Observational transversal study to relate functional status and age with the doublet or triplet chemotherapy based on capecitabine in advanced gastric cancer patients.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 59-59 ◽  
Author(s):  
B. Martinez Amores ◽  
M. Alsina ◽  
E. Jiménez ◽  
M. Jorge ◽  
J. Martin Valades ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Cross Sectional ◽  
Exact Test ◽  
Triplet Chemotherapy ◽  
Ecog Ps ◽  
Triplet Regimen

59 Background: The available evidence suggests that selection of treatment for advanced gastric cancer (AGC) correlates with age and ECOG PS. This study was conducted to analyze whether previously mentioned variables are relevant for the choice of doublet or triplet regimens with capecitabine and determining prognosis. Methods: Multicenter, cross-sectional, observational study in patients with AGC who received at least 2-cycles of capecitabine-based doublet or triplet chemotherapy, with or without measurable disease. The age, as a continuous and categorical (> 64 vs ≤ 64) variable, and ECOG PS were analyzed by logistic regression. Results: A total of 175 patients were evaluated. Median age 65.5 (56-72) years, male: 68% ECOG 0/1/2: 32.7%/55.6%/11.1%. 33% underwent doublet and 67% triplet chemotherapy. Tumour histology: signet-ring cell carcinoma (29%), papillary (13%), mucinous (12%) and tubular (3.5%). Most common sites of metastases: lymph nodes (48%), peritoneum (41%), liver (38%) and lung (12%). Multivariante analysis demonstrated that age ≤ 64 (OR 2.326; p = 0.016) and ECOG 0 (vs 2) (OR 3.937; p = 0.016) were risk factors for the choice of triplet chemotherapy, and failed to show an association between ECOG 1 and regimen. While in patients underwent triplet regimen 51% were aged ≤ 64 and 49% > 64, in those treated with doublet these rates were 32% and 68% respectively; (p = 0.016, Chi-square test). A statistical difference was found for ECOG 0/1/2/4 and regimen chosen. Concretely, among patients who received triplet regimen, 15% had ECOG 2 and 85% ECOG 0 while in case of doublet regimen these rates changed to 43 and 57%; (p = 0.01, Fisher's exact test). Main grade 1/2 capecitabine-related toxicities: diarrhea (10%), mucositis (7%), hand-foot syndrome (5%) and emesis (4%). Most frequent grade 3 were diarrhea in 5% and emesis, asthenia and febrile neutropenia in 2%. No toxicity grade 4 occurred. Conclusions: Age ≤ 64 years and ECOG 0 are risk factors of choice of capecitabine-based triplet chemotherapy in AGC. These results support previous reports showing that age and ECOG PS are associated with treatment choices for AGC. No significant financial relationships to disclose.

Risk Factors for Lymph Node Metastasis in Early Gastric Cancer with Signet Ring Cell Carcinoma

2015 ◽  
Vol 19 (11) ◽  
pp. 1958-1965 ◽  
Author(s):  
Chun Guang Guo ◽  
Dong Bing Zhao ◽  
Qian Liu ◽  
Zhi Xiang Zhou ◽  
Ping Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Node Metastasis ◽  
Signet Ring ◽  
Ring Cell

scholarly journals Adenocarcinoma with mixed subtypes in the early and advanced gastric cancer.

2021 ◽  
Author(s):  
Xixian Zhao ◽  
Yizhang Li ◽  
Zhenwei Yang ◽  
Hailin Zhang ◽  
Hongling Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Validation Cohort ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Training Cohort ◽  
Clinical Benefits ◽  
Similar Survival

Abstract Background Based on the WHO classification, adenocarcinoma with mixed subtypes (AM) is a histological classification. We aimed to compare the prognosis among AM, classic adenocarcinoma (CA), mucinous adenocarcinoma (MAC), and signet-ring cell carcinoma (SRCC) in early and advanced gastric cancer (EGC, AGC), respectively. Methods We compared the clinicopathologic features and prognosis between AM and other histologic subtypes of CA, SRCC and MAC in ECG and ACG, respectively. A nomogram was established to predict the cancer-specific survival (CSS) of gastric cancer (GC) patients with AM. C-index, calibration curves, Receiver Operating Characteristic (ROC) and Decision Curve Analysis (DCA) curves were applied to examine the accuracy and clinical benefits. Results In the prognosis among these four histological subtypes in EGC patients, there are no differences. For AGC patients, AM had a significantly poorer prognosis compared with CA and MAC (P = 0.003, 0.029), but similar prognosis to SRCC. A nomogram based on race, T stage, N stage, M stage and surgical modalities were proposed to predict 1- and 3- year CSS for GC patients with AM (C-index: training cohort: 0.804, validation cohort: 0.748. 1-, 3-year CSS AUC: training cohort: 0.871, 0.914, validation cohort: 0.810, 0.798). 1- and 3-year CSS DCA curves showed good net benefits. Conclusions EGC patients with AM had similar survival to those with CA, MAC and SRCC. AM was an independent predictor of poor prognosis in AGC. A nomogram for predicting the prognosis of GC patients with AM was proposed to quantitatively assess the long-term survival.

Apatinib in the treatment of non-operable or advanced gastric cancer: Evidence of efficacy and safety in a real-world study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15515-e15515
Author(s):  
Ligang Xing ◽  
Wei Cao ◽  
Gang Cui ◽  
Huanhu Zhang ◽  
Yiran Shi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cell Carcinoma ◽  
Advanced Gastric Cancer ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Combined Chemotherapy ◽  
Efficacy And Safety ◽  
Signet Ring ◽  
Organ Metastasis ◽  
Ring Cell

e15515 Background: Apatinib, a small molecule tyrosine kinase inhibitor, has been approved to use in patients with advanced gastric adenocarcinoma or gastroesophageal junction adenocarcinoma after at least two systemic chemotherapy regimens in China. This study aims to observe the efficacy and safety of apatinib in real word clinical practice and preliminarily explore the characteristics of population with more clinical benefit. Methods: This study included patients with non-operative or advanced gastric cancer confirmed by histopathology or cytology, and did not intervene the regimen which was entirely determined by the clinicians and patients. Results: From April 16, 2018 to January 12, 2019, 732 patients enrolled, and all patients had been followed up at least once. Total 342 patients were eligible for efficacy evaluation. Among them, 43 patients achieved partial response (PR), 209 patients achieved stable disease (SD) and 90 patients experienced progression disease (PD). The overall response rate (ORR) was 12.55%, and the disease control rate was 73.6%. The mPFS have not yet reached. For patients ≥65 years, the ORR was 26.32%, and for patients < 65 years, ORR was 8.33%. For patients with non-signet ring cell carcinoma and signet ring cell carcinoma, the ORRs were 15.22% and 6.0%. For patients with and without organ metastasis, the ORRs were 15.25% and 3.75% respectively. The PFS analysis showed that, Combined chemotherapy and age > 65 may predict longer PFS. The OS analysis showed that, ECOG 0-1, combined chemotherapy, AFP positive and male predict longer OS. The overall incidence of adverse events was 84%. The most common adverse events were hypertension (28.8%), fatigue (22.4%), hand-foot syndrome (17.3%), anorexia (12.8%) and nausea (10.5%). Conclusions: Apatinib showed promising antitumor activity in patients with non- operable or advanced Gastric Cancer in this real word study. The prolonging survival benefits maybe could be attenuated by age <65, without organ metastasis, ECOG score >1, treatment regimen, normal AFP, and pathological diagnosis of non-signet ring cell carcinoma. Clinical trial information: ChiCTR1800015701.

scholarly journals Clinical Features and Risk Factors for Lymph Node Metastasis in Early Signet Ring Cell Gastric Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaoliang Jin ◽  
Wei Wu ◽  
Jing Zhao ◽  
Shuang Song ◽  
Chunli Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Undifferentiated Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Node Metastasis ◽  
Signet Ring ◽  
Ring Cell

Signet ring cell carcinoma (SRCC) was previously thought to have a worse prognosis than differentiated gastric carcinoma (DC). However, recent studies have shown that its prognosis is related to staging. Here, we analyzed the clinicopathological features and the rate of lymph node metastasis (LNM) in 2166 patients with gastric cancer (605 early and 1561 advanced cases) who underwent gastrectomy and lymph node dissection (D2) from 2016 to 2019. The LNM rate for early and advanced cases was 18.0% and 74.2%, respectively. Regarding early cases, the LNM rate in SRCC was similar to that in DC (10% vs. 16.1%, p=0.224), and significantly lower than that in undifferentiated carcinoma (UDC; 10% vs. 23.3%, p=0.024). Tumor size, infiltration depth, pathological type, and mixed type were risk factors for LNM in early cases. Regarding intramucosal cases, the LNM rate in SRCC was similar to that in DC (4.3% vs. 3.7%, p=0.852), and significantly lower than that in UDC (11.2%). The LNM rate was significantly higher in submucosal than intramucosal cases (28.1% vs. 6.3%, p&lt;0.001), and in early mixed cases than early pure cases (23.2% vs. 12.4%, p&lt;0.001). Regarding early pure cases, the LNM rate in SRCC was similar to that in DC (9.3% vs. 7.2%, p=0.641), but significantly lower than that in UDC (9.3% vs. 24.7%, p=0.039). In summary, the LNM rate in early SRCC was similar to that in early DC but significantly lower than that in early UDC. Early SRCC fits with the endoscopic submucosal dissection (ESD) indication related to undifferentiated cases, and ESD may be effective. Additionally, the LNM rate was markedly higher for submucosal cases than intramucosal cases, and for mixed cases than pure cases.

scholarly journals Adenocarcinoma with Mixed Subtypes in the Early and Advanced Gastric Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Xixian Zhao ◽  
Yizhang Li ◽  
Zhenwei Yang ◽  
Hailin Zhang ◽  
Hongling Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Validation Cohort ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Training Cohort ◽  
Clinical Benefits ◽  
Similar Survival

Objective. Adenocarcinoma with mixed subtypes (AM) is a histological classification based on the WHO classification. We aimed to compare the prognosis among AM, classic adenocarcinoma (CA), mucinous adenocarcinoma (MAC), and signet-ring cell carcinoma (SRCC) in early and advanced gastric cancer (EGC and AGC), respectively. Methods. The Surveillance, Epidemiology, and End Results (SEER) database was queried from 2001 to 2016. Univariate and multivariate Cox analyses were performed to compare prognosis between AM and histologic subtypes of CA, SRCC, and MAC in ECG and ACG. A nomogram was established to predict the cancer-specific survival (CSS) of gastric cancer (GC) patients with AM. C-index, calibration curves, and receiver operating characteristic (ROC) and decision curve analysis (DCA) curves were applied to examine the accuracy and clinical benefits. Results. In the prognosis among these four histological subtypes in EGC patients, there are no differences. For AGC patients, AM had a significantly poorer prognosis compared with CA and MAC ( P = 0.003 , 0.029) but similar prognosis to SRCC. A nomogram based on race, T stage, N stage, M stage, and surgical modalities was proposed to predict 1- and 3-year CSS for GC patients with AM (C-index: training cohort: 0.804, validation cohort: 0.748. 1- and 3-year CSS AUC: training cohort: 0.871 and 0.914, validation cohort: 0.810 and 0.798). 1- and 3-year CSS DCA curves showed good net benefits. Conclusions. EGC patients with AM had similar survival to those with CA, MAC, and SRCC. AM was an independent predictor of poor prognosis in AGC. A nomogram for predicting the prognosis of GC patients with AM was proposed to quantitatively assess the long-term survival.

scholarly journals A Prognostic Model for Patients With Gastric Signet Ring Cell Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110279
Author(s):  
Qinping Guo ◽  
Yinquan Wang ◽  
Jie An ◽  
Siben Wang ◽  
Xiushan Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Training Set ◽  
Cox Regression Analysis ◽  
Signet Ring ◽  
Ring Cell ◽  
Independent Risk Factors

Background: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). Methods: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. Results: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. Conclusion: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.

Comparison of 68Ga-FAPI-04 and 18F-FDG for the Detection of Primary Gastric Cancers and Metastasis 

2021 ◽  
Author(s):  
Donglang Jiang ◽  
Xing Chen ◽  
Zhiwen You ◽  
Hao Wang ◽  
Xiaoyun Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cell Carcinoma ◽  
Cancer Diagnosis ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Gastric Cancers ◽  
Signet Ring ◽  
Ring Cell

Abstract Introduction Early and precise diagnosis and staging of gastric cancer are important for its treatment and management. However, the low sensitivity of 18F-fluorodeoxyglucose (18F-FDG) for gastric cancer diagnosis limits its application. Currently, the tracer 68Ga-FAPI, which targets fibroblast activation protein (FAP), is widely used to diagnose various cancers. However, the diagnostic value of 68Ga-FAPI in gastric cancer is still unclear. In this study, we aimed to investigate the potential advantage of 68Ga-FAPI-04 over 18F-FDG in the evaluation of gastric cancer.Methods: Thirty-eight patients with gastric cancer (31 with adenocarcinoma and 7 with signet ring cell carcinoma) were recruited for this study. All of the participants underwent 68Ga-FAPI-04 and 18F-FDG imaging by positron emission tomography (PET)/computed tomography (CT) or PET/magnetic resonance (MR). The results were interpreted by two experienced nuclear medicine physicians, and the maximum standardized uptake value (SUVmax) was calculated.Results: For the detection of primary gastric cancer, the sensitivities of 68Ga-FAPI-04 PET and 18F-FDG PET were 100% (38/38) and 81.6% (31/38), respectively. Four cases of adenocarcinoma and three cases of signet ring cell carcinoma were missed by 18F-FDG PET. The SUVmax of 68Ga-FAPI-04 in tumors greater than 4 cm (11.0 ± 4.5) was higher than tumors less than 4 cm (4.5 ± 3.2) (P = 0.0015). The SUVmax of 68Ga-FAPI-04 was higher in T2-4 tumors (9.7 ± 4.4) than in T1 tumors (3.1 ± 1.5) (P = 0.0002). For the detection of metastatic lesions, the sensitivities of 68Ga-FAPI-04 PET and 18F-FDG PET in 10 patients with regional lymph node metastasis and distant metastasis were 6/10 and 5/10, respectively.Conclusion: Compared to 18F-FDG PET, 68Ga-FAPI-04 PET had superior potential in detecting primary gastric cancers and metastatic lymph nodes, 68Ga-FAPI-04 PET also had a better performance on small gastric cancer detection. 68Ga-FAPI-04 PET could provide better performance for gastric cancer diagnosis and staging.

scholarly journals Tu1327 – Risk Factors of Early and Advanced Gastric Cancer: A 8 Years Population Study in Northern Italy

2019 ◽  
Vol 156 (6) ◽  
pp. S-1027
Author(s):  
Chiara Miraglia ◽  
Ottavia Cavatorta ◽  
Marilisa Franceschi ◽  
Pellegrino Crafa ◽  
Gianluca Baldassarre ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Population Study ◽  
Northern Italy
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