hazard ratios (HR) were extracted from the publications on the basis of reported values or were extracted from survival curves by established methods.Results Ten retrospective studies involving 2565 patients were included. In the direct comparison analyses, G-A showed comparable 5-year overall survival rate (HR: 1.1, 95%CI: 0.97-1.3) but lower total complication rate (OR: 0.37, 95%CI: 0.17-0.77) compared with G+S. Similarly, the 5-year overall survival rate between G+SPSHD and G+S was comparable (HR: 1.1, 95%CI: 0.92-1.4), while the total complication rate of G+SPSHD was lower than that of G+S (OR: 0.50, 95%CI: 0.28-0.88). In the indirect comparison analyses, both the 5-year overall survival rate (HR: 1.0, 95%CI: 0.78-1.3) and total complication rate (OR: 0.75, 95%CI: 0.29-1.9) were comparable between G-A and G+SPSHD.Conclusion Prophylactic No.10 lymph node clearance was not recommended for treatment of upper and middle third gastric cancer.

Clinicopathological and prognostic significance of microsatellit instability (MSI) status and PDl-1 expression in Turkish patients with gastric cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15538-e15538
Author(s):  
Ibrahim Yildiz ◽  
Seyma Bahsi ◽  
Sibel Erdamar ◽  
Suha Goksel ◽  
Gokhan Demir ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Microsatellite Instability ◽  
Tumor Cells ◽  
Immune Cells ◽  
Prognostic Significance ◽  
Rational Approach ◽  
Preoperative Treatment ◽  
Gastric Cancer Patients ◽  
The Impact

e15538 Background: The aim of this study was to evaluate the prognostic role of microsatellite instability (MSI) status and PD-L1 expression in surgically resected gastric cancer and the relationship of these parameters with clinicopathological features. Methods: Eighty six gastric cancer patients which had curative surgical resection at Acibadem Atakent and Maslak Hospitals between 2010 and 2017 were analysed. Tumor samples were evaluated with MSI and PD-L1 antibodies by immunohistochemical (IHC) methods. PD-L1 IHC scoring was performed using the combined positive score (CPS). Survival analysis was accomplished using the Kaplan-Meier method. Cox proportional hazard regression model was used to identify independent risk factors that affect patients' overall survival. Results: The rate of PD-L1 expression in tumor cells was 34.9% (n = 30) and the frequency of PD-L1 expression in immune cells with CPS (≥1%) was 57% (n = 49). MSI-H was detected in 11.6%(n = 10), and more observed in PD-L1 positive cases (p = 0.021). MSI-H status was significantly correlated with older age, increased tumor size, presence of PD-L1 expression, and adenocarcinoma subtype. PD-L1 expression was associated with lymph node metastasis, adenocarcinoma subtype, microsatellite instability, presence of preoperative treatment and improved response to preoperative chemotherapy. In our study, the impact of MSI status on survival was not demonstrated, but PD-L1 expression positivity(≥1%) in both tumor cells (15.7 vs 53.4 months, p = 0.008)and in immune cells (20.4 vs NR; p = 0.027) was associated with short overall survival. PD -L1 expression in tumor cells was an independent prognostic factor for overall survival in multivariate analysis (HR: 2.28, p = 0.047). Conclusions: PD-L1 expression was related to a poor prognosis in patients with gastric cancer and can represent a rational approach for PD-1/PD-L pathway-targeted immunotherapy.

scholarly journals Use of serum and peritoneal CEA and CA19-9 in prediction of peritoneal dissemination and survival of gastric adenocarcinoma patients: are they prognostic factors?

2018 ◽  
Vol 100 (4) ◽  
pp. 257-266 ◽  
Author(s):  
M Hasbahceci ◽  
FU Malya ◽  
E Kunduz ◽  
M Guzel ◽  
N Unver ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Peritoneal Carcinomatosis ◽  
Gastric Adenocarcinoma ◽  
High Serum ◽  
Peritoneal Washing ◽  
Peritoneal Washing Cytology ◽  
Serum Cea ◽  
The Impact ◽  
Disease Free

Introduction To evaluate the impact of serum and peritoneal levels of tumour markers on peritoneal carcinomatosis and survival in gastric adenocarcinoma. Materials and methods Patients with gastric adenocarcinoma were evaluated with regard to serum and peritoneal carcinoembryonic antigen (CEA) and CA19-9. Numeric values and groupings based on serum and peritoneal cutoff values were used. Development of peritoneal carcinomatosis, including positive washing cytology, was regarded as main outcome. Gastric cancer outcomes as disease free and overall survival were analysed. Results There were 67 patients with a mean age of 60 ± 11 years. Positive peritoneal washing cytology was significantly associated with serum CA19-9 and high serum CA 19–9 group (P = 0.033 and P = 0.011, respectively). High peritoneal CEA was shown to be significantly associated with peritoneal carcinomatosis (P = 0.032). After a median follow up of 17 months, 48 patients (71.7%) were alive. Patients with peritoneal carcinomatosis showed significant poorer prognosis as shown by overall survival rate of 28.6%. Only serum CEA was significantly associated with lower disease free and overall survival (P = 0.002 and P = 0.001, respectively). Discussion and conclusion Serum CEA is shown to be significantly associated with poor prognosis for gastric cancer patients. Serum level of CA19-9 and high peritoneal CEA levels are significant predictors for positive peritoneal washing cytology and the development of peritoneal carcinomatosis, respectively. Therefore, the possible impact of serum and peritoneal tumor markers especially on the staging and prognosis of gastric cancer remains to be clarified by future studies.

scholarly journals Role of Postoperative Complications in Overall Survival after Radical Resection for Gastric Cancer: A Retrospective Single-Center Analysis of 1107 Patients

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1890 ◽  
Author(s):  
Christian Galata ◽  
Susanne Blank ◽  
Christel Weiss ◽  
Ulrich Ronellenfitsch ◽  
Christoph Reissfelder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Overall Survival ◽  
Postoperative Complications ◽  
Hospital Mortality ◽  
Surgical Complications ◽  
Multivariable Analysis ◽  
Radical Resection ◽  
Entire Cohort ◽  
The Impact

Background: The aim of this study was to investigate the impact of postoperative complications on overall survival (OS) after radical resection for gastric cancer. Methods: A retrospective analysis of our institutional database for surgical patients with gastroesophageal malignancies was performed. All consecutive patients who underwent R0 resection for M0 gastric cancer between October 1972 and February 2014 were included. The impact of postoperative complications on OS was evaluated in the entire cohort and in a subgroup after exclusion of 30 day and in-hospital mortality. Results: A total of 1107 patients were included. In the entire cohort, both overall complications (p < 0.001) and major surgical complications (p = 0.003) were significant risk factors for decreased OS in univariable analysis. In multivariable analysis, overall complications were an independent risk factor for decreased OS (p < 0.001). After exclusion of patients with complication-related 30 day and in-hospital mortality, neither major surgical (p = 0.832) nor overall complications (p = 0.198) were significantly associated with decreased OS. Conclusion: In this study, postoperative complications influenced OS due to complication-related early postoperative deaths. In patients successfully rescued from early postoperative complications, neither overall complications nor major surgical complications were risk factors for decreased survival.

scholarly journals Impact of Type of Postoperative Complications on Long-Term Survival of Gastric Cancer Patients: Results From a High-Volume Institution in China

2021 ◽  
Vol 11 ◽  
Author(s):  
Hua-Yang Pang ◽  
Lin-Yong Zhao ◽  
Hui Wang ◽  
Xiao-Long Chen ◽  
Kai Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Postoperative Complications ◽  
Negative Impact ◽  
Infectious Complications ◽  
Curative Gastrectomy ◽  
Term Survival ◽  
Long Term Survival ◽  
The Impact

BackgroundThis study aimed to evaluate the impact of postoperative complication and its etiology on long-term survival for gastric cancer (GC) patients with curative resection.MethodsFrom January 2009 to December 2014, a total of 1,667 GC patients who had undergone curative gastrectomy were analyzed. Patients with severe complications (SCs) (Clavien–Dindo grade III or higher complications or those causing a hospital stay of 15 days or longer) were separated into a “complication group.” Univariate and multivariate analyses were performed to reveal the relationship between postoperative complications and long-term survival. A 2:1 propensity score matching (PSM) was used to balance baseline parameters between the two groups.ResultsSCs were diagnosed in 168 (10.08%) patients, including different etiology: infectious complications (ICs) in 111 (6.66%) and non-infectious complications (NICs) in 71 (4.26%) patients. Multivariate analysis showed that presence of SCs (P=0.001) was an independent prognostic factor for overall survival, and further analysis by complication type demonstrated that the deteriorated overall survival was mainly caused by ICs (P=0.004) rather than NICs (P=0.068). After PSM, patients with SCs (p=0.002) still had a significantly decreased overall survival, and the presence of ICs (P=0.002) rather than NICs (P=0.067) showed a negative impact on long-term survival.ConclusionSerious complications, particularly of an infectious type, may have a negative impact on overall survival of GC patients. However, additional multicenter prospective studies with larger sample size are required to verify this issue.

scholarly journals Necessity of prophylactic splenic hilum lymph node clearance for middle and upper third gastric cancer: a network meta-analysis

2020 ◽  
Author(s):  
Gaozan Zheng ◽  
Jinqiang Liu ◽  
Yinghao Guo ◽  
Fei Wang ◽  
Shushang Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Survival Rate ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Overall Survival Rate ◽  
The Impact

Abstract Background It remains controversial whether prophylactic No.10 lymph node clearance is necessary for gastric cancer. Thus, the present study aims to investigate the impact of prophylactic No.10 lymph node clearance on the perioperative complications and prognosis of upper and middle third gastric cancer. Methods A network meta-analysis to identify both direct and indirect evidence with respect to the comparison of gastrectomy alone (G-A), gastrectomy combination with splenectomy (G+S) and gastrectomy combination with spleen-preserving splenic hilar dissection (G+SPSHD) was conducted. We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies published before September 2018. Perioperative complications and overall survival were analyzed. Hazard ratios (HR) were extracted from the publications on the basis of reported values or were extracted from survival curves by established methods. Results Ten retrospective studies involving 2565 patients were included. In the direct comparison analyses, G-A showed comparable 5-year overall survival rate (HR: 1.1, 95%CI: 0.97-1.3) but lower total complication rate (OR: 0.37, 95%CI: 0.17-0.77) compared with G+S. Similarly, the 5-year overall survival rate between G+SPSHD and G+S was comparable (HR: 1.1, 95%CI: 0.92-1.4), while the total complication rate of G+SPSHD was lower than that of G+S (OR: 0.50, 95%CI: 0.28-0.88). In the indirect comparison analyses, both the 5-year overall survival rate (HR: 1.0, 95%CI: 0.78-1.3) and total complication rate (OR: 0.75, 95%CI: 0.29-1.9) were comparable between G-A and G+SPSHD. Conclusion Prophylactic No.10 lymph node clearance was not recommended for treatment of upper and middle third gastric cancer.

Sign in / Sign up

Export Citation Format

Share Document