scholarly journals T stage and venous invasion are crucial prognostic factors for long-term survival of patients with remnant gastric cancer: a cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kentaro Matsuo ◽  
Sang-Woong Lee ◽  
Ryo Tanaka ◽  
Yoshiro Imai ◽  
Kotaro Honda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Venous Invasion ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Factors Associated ◽  
T Stage ◽  
History Of

Abstract Background The incidence of remnant gastric cancer (RGC) after distal gastrectomy is 1–5%. However, as the survival rate of patients with gastric cancer improves due to early detection and treatment, more patients may develop RGC. There is no consensus on the surgical and postoperative management of RGC, and the clinicopathological characteristics correlated with the long-term outcomes remain unclear. Therefore, we investigated the clinicopathological factors associated with the long-term outcomes of RGC. Methods We included 65 consecutive patients who underwent gastrectomy for RGC from January 2000 to December 2015 at the Osaka Medical and Pharmaceutical University Hospital, Japan. The Kaplan–Meier method was used to create survival curves, and differences in survival were compared between the groups (clinical factors, pathological factors, and surgical factors) using the log-rank test. Multivariate analyses using the Cox proportional hazard model were used to identify factors associated with long-term survival. Results No significant differences were noted in the survival rate based on clinical factors (age, body mass index, diabetes mellitus, hypertension, cardiovascular disease, pulmonary complications, liver disease, diet, history of alcohol drinking, and history of smoking) or the type of remnant gastrectomy. Significant differences were noted in the survival rate based on pathological factors and surgical characteristics (intraoperative blood loss, operation time, and the number of positive lymph nodes). Multivariate analysis revealed that the T stage (hazard ratio, 5.593; 95% confidence interval [CI], 1.183–26.452; p = 0.030) and venous invasion (hazard ratio, 3.351; 95% CI, 1.030–10.903; p = 0.045) were significant independent risk factors for long-term survival in patients who underwent radical resection for RGC. Conclusions T stage and venous invasion are important prognostic factors of long-term survival after remnant gastrectomy for RGC and may be keys to managing and identifying therapeutic strategies for improving prognosis in RGC.

scholarly journals T stage and venous invasion are crucial prognostic factors for long-term survival of patients with remnant gastric cancer: A cohort study

2021 ◽  
Author(s):  
Kentaro Matsuo ◽  
Sang-Woong Lee ◽  
Ryo Tanaka ◽  
Yoshiro Imai ◽  
Kotaro Honda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Venous Invasion ◽  
Remnant Gastric Cancer ◽  
Clinical Factors ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Factors Associated ◽  
T Stage

Abstract Background The incidence of remnant gastric cancer (RGC) after distal gastrectomy is 1–5%. However, as the survival rate of patients with gastric cancer improves due to early detection and treatment, more patients may develop RGC. There is no consensus on the surgical and postoperative management of RGC, and the clinicopathological characteristics correlated with the long-term outcomes remain unclear. Therefore, we have investigated the clinicopathological factors associated with the long-term outcomes of RGC. Methods We included 65 consecutive patients who underwent gastrectomy for RGC from January 2000 to December 2015 at the Osaka Medical College, Japan. The Kaplan–Meier method was used to create survival curves, and differences in survival were compared between the groups (clinical factors, pathological factors, and surgical factors) using the log-rank test. Multivariate analyses using the Cox proportional hazard model were used to identify factors associated with long-term survival. Results There were no significant differences in the survival based on clinical factors (age, body mass index, and diabetes mellitus) or the type of remnant gastrectomy. There were significant differences in the survival based on pathological factors and surgical characteristics (intraoperative blood loss and operation time). Multivariate analysis revealed that the T stage (hazard ratio, 4.70; 95% confidence interval [CI], 1.005–22.014; p = 0.049) and venous invasion (hazard ratio 3.047; 95% CI, 1.008–9.214; p = 0.048) were significant independent risk factors for long-term survival in patients who underwent radical resection for RGC. Conclusions T stage and venous invasion are important prognostic factors of long-term survival after remnant gastrectomy for RGC and may be key to managing and identifying therapeutic strategies for improving prognosis in RGC.

scholarly journals Long-Term Survival of Patients with a History of Venous Thromboembolism

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3168-3168
Author(s):  
Sylvia Elisabeth Reitter ◽  
Thomas Waldhoer ◽  
Michaela Mayerhofer ◽  
Ernst Eigenbauer ◽  
Cihan Ay ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Survival Rate ◽  
Relative Survival ◽  
Term Survival ◽  
Long Term Survival ◽  
Cumulative Survival ◽  
History Of ◽  
Austrian Population ◽  
Long Term Mortality

Abstract Abstract 3168 Background: Only limited data are available regarding long-term survival following venous thromboembolism (VTE). Objectives: In our study, we aimed to evaluate the long-term mortality rate in patients having a history of deep vein thrombosis (DVT) and/or pulmonary embolism (PE). Patients were referred to our outpatient department for thombophilia testing. We assessed long-term mortality according to the etiology of VTE (spontaneous or following a triggering event) as well as according to the site of thrombosis. In addition, we investigated the relative survival of our patients in comparison to the general Austrian population. Patients/Methods: In our analysis, we included patients with a history of VTE (at least 3 months after a VTE event), who were examined at our out-patient department for routine thrombophilia testing between September 1, 1994 and December 31, 2007. We were provided with information concerning mortality and causes of death of our patients from the Austrian Central Death Registry. The data supplied by Statistics Austria was compared with mortality rates of the general Austrian population, which were also obtained through Statistics Austria. Results: Our study covered a total of 3209 patients (mean age 46.2, range 14–89 years, 1280 men = 40%). The median time interval between the initial occurrence of VTE and study inclusion was 14 months, the median observation period was 6.6 years. During the considered time period (September 1, 1994 and December 31, 2008) a total of 169 patients (5.3%) died, 6 patients died from definite and 2 from probable PE, another 6 patients died from bleeding. The remaining patients died from cancer (34%), cardiovascular causes others than PE (27%) or other diseases (30%). The cumulative survival rate of patients was 0.97 and 0.87 after 5 and 10 years, respectively, the death rate in men was higher than that of the women and the survival of patients with idiopathic VTE was lowest in comparison to those having a triggering event. When patients were compared to the general population, the cumulative relative survival was 1.02 (95% CI 1.00–1.03). In none of the analysed subgroups a reduced cumulative relative survival rate among our patients was noted. Male patients showed a tendency for a better relative survival (1.05, 95 % CI 1.03 – 1.08), whereas that of women (1.00, 95 % CI 0.98 – 1.01) equalled that of the normal population. Duration of anticoagulation (less than 6 months in comparison to more than 18 months after first VTE) did not have an influence on the cumulative survival rates (p = 0.96). Conclusion: Our findings indicate that after the critical initial period, VTE does not seem to have an impact on long-term survival of outpatients with a history of VTE without active malignancy. This is most likely due to the currently prevailing improved diagnostic and treatment modalities of recurrent VTE, which have proved to be most effective and safe. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Long-Term Survival of Two Patients with Liver Metastases from Advanced Gastric Cancer Treated with Radiofrequency Ablation and Chemotherapy

2021 ◽  
pp. 67-72
Author(s):  
Sung Jin Oh
Keyword(s):  
Gastric Cancer ◽  
Radiofrequency Ablation ◽  
Liver Metastases ◽  
Advanced Gastric Cancer ◽  
Systemic Chemotherapy ◽  
Subtotal Gastrectomy ◽  
Hepatic Metastases ◽  
Term Survival ◽  
Long Term Survival

Liver metastasis from gastric cancer has a very poor prognosis. Herein, we present two cases of liver metastases (synchronous and metachronous) from advanced gastric cancer. In the first case, the patient underwent radical subtotal gastrectomy. Liver metastases occurred 6 months after surgery while the patient was receiving adjuvant chemotherapy, but two hepatic tumors were successfully removed by radiofrequency ablation (RFA). In the second case, liver metastases occurred 15 months after surgery for gastric cancer. The patient also received RFA for one hepatic tumor, and other suspicious metastatic tumors were treated with systemic chemotherapy. Although these case presentations are limited for the efficacy of RFA treatment with systemic chemotherapy for hepatic metastases from gastric cancer, our findings showed long-term survival (overall survival for 108 and 67 months, respectively) of the affected patients, without recurrence. Therefore, we suggest that RFA treatment with systemic chemotherapy could be an effective alternative treatment modality for hepatic metastases from gastric cancer.

scholarly journals The Anti-PD-1/PD-L1 Immunotherapy for Gastric Esophageal Cancer: A Systematic Review and Meta-Analysis and Literature Review

2021 ◽  
Vol 28 ◽  
pp. 107327482199743
Author(s):  
Ke Chen ◽  
Xiao Wang ◽  
Liu Yang ◽  
Zheling Chen
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Survival Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control

Background: Treatment options for advanced gastric esophageal cancer are quite limited. Chemotherapy is unavoidable at certain stages, and research on targeted therapies has mostly failed. The advent of immunotherapy has brought hope for the treatment of advanced gastric esophageal cancer. The aim of the study was to analyze the safety of anti-PD-1/PD-L1 immunotherapy and the long-term survival of patients who were diagnosed as gastric esophageal cancer and received anti-PD-1/PD-L1 immunotherapy. Method: Studies on anti-PD-1/PD-L1 immunotherapy of advanced gastric esophageal cancer published before February 1, 2020 were searched online. The survival (e.g. 6-month overall survival, 12-month overall survival (OS), progression-free survival (PFS), objective response rates (ORR)) and adverse effects of immunotherapy were compared to that of control therapy (physician’s choice of therapy). Results: After screening 185 studies, 4 comparative cohort studies which reported the long-term survival of patients receiving immunotherapy were included. Compared to control group, the 12-month survival (OR = 1.67, 95% CI: 1.31 to 2.12, P < 0.0001) and 18-month survival (OR = 1.98, 95% CI: 1.39 to 2.81, P = 0.0001) were significantly longer in immunotherapy group. The 3-month survival rate (OR = 1.05, 95% CI: 0.36 to 3.06, P = 0.92) and 18-month survival rate (OR = 1.44, 95% CI: 0.98 to 2.12, P = 0.07) were not significantly different between immunotherapy group and control group. The ORR were not significantly different between immunotherapy group and control group (OR = 1.54, 95% CI: 0.65 to 3.66, P = 0.01). Meta-analysis pointed out that in the PD-L1 CPS ≥10 sub group population, the immunotherapy could obviously benefit the patients in tumor response rates (OR = 3.80, 95% CI: 1.89 to 7.61, P = 0.0002). Conclusion: For the treatment of advanced gastric esophageal cancer, the therapeutic efficacy of anti-PD-1/PD-L1 immunotherapy was superior to that of chemotherapy or palliative care.

scholarly journals Impact of Comorbidities, Sarcopenia, and Nutritional Status on the Long-Term Outcomes after Endoscopic Submucosal Dissection for Early Gastric Cancer in Elderly Patients Aged ≥ 80 Years

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3598
Author(s):  
Ga Hee Kim ◽  
Kee Don Choi ◽  
Yousun Ko ◽  
Taeyong Park ◽  
Kyung Won Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Early Gastric Cancer ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Endoscopic Submucosal Dissection ◽  
Term Survival ◽  
Factors Associated ◽  
Submucosal Dissection

Background/Aim: We investigated the oncologic outcomes in elderly patients who underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) by focusing on the impact of comorbidities, sarcopenia, and nutritional status. Methods: Between 2005 and 2016, 280 patients aged ≥ 80 years with 289 EGCs underwent ESD at a tertiary care center. The short- and long-term survival outcomes were assessed. Cox regression analysis was used to identify factors associated with survival, including clinicopathologic factors and abdominal muscle area measured by computed tomography. Results: The rates of en bloc, R0, and, curative resection were 99.3%, 90.0%, and 69.2%, respectively. The rates of post-ESD bleeding and perforation rates were 2.1% and 3.1%, respectively, and no cases showed significant life-threatening adverse events. Over a median follow-up period of 70.5 months, the 3- and 5-year overall survival (OS) rates were 89.5% and 77.1%, respectively; of the114 patients who died, only four (3.5%) were due to gastric cancer. A total of 173 (61.8%) had sarcopenia, and they had lower rates of 3-year (88.4% vs. 91.4%) and 5-year (73.1% vs. 84.0%; p = 0.046) OS than did those without sarcopenia. In multivariable analyses, prognostic nutritional index (hazard ratio [HR], 0.93; 95% confidence interval [CI]: 0.90–0.98; p = 0.002) and Charlson comorbidity index (HR 1.19; 95% CI: 1.03–1.37; p = 0.018) were significant factors associated with overall survival. Conclusions: ESD was a feasible and safe therapeutic method to use in elderly patients, whose long-term survival was significantly associated with nutritional status and comorbidities. These results suggest the need for a possible extension of the curative criteria for ESD in elderly patients with EGC.

scholarly journals Impact of the Number of Dissected Lymph Nodes on Survival for Gastric Cancer after Distal Subtotal Gastrectomy

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Chang-Ming Huang ◽  
Jian-Xian Lin ◽  
Chao-Hui Zheng ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Lymph Nodes ◽  
Distal Gastrectomy ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Prognostic Impact ◽  
Term Survival

Objectives. To investigate the prognostic impact of the number of dissected lymph nodes (LNs) in gastric cancer after curative distal gastrectomy.Methods. The survival of 634 patients who underwent curative distal gastrectomy from 1995 to 2004 was retrieved. Long-term surgical outcomes and associations between the number of dissected LNs and the 5-year survival rate were investigated.Results. The number of dissected LNs was one of the most important prognostic indicators. Among patients with comparable T category, the larger the number of dissected LNs was, the better the survival would be (). The linear regression showed that a significant survival improvement based on increasing retrieved LNs for stage II, III and IV (). A cut-point analysis yields the greatest variance of survival rate difference at the levels of 15 LNs (stage I), 25 LNs (stage II) and 30 LNs (stage III).Conclusion. The number of dissected LNs is an independent prognostic factor for gastric cancer. To improve the long-term survival of patients with gastric cancer, removing at least 15 LNs for stage I, 25 LNs for stage II, and 30 LNs for stage III patients during curative distal gastrectomy is recommended.

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