Su1873 Early Tumor Marker Response as a Predictor for Clinical Outcome in Patients With Advanced Gastric Cancer Undergoing Palliative Chemotherapy

2012 ◽  
Vol 142 (5) ◽  
pp. S-524
Author(s):  
In Rae Cho ◽  
Jun Chul Park ◽  
Ji Young Yoon ◽  
Kyung Seok Cheoi ◽  
Hyuk Lee ◽  
...  
Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5095-5095
Author(s):  
Ji Yeon Kwon ◽  
Han Jo Kim ◽  
Kyoung Ha Kim ◽  
Se-Hyung Kim ◽  
Sang-Cheol Lee ◽  
...  

Abstract Abstract 5095 Background Although it is not common to encounter patients with myelophthisic anemia arising from advanced gastric cancer, clinical features and optimal treatment are not yet to be elucidated. Prognosis for gastric cancer patients with bone marrow metastases is extremely poor. The current study was performed to evaluate clinical outcome of patients with myelophthisic anemia arising from advanced gastric cancer. Methods We retrospectively reviewed the medical records of 26 advanced gastric cancer patients with bone marrow metastases between September 1986 and February 2009 at Soonchunhyang University Hospital. Results The median age was 46 years (range 24-61 yeras). All patients had poorly differentiated adenocarcinoma, including 17 signet ring cell carcinomas. The majority of the patients showed thrombocytopenia, anemia, and elevation of lactate dehydrogenase. Sixteen patients (61.5%) were received palliative chemotherapy with a median of 4 cycles. (range, 1-13 cycles). Median survival durations after bone marrow metastases for entire patients were 37 days (95% CI, 12.5-61.5 days). The median survival times from bone marrow involvement were 11 days in the best supportive care group (range 9.5-12.5 days) and 121 days (range 94.7-147.3 days) in the palliative chemotherapy group (p <0.001). Patients died of tumor progression (11 patients, 45%), brain hemorrhage (6 patients, 25%), infection (5 patients, 21%), and DIC (1 patient, 4%). There were no chemotherapy related deaths. Conclusion It is difficult to decide whether to proceed with aggressive treatment for gastric cancer patients with bone marrow metastases because of the hematologic findings, e.g. anemia, thrombocytopenia, and DIC. However, this study suggests that palliative chemotherapy should be actively considered in patients with myelophthisic anemia arising from advanced gastric cancer. Disclosures No relevant conflicts of interest to declare.


2014 ◽  
Vol 14 (5) ◽  
pp. 418-423 ◽  
Author(s):  
F Graziano ◽  
V Catalano ◽  
P Lorenzini ◽  
E Giacomini ◽  
D Sarti ◽  
...  

Author(s):  
Masashi TAKEMURA ◽  
Harushi OSUGI ◽  
Shigeru LEE ◽  
Takayuki NISHIKAWA ◽  
Kennichirou FUKUHARA ◽  
...  

2016 ◽  
Vol 27 ◽  
pp. vii94
Author(s):  
Miyuki Kuwayama ◽  
Hisanobu Oda ◽  
Fumiyoshi Fushimi ◽  
Yudai Shinohara ◽  
Tatsuhiro Kajitani ◽  
...  

2014 ◽  
Vol 47 (4) ◽  
pp. 697-705 ◽  
Author(s):  
Jang Ho Cho ◽  
Jae Yun Lim ◽  
Ah Ran Choi ◽  
Sung Min Choi ◽  
Jong Won Kim ◽  
...  

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 83-83
Author(s):  
Chan-Young Ock ◽  
Do-Youn Oh ◽  
Tae-Yong Kim ◽  
Kyung-Hun Lee ◽  
Sae-Won Han ◽  
...  

83 Background: Weight loss during chemotherapy is a significant prognostic factor for poor survival in patients advanced gastric cancer (AGC). However, in most studies, weight loss was measured at the end of chemotherapy, limiting its clinical use. In this study, we evaluated whether weight loss during the first month of chemotherapy could predict survival outcomes in patients with AGC. Methods: We analyzed 719 patients with metastatic or recurrent AGC who were receiving palliative chemotherapy. We calculated initial body mass index (BMIi), percent weight loss after one month of chemotherapy (ΔW1m), percent weight loss after last administration of chemotherapy (ΔWend), and average weight loss per month during chemotherapy (ΔW/m). We correlated these data with overall survival (OS) by receiver operating characteristic (ROC) curves and Kaplan-Meier curves, and performed a subgroup analysis using Cox regression. Results: The probabilities of longer OS had stronger correlations with ΔW/m and ΔW1m than with ΔWend or BMIi. The optimal cutoff values of ΔW/m and ΔW1m for predicting shorter survival were 1% and 3%, respectively. A significant positive correlation between ΔW1m and ΔW/m (r2 = 0.591, p < 0.001) was observed. Patients with ΔW1m more than 3% significantly younger, had worse performance status, more diffuse-type Lauren classification, more HER2-negative pathology, a higher number of involved organs, and more peritoneal seeding at initial presentation. OS of patients with ΔW1m more than 3% were significantly shorter than patients with less weight loss (ΔW1m ≥3%: 9.7, <3%: 16.3 months, p < 0.001). Patients who recovered average weight loss per month after experiencing weight loss at the first month showed prolonged OS compared with patients who did not recovered (ΔW/m < 1%: 21.3, ≥1%: 7.8 months, p < 0.001). Subgroup analysis revealed ΔW1m accompanied poor survival irrespective of other clinical characteristics. Multivariate analysis showed weight loss at the first month of chemotherapy adversely affected OS (p= 0.038). Conclusions: Weight loss at the very first month of palliative chemotherapy could predict unfavorable survival outcomes in AGC.


2006 ◽  
Vol 24 (12) ◽  
pp. 1883-1891 ◽  
Author(s):  
Annamaria Ruzzo ◽  
Francesco Graziano ◽  
Kazuyuki Kawakami ◽  
Go Watanabe ◽  
Daniele Santini ◽  
...  

Purpose To investigate whether polymorphisms with putative influence on fluorouracil/cisplatin activity are associated with clinical outcomes of patients with advanced gastric cancer (AGC). Patients and Methods Peripheral blood samples from 175 prospectively enrolled AGC patients treated with fluorouracil/cisplatin palliative chemotherapy were used for genotyping 13 polymorphisms in nine genes (TS, MTHFR, XPD, ERCC1, XRCC1, XRCC3, GSTPI, GSTTI, GSTMI). Genotypes were correlated to response and survival. Results The overall response rate was 41%, the median progression-free survival (PFS) was 24 weeks (range, 4 to 50 weeks), and the median overall survival (OS) was 39 weeks (range, 8 to 72+ weeks). Chemoresistance and poor survival were significantly associated with TS 5′-UTR 3G-genotype (2R/3G, 3C/3G, 3G/3G) and GSTP1 105 A/A homozygous genotype. Sixty-one patients (35%) did not show any of these risk genotypes (group 0), 57 patients (32.5%) showed one of the two risk genotypes (group 1), and 57 patients (32.5%) showed both risk genotypes (group 2). Median PFS and OS in group 0 patients were 32 weeks (range, 8 to 50 weeks) and 49 weeks (range, 18 to 72+ weeks), respectively. Group 1 and group 2 patients showed significantly worse PFS (median, 26 weeks [range, 6 to 44 weeks] and 14 weeks [range, 4 to 38 weeks], respectively) and worse OS (median, 39 weeks [range, 10 to 58 weeks] and 28 weeks [range, 8 to 56 weeks]), respectively, than group 0 patients. This adverse effect was retained in multivariate analysis. Conclusion Specific polymorphisms may influence clinical outcomes of AGC patients. Selecting palliative chemotherapy on the basis of pretreatment genotyping may represent an innovative strategy that warrants prospective studies.


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