Characteristics of interval gastric neoplasms detected within two years after negative screening endoscopy among Koreans

Abstract Background In Korea, where gastric cancer is highly prevalent, biennial endoscopy is recommended among individuals over 40. Even under regular screening, some are still diagnosed at advanced stages. We aimed to identify characteristics of interval gastric neoplasms (IGNs) with rapid progression. Results Newly-diagnosed gastric neoplasms detected in screening endoscopy between January 2004 and May 2016 were reviewed. Among them, those who had previous endoscopy within 2 years were enrolled. Endoscopic findings, family history of gastric cancer, smoking, and H. pylori status were analysed. Totally, 297 IGN cases were enrolled. Among them, 246 were endoscopically treatable IGN (ET-IGN) and 51 were endoscopically untreatable IGNs (EUT-IGN) by the expanded criteria for endoscopic submucosal dissection. Among EUT-IGNs, 78% were undifferentiated cancers (40/51) and 33% showed submucosal invasion (13/40). They were median 2.0 cm in size and more commonly located in the proximal stomach than ET-IGNs (70.6% vs. 41.9%, p < 0.001). EUT-IGN was independently related with age < 60 (OR, 2.09; 95%CI, 1.03–4.26, p = 0.042), H. pylori (OR, 2.81; 95%CI, 1.20–6.63, p = 0.018), and absent/mild gastric atrophy (OR, 2.67; 95%CI, 1.25–5.72, p = 0.011). Overall and disease-specific survival were not significantly different between the two groups, however EUT-IGN tended to have short disease-specific survival (overall survival, p = 0.143; disease-specific survival, p = 0.083). Conclusions Uniform screening endoscopy with two-year interval seems not enough for rapid-growing gastric neoplasms, such as undifferentiated cancers. They tended to develop in adults younger than 60 with H. pylori infection without severe gastric atrophy. More meticulous screening, especially for proximal lesions is warranted for adults younger than 60 with H. pylori infection before development of gastric atrophy.

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Prognostic significance of the combination of preoperative red cell distribution width and platelet distribution width in patients with gastric cancer

BMC Cancer ◽

10.1186/s12885-021-09043-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hiroaki Saito ◽

Shota Shimizu ◽

Yuji Shishido ◽

Kozo Miyatani ◽

Tomoyuki Matsunaga ◽

...

Keyword(s):

Gastric Cancer ◽

Multivariate Analysis ◽

Prognostic Significance ◽

Prognostic Indicators ◽

Red Cell ◽

Cell Distribution ◽

Disease Specific Survival ◽

Platelet Distribution Width ◽

Distribution Width ◽

Disease Specific

Abstract Background Platelet distribution width (PDW) and red cell distribution width (RDW) are readily obtainable data, and are reportedly useful as prognostic indicators in some cancers. However, their prognostic significance is unclear in gastric cancer (GC). Methods We enrolled 445 patients with histopathological diagnoses of gastric adenocarcinoma who had undergone curative surgeries. Results According to the optimal cut-off value of PDW and RDW by receiver operating characteristic (ROC) analysis, we divided patients into PDWHigh (≥ 16.75%), PDWLow (< 16.75%), RDWHigh (≥ 14.25%), and RDWLow (< 14.25%) subgroups. Overall survival (OS) was significantly worse in patients with PDWHigh than in those with PDWLow (P = 0.0015), as was disease specific survival (P = 0.043). OS was also significantly worse in patients with RDWHigh than in those with RDWLow (P < 0.0001), as was disease specific survival (P = 0.0002). Multivariate analysis for OS revealed that both PDW and RDW were independent prognostic indicators. Patients were then given PDW-RDW score by adding points for their different subgroups (1 point each for PDWHigh and RDWHigh; 0 points for PDWLow and RDWLow). OS significantly differed by PDW-RDW score (P < 0.0001), as did disease specific survival (P = 0.0005). In multivariate analysis for OS, PDW-RDW score was found to be an independent prognostic indicator. Conclusions The prognosis of GC patients can be precisely predictable by using both PDW and RDW.

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Race Influences Stage-specific Survival in Gastric Cancer

The American Surgeon ◽

10.1177/000313481508100327 ◽

2015 ◽

Vol 81 (3) ◽

pp. 259-267 ◽

Cited By ~ 15

Author(s):

J. Harrison Howard ◽

Jason M. Hiles ◽

Anna M. Leung ◽

Stacey L. Stern ◽

Anton J. Bilchik

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Surgical Treatment ◽

Lymph Nodes ◽

Gastric Adenocarcinoma ◽

Surgical Patients ◽

Disease Specific Survival ◽

Stage Number ◽

Survival Differences ◽

Disease Specific

Gastric adenocarcinoma studies show improved survival for Asians but have not reported stage-specific overall survival (OS) or disease-specific survival (DSS) by race. The Surveillance, Epidemiology and End Results database was queried for cases of gastric adenocarcinoma between 1998 and 2008. We evaluated OS and DSS by race and stage. Number of assessed lymph nodes was compared among surgical patients. Of 49,058 patients with complete staging data, 35,300 were white, 7709 were Asian, and 6049 were black. Asians had significantly better OS for all stages ( P < 0.001) and significantly better DSS for Stages I ( P < 0.0001) and II ( P = 0.0006). As compared with blacks, whites had significantly better DSS for Stages I ( P < 0.0001), II ( P = 0.0055), III ( P = 0.0165), and IV ( P < 0.0001). Among the 28,133 (57%) surgical patients, average number of evaluated lymph nodes was highest for Asians ( P < 0.0001). Among surgical patients with 15 or more nodes evaluated, DSS was worse in blacks with Stage I disease ( P < 0.05). Blacks with gastric adenocarcinoma have a worse DSS, which disappears when surgical treatment includes adequate lymphadenectomy. Race-associated survival differences for gastric adenocarcinoma might simply reflect variations in surgical staging techniques and socioeconomic factors.

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Verrucous antral gastritis in relation to Helicobacter pylori infection, nutrition, and gastric atrophy

Gastroenterology Report ◽

10.1093/gastro/goz057 ◽

2019 ◽

Vol 8 (4) ◽

pp. 293-298

Author(s):

Naoko Tsuji ◽

Yasuko Umehara ◽

Mamoru Takenaka ◽

Yasunori Minami ◽

Tomohiro Watanabe ◽

...

Keyword(s):

Helicobacter Pylori ◽

Reflux Esophagitis ◽

English Literature ◽

Indigo Carmine ◽

Gastric Atrophy ◽

Helicobacter Pylori Infection ◽

Antral Gastritis ◽

Numerous Type ◽

History Of ◽

H Pylori

Abstract Background There have been few studies in the English literature regarding verrucous gastritis (VG). The present study investigated the clinical and endoscopic features of verrucous antral gastritis, especially focusing on Helicobacter pylori infection, nutrition, and gastric atrophy. Methods We performed a retrospective study of patients who underwent routine endoscopy with indigo carmine chromoendoscopy and a comparative study was conducted between VG-positive and VG-negative groups. VG was subdivided into classical and numerous types based on the number and distribution of verrucous lesions. Demographic, clinical, and endoscopic data including body mass index (BMI), serum albumin and cholesterol, gastric atrophy, reflux oesophagitis, Barrett’s oesophagus, and H. pylori status were collected. Univariate and multivariable analyses were performed to identify factors associated with VG. Results We analysed the data of 621 patients undergoing routine endoscopy and found that VG (n = 352) was significantly associated with increased BMI (1.12 [1.05–1.18], P < 0.01), reflux esophagitis (1.96 [1.10–3.28], P < 0.01), and H. pylori negativity with or without a history of eradication (9.94 [6.00–16.47] and 6.12 [3.51–10.68], P < 0.001, respectively). Numerous-type (n = 163) VG was associated with both closed- and open-type gastric atrophy (9.9 [4.04–21.37] and 8.10 [3.41–19.24], P < 0.001, respectively). There were no statistical differences between groups regarding age, sex, total cholesterol, albumin, and bile-colored gastric juice. Conclusions Verrucous antral gastritis was related to increased BMI, reflux esophagitis, and H. pylori negativity. Numerous-type verrucous lesions were associated with gastric atrophy. These indicate that VG may be a physiological phenomenon due to high gastric acidity, mechanical overload, and vulnerability of background mucosa.

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Will Treatment of Helicobacter Pylori Infection in Childhood Alter the Risk of Developing Gastric Cancer?

Canadian Journal of Gastroenterology ◽

10.1155/2005/732369 ◽

2005 ◽

Vol 19 (7) ◽

pp. 409-411 ◽

Cited By ~ 41

Author(s):

Billy Bourke

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Precancerous Lesions ◽

Positive Family History ◽

Population Based ◽

Screening Programs ◽

History Of ◽

Different Populations ◽

H Pylori ◽

Developed Nations

Helicobacter pylori has been classified as a group 1 carcinogen for gastric cancer. It is estimated that there is between a two- and sixfold increase in the risk of developing gastric cancer among infected patients. Among different populations, the risk of H pylori-infected individuals developing gastric cancer varies greatly. However, on a worldwide scale, gastric cancer is the second most common cause of cancer-related death. Therefore, H pylori eradication could help prevent up to three to four million gastric cancer deaths per year. H pylori is usually acquired in childhood. Because infected children have not harboured the organism for long enough to have developed precancerous lesions, childhood is theoretically an attractive time for H pylori eradication and, thus, could help prevent gastric cancer later in life. However, as H pylori prevalence and the incidence of gastric cancer are falling rapidly in developed nations, widespread population screening programs aimed at the eradication of H pylori in these countries would be enormously expensive. Therefore, except in groups with a high risk for development of gastric cancer (eg, Japanese or those with a strong positive family history of gastric cancer), a population-based test-and-treat policy is not justified.

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Effectiveness of D2 gastrectomy for lymph node positive and advanced gastric cancer: Survival results of the Italian Gastric Cancer Study Group (IGCSG) randomized surgical trial on D1 versus D2 dissection for gastric carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.4027 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 4027-4027

Author(s):

Maurizio Degiuli ◽

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Survival Benefit ◽

Cancer Survival ◽

D2 Lymphadenectomy ◽

Disease Specific Survival ◽

Intention To Treat ◽

Surgical Trial ◽

Gastric Cancer Study ◽

Disease Specific

4027 Background: It is still unclear whether D2 lymphadenectomy can significantly improve survival of gastric cancer and therefore should be applied routinely or performed in selected cases. We conducted a multicenter randomized trial to compare the efficacy of D2 and D1 lymphadenectomy for gastric cancer. Primary outcome was overall survival; secondary endpoints were disease specific survival, morbidity and in-hospital mortality. Methods: Between June 1998 and December 2006 patients with gastric adenocarcinoma were randomly assigned to either D1 or D2 lymphadenectomy. Intraoperative randomization was implemented centrally by telephone. Results: A total of 267 eligible patients were allocated to either D1 (133) or D2 group (134). Morbidity (12·0% vs 17·9%, p=0·18) and mortality (3·0% vs 2·3%; p=0·72) were similar. There was no difference in the overall 5-year survival (66·5% vs 64·2%, p = 0.70). Subgroups analyses showed a 5-years disease specific survival benefit for pT1 cases treated with D1 dissection (98.0% vs 82.9%, p = 0.01) and of pT>1 LN+ patients treated with D2 resection (38·4% vs 59·5%, p = 0.05 at five years). Conclusions: In intention to treat analysis we observed no overall 5-year survival benefit from D2 resection. The trial showed a survival benefit of D1 procedure in early stages. On the opposite, despite evidence of contamination in the D1 arm, a survival advantage was documented in patients with advanced disease and lymph node metastases submitted to D2 procedure. Clinical trial information: ISRCTN11154654. [Table: see text]

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Gastric cancer prevention and early detection program for an at-risk population: A prospective study of the Korean American community.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.42 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 42-42

Author(s):

Yanghee Woo ◽

Garrick Trapp ◽

Jae Geun Hyun ◽

Chul Soo Hyun ◽

Lu Zen Katherine ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Early Detection ◽

Prospective Study ◽

Korean American ◽

Upper Endoscopy ◽

Prevention And Early Detection ◽

Gastric Cancer Prevention ◽

History Of ◽

H Pylori

42 Background: Gastric cancer development is multifactorial with varying incidence rates. People of Korean heritage have the highest rate of gastric cancer in the world and among Americans. While this gastric cancer disparity is well known, an evaluation of the population-specific risk factors and the effectiveness of selective screening in the Korean American communities have not been studied. Methods: Korean Americans living in Northern New Jersey over 40 years of age without a known history of gastric cancer were eligible to participate in this prospective study. Each participant received a 30-minute one-to-one consultation with a gastric cancer surgeon, given a 44-item questionnaire, and underwent an upper endoscopy with biopsies. The consultation included assessment for the presence of relevant history, symptoms, and signs. The questionnaire addressed patient-specific demographic, epidemiologic, and cultural information. Two gastroenterologists blinded to the consultation and questionnaire results performed the upper endoscopies. Results: Between September 2013 and September 2014, one hundred participants enrolled in our study. All participants denied the presence of alarm symptoms, such as acute weight loss, melena or persistent vomiting. Risk factors, including prior H. pylori infection (25%), family history of gastric cancer (15%), cigarette smoking (16%), and daily intake of salty and pickled foods (87%) were present. On upper endoscopy, 18% of the participants were found to have “moderate to severe H. pylori associated chronic active gastritis." Other endoscopic findings were mild gastritis (61%), severe erosive gastritis (4%), polyps (4%), and metaplasia (21%). Only 4 patients had normal mucosal pathology. Gastric dysplasia or cancer has not yet been identified. Conclusions: Korean Americans have high rates of modifiable risk factors for developing gastric cancer. Novel population-specific gastric cancer prevention and early detection strategies should be designed to eliminate gastric cancer from the Korean American Community.

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Increased risk of gastro-oesophageal cancers among married couples: Data from the Ardabil Cancer Registry (ACR) in Northwest of Iran, 2002-2016

10.21203/rs.3.rs-143888/v1 ◽

2021 ◽

Author(s):

Manouchehr Iranparvar-Alamdari ◽

Abbas Yazdanbod ◽

Nasrollah Maleki ◽

Majid Rostami-Mogaddam ◽

Farnaz Amani

Keyword(s):

Gastric Cancer ◽

Cancer Registry ◽

Oesophageal Cancer ◽

Married Couples ◽

Medical Personnel ◽

Cancer Etiology ◽

Increased Risk ◽

History Of ◽

H Pylori ◽

Shared Risk

Abstract Background: The study of cancer in spouses may play an important role in the assessment of cancer etiology. This study aims to evaluate the risk of gastro-oesophageal cancers among spouses.Methods: We performed a retrospective cohort study of the Ardabil Cancer Registry (ACR) office for patients with a diagnosis of gastro-oesophageal cancers from 2002 to 2016. Data were collected by trained medical personnel through medical records.Results: A total of 2741 participants diagnosed with gastro-oesophageal cancer were enrolled in this study: 1786 (65.2%) had gastric cancer and 955 (34.8%) had oesophageal cancer. In the 14 years of the study period, twelve couples with gastro-oesophageal cancer were identified. The mean duration at marriage among the couples was 42.5 years of age. A positive history of consanguineous marriage was found in 2 (16.7%) of the cases. Of these 12 couples with gastro-oesophageal cancer, 8 (33.3%) were located in the oesophagus, 15 (62.5%) in the stomach, and one (4.2%) at the gastro-oesophageal junction. Histologically, all gastric cancers were adenocarcinoma and were located mainly in the cardia region (66.7%). However, squamous cell carcinoma was the most common histologic type of oesophageal cancer (87.5%) and were located mainly in the middle thirds and lower thirds of the oesophagus.Conclusions: The presence of shared risk factors among married couples such as lifestyle (smoking and alcohol consumption), nutritional habits, psychological stress, and H. pylori infection, indicating that environmental factors play an important role in the development of gastric cancer.

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Appraisal of Long-time Outcomes After Curative Surgery in Elderly Patients with Gastric Cancer: A Propensity Score Matching Analysis

10.21203/rs.3.rs-75500/v1 ◽

2020 ◽

Author(s):

Tomoyuki Matunaga ◽

Ryo Ishiguro ◽

Wataru Miyauchi ◽

Yuji Shishido ◽

Kozo Miyatani ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Propensity Score ◽

Elderly Patients ◽

Propensity Score Matching ◽

Cancer Patients ◽

Stage Iii ◽

Disease Specific Survival ◽

Gastric Cancer Patients ◽

Disease Specific

Abstract Background: This study was conducted to assess the long-term outcomes of elderly patients among propensity-score-matched gastric cancer patients after curative gastrectomy and to propose the proper management of elderly gastric cancer patients.Methods: We enrolled 626 patients with gastric cancer who underwent curative gastrectomy at our institution between January 2004 and December 2015. To minimize selection bias among 2 groups, propensity score matching was performed.Results: Patients were divided into an elderly group over 75 years old (EP group; n=186) and a non-elderly group (NEP group; n=440). After propensity score matching, patients were divided into EP group (n=186) and NEP group (n=186). Five-year overall survival was significantly lower in the EP group than in the NEP group, consistent with a subgroup analysis of each stage. However, the 5-year disease-specific survival among all enrolled patients and those with stage I and II disease did not differ significantly. Moreover, in the subgroup of stage III patients, 5-year disease-specific survival was significantly lower in the EP group (23.0%) than in the NEP group (59.4%; P=0.004). Because elderly patients with stage III disease had an extremely poor prognosis, we decided to compare the two groups with stage III. The EP group contained significantly fewer patients with D2 lymphadectomy (P=0.002) and adjuvant chemotherapy (P<0.001) than the NEP group. Multivariate analysis revealed that older age and lymphatic invasion were independent prognostic factors. C-reactive protein to albumin ratio was significantly higher in patients in the EP group than in the NEP group (P=0.046), and the prognostic nutritional index was significantly lower in EP group patients than NEP group patients (P=0.045). Conclusions: Elderly gastric cancer patients with stage III disease showed poorer disease-specific survival compared with non-elderly patients, which may be due to fewer D2 lymphadenectomies, a lack of adjuvant chemotherapy, and a poorer nutritional and inflammatory background. The safe induction of standard lymphadenectomy and adjuvant chemotherapy with perioperative aggressive nutritional support may improve the prognosis of elderly gastric cancer patients with stage III disease.

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