Incidence of and Risk Factors for Tuberculosis (TB) in Gastric Cancer Patients in an Area Endemic for TB

39 Background: In patients with stage 1 gastric cancer, surgical resection without neoadjuvant therapy is offered as the first line treatment. However, some of these patients are found to have higher stage after resection and miss the opportunity for neoadjuvant therapy. Preoperative patient and tumor characteristics may be predictive of the likelihood of pathological upstaging in stage 1 gastric cancer patients who have not received neo-adjuvant therapy. Methods: The National Cancer Database was queried for patients diagnosed from 2004-2015 with clinical stage 1 gastric adenocarcinoma who had undergone surgical resection without neoadjuvant therapy. Univariate analysis and multivariable logistic regression were conducted to determine pre-operative factors associated with pathological upstaging. Candidate variables examined included age, sex, race, tumor size, histology, grade, tumor location, days to surgery, and lymphovascular invasion. Results: Analysis was conducted on 8,015 clinical stage 1 patients. Overall 1,981 (25%) patients were upstaged. On multivariable logistic regression analysis, significant predictors of upstaging included increasing tumor size [ref : size < 1 cm, 1-2 cm aOR=3.8 (95% CI 2.3-6.1); 2-4 cm aOR=12.4 (7.9-19.5); > = 4cm aOR=25.9 (22.9-56.4)], younger age [ref: > = 75, < 50 aOR=1.7 (1.4-2.1), 50-65 aOR=1.4 (1.2-1.6), 65-75 aOR=1.2 (1.1-1.5)], male gender [aOR=1.16 (1.0-1.3)], presence of diffuse type gastric cancer [aOR=2.3 (1.7-3.2)], mucinous type [aOR=1.7 (1.1-2.5)], or signet ring cell histology [aOR=1.6 (1.3-2.0)] compared to intestinal histology, presence of lymphovascular invasion [aOR=6.0 (5.0-7.1)], and increasing grade [ref: grade 1, grade 2 aOR=2.30 (1.7-3.5); grade 3 aOR=4.9 (3.6- 6.7)]. Conclusions: A quarter of all patients thought to have stage 1 gastric cancer prior to surgery had higher pathologic stage at time of resection. Patients with the above risk factors may be understaged with currently available diagnostic tools. The addition of neoadjuvant therapy should be considered when the above risk factors are present in clinical stage 1 patients.

Download Full-text

Risk factors for peritoneal recurrence in stage II/III gastric cancer patients who received S-1 adjuvant chemotherapy after D2 gastrectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.4_suppl.51 ◽

2013 ◽

Vol 31 (4_suppl) ◽

pp. 51-51

Author(s):

Toru Aoyama ◽

Takaki Yoshikawa ◽

Junya Shirai ◽

Hirohito Fujikawa ◽

Tsutomu Hayashi ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Adjuvant Chemotherapy ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Peritoneal Recurrence ◽

Tumor Diameter ◽

Node Metastasis ◽

Gastric Cancer Patients

51 Background: Peritoneum is still the most frequent site of the recurrence in stage II/III gastric cancer patients although the survival was improved by S-1 adjuvant chemotherapy. The objective of this retrospective study was to clarify the risk factors of peritoneal recurrence in patients who received S-1 adjuvant chemotherapy. Methods: Peritoneal recurrence free survival (P-RFS) was examined in 100 gastric cancer patients who underwent curative D2 surgery, were diagnosed with stage II or III pathologically, and received adjuvant S-1 between June of 2002 and March of 2011. Uni- and multi- variate analyses were performed to identify risk factors by Cox’s proportional hazard analyses. Results: P-RFS was 64.3% at 3 years and 58.8% at 5 years. A total of 18 patients were diagnosed with peritoneal recurrence. Macroscopic tumor diameter, depth of tumor invasion, and lymph node metastasis were the significant factors by univariate analysis, while tumor diameter and lymph node metastasis were the only significant independent risk factors by multivariate analysis. Conclusions: The macroscopic tumor diameter and lymph node metastasis were the most important risk factors for P-RFS. When patients had these risk factors, S-1 was not sufficient to inhibit peritoneal recurrence. When developing a novel adjuvant chemotherapy targeting peritoneal metastasis in the future, clinical trials should be limited to these patients.

Download Full-text

A simple model established by blood markers predicting overall survival after radical resection of gastric cancer

10.21203/rs.2.17763/v1 ◽

2019 ◽

Author(s):

Li-xiang Zhang ◽

Zhi-jian Wei ◽

Wen-xiu Han ◽

A-Man Xu

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Cancer Patients ◽

Characteristic Curve ◽

Training Group ◽

Radical Resection ◽

Receiver Operator Characteristic Curve ◽

Clinical Indicators ◽

Score System ◽

Gastric Cancer Patients

Abstract The prognostic prediction after radical resection of gastric cancer patients has not been well established. We aimed to establish a prognostic model based on a new score system, which included another clinical routine serum marker. Methods 904 patients who underwent surgery at the First Affiliated Hospital of Anhui Medical University from January 2010 to January 2011 were included. Univariate and multivariate analyses were used to screen for prognostic risk factors. The construction of the nomogram is based on the Cox proportional hazard regression model. The construction of the new scoring model is analyzed by the receiver operator characteristic curve (ROC curve) and then compared with other clinical indicators. Results Multivariate analysis showed that TNM stage, CEA, SII and age were independent prognostic factors. The new score system had a higher AUC value than other risk factors, and the C-index of the nomogram was highly consistent for evaluating survival of gastric cancer patients in The validation groups and training group. Conclusions Based on the serum markers and other clinical indicators, we developed a precise model to predict the prognosis of gastric cancer patients after radical surgery. This score system can provide effective help for surgeons and patients.

Download Full-text

Risk evaluation of splenic hilar or splenic artery lymph node metastasis and survival analysis for patients with proximal gastric cancer after curative gastrectomy: a retrospective study

BMC Cancer ◽

10.1186/s12885-019-6112-4 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Peng Ding ◽

Ziming Gao ◽

Chen Zheng ◽

Junqing Chen ◽

Kai Li ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Lymph Node Metastases ◽

Splenic Artery ◽

Proximal Gastric Cancer ◽

Curative Gastrectomy ◽

Node Metastases ◽

Gastric Cancer Patients

Abstract Background As splenectomy and spleen-preserving lymphadenectomy are performed only in some proximal gastric cancer patients, it is difficult to identify patients who have undergone radical gastrectomy with or without splenic hilar (No.10) or splenic artery (No.11) lymph node metastases. We aimed to determine the risk factors for No.10 and No.11 lymph node metastases and evaluate the survival significance of No.10 and No.11 lymph node dissection in advanced proximal gastric cancer patients. Methods A total of 873 advanced proximal gastric cancer patients who underwent curative gastrectomy with or without splenectomy or pancreaticosplenectomy were analyzed retrospectively. The clinicopathological characteristics of 152 patients who underwent splenectomy or pancreaticosplenectomy were analyzed to determine the risk factors for No.10 and No.11 lymph node metastases. The survival difference between patients with No.10 and No.11 lymph node dissections and those who did not undergo these dissections were compared. Results Patients with No.10 and No.11 lymph node metastases had very poor prognoses. Tumor invasion of the greater curvature and No.2 and No.4 lymph node metastases were independent risk factors for No.10 and No.11 lymph node metastases. No survival differences were evident between patients with No.10 and No.11 lymph node metastases who underwent No.10 and No.11 lymph node dissections and those who did not undergo these dissections but were at high risks of No.10 and No.11 lymph node metastases. Conclusions Splenic hilar or splenic artery lymph node dissection was not associated with increased survival, in proximal gastric cancer patients without direct cancer invasion of the spleen and pancreas, regardless of whether splenectomy, pancreaticosplenectomy, or spleen-preserving lymphadenectomy was performed.

Download Full-text

The irreversible HCV-associated risk of gastric cancer following interferon-based therapy: a joint study of hospital-based cases and nationwide population-based cohorts

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284819855732 ◽

2019 ◽

Vol 12 ◽

pp. 175628481985573 ◽

Cited By ~ 2

Author(s):

Chun-Wei Chen ◽

Jur-Shan Cheng ◽

Tai-Di Chen ◽

Puo-Hsien Le ◽

Hsin-Ping Ku ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Cancer Risk ◽

Cancer Patients ◽

Population Based ◽

Hcv Infection ◽

Research Database ◽

Gastric Cancer Risk ◽

Male Sex ◽

Gastric Cancer Patients

Background: Hepatitis C virus (HCV) infection causes many extrahepatic malignancies; whether it increases gastric cancer risk and the risk reverses after anti-HCV therapy remain elusive. Method: A nationwide population-based cohort study of Taiwan National Health Insurance Research Database (TNHIRD) was conducted. In parallel, the risk factors and HCV-core-protein expressions were surveyed in gastric cancer patients from a tertiary care center. Results: From 2003 to 2012, of 11,712,928 patients, three 1:4:4, propensity-score-matched TNHIRD cohorts including HCV-treated (7545 patients with interferon-based therapy ⩾ 6 months), HCV-untreated ( n = 30,180), and HCV-uninfected cohorts ( n = 30,180) were enrolled. The cumulative incidences of gastric cancer [HCV-treated: 0.452%; 95% confidence interval (CI): 0.149–1.136%; HCV-untreated: 0.472%; 95% CI: 0.274–0.776%; HCV-uninfected: 0.146%; 95% CI 0.071–0.280%] were lowest in HCV-uninfected cohort ( p = 0.0028), but indifferent between treated and untreated cohorts. HCV infection [hazards ratio (HR): 2.364; 95% CI: 1.337–4.181], male sex (HR: 1.823; 95% CI: 1.09–3.05) and age ⩾ 49 years (HR: 3.066; 95% CI: 1.56–6.026) were associated with incident gastric cancers. Among 887 (males: 68.4%; mean age: 66.5 ± 12.9 years, 2008–2018) hospitalized gastric cancer patients, HCV Ab-positive rate was 7.8%. None of the investigated factors exhibited different rates between HCV Ab-positive and Ab-negative patients. No HCV-core-positive cells were demonstrated in gastric cancer tissues. Conclusions: HCV infection, male sex and old age were risk factors for gastric cancer development. HCV-associated gastric cancer risk might be neither reversed by interferon-based therapy, nor associated with in situ HCV-core-related carcinogenesis.

Download Full-text