Clinical study on harvesting lymph nodes with carbon nanoparticles for advanced gastric cancer: A prospective randomized trail.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 159-159
Author(s):  
Ziyu Li ◽  
Sheng Ao ◽  
Jiafu Ji
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Advanced Gastric Cancer ◽  
Carbon Nanoparticles ◽  
Control Group ◽  
Solution Methods ◽  
The Mean ◽  
Set Up ◽  
Experimental Group ◽  
Clinical Trial Information

159 Background: There were no ideal materials nor quantizing regime for surgeons’ training on harvesting lymph nodes in advanced gastric cancer(AGC). A prospective randomized trial on Carbon Nanoparticles (CNP),a kind of lymphatic tracers, was designed to find a solution. Methods: Patients with previously untreated resectable AGC were eligible for inclusion in this study. All patients were randomly allocated to two subgroups. In experimental group, total of 1.0 mL CNP was injected into the subserosa of stomach around the tumor before gastrectomy with D2 dissection performed. On the contrary, the same procedure was performed directly without any coloring materials in control arm. Following surgery,the investigator harvested lymph nodes (LNs), counted colored LNs and measured the diameters with pathologist. Results: 30 patients were enrolled in the study. We observed no serious adverse effects related to CNP injection. The rate of stained LNs was 46.6%. The mean number of harvested LNs was larger in experimental than control group (38.33 vs. 28.27, p=0.041). Smaller diameter was recorded in experimental arm (3.32vs4.30mm,p=0.023), which might clarify the reason why the number of LNs was larger with CNP. In addition, we set up a model for predicting total number of LNs based on the data of CNP-staining LNs and metastatic LNs(MLNs), which might help the surgeons review their work of removing LNs so as to improve their surgical skills. Conclusions: CNP was a kind of safe materials and surgeons could harvest more LNs with it in AGC, which might benefit from the harvest of more smaller ones. Further study was needed to prove the model’s practicability. Clinical trial information: NCT02123407.

scholarly journals Segmentation of Gastric Computerized Tomography Images under Intelligent Algorithms in Evaluation of Efficacy of Decitabine Combined with Paclitaxel in Treatment of Gastric Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zhenghui Ge ◽  
Mengyun Wang ◽  
Qun Liu
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Mean Shift ◽  
Control Group ◽  
Line Treatment ◽  
First Line ◽  
Mean Shift Algorithm ◽  
The Mean ◽  
Experimental Group ◽  
First Line Treatment

To analyze the evaluation of artificial intelligence algorithm combined with gastric computed tomography (CT) image in clinical chemotherapy for advanced gastric cancer, 112 patients with advanced gastric cancer were selected as the research object. Among which, 56 patients in the experimental group received paclitaxel (PTX) combined with decitabine sequential decitabine maintenance therapy. Fifty-six patients in the control group received first-line treatment with decitabine combined with cisplatin. The image segmentation algorithm based on fast interactive dictionary selection was used to process gastric CT images. Complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), response rate (RR), disease control rate (DCR), and overall survival (OS) after treatment were recorded. The true-positive rate (TPR) and coincidence ratio (CR) of the proposed algorithm for image segmentation were significantly higher than those of the mean shift algorithm and the iCoseg algorithm. The mean edge distance (MED) and edge distance variance (EDV) were significantly lower than the mean shift algorithm and the iCoseg algorithm, and the differences were considerable ( P < 0.05 ). The number of CR (5 cases), PR (13 cases), RR (18 cases), and DCR (44 cases) in the experimental group was significantly higher than that in the control group, while the number of PD (12 cases) was significantly lower than that in the control group ( P < 0.05 ). The number of patients complicated with hematological toxicity, leucopenia, thrombocytopenia, and digestive tract reaction in the experimental group was less than that in the control group ( P < 0.05 ). From the comparison of long-term efficacy, the survival rate of patients in both groups showed a decreasing trend within 24 months, but the decreasing trend of survival rate of patients in the experimental group was better than that in the control group. In short, the proposed algorithm had better segmentation performance than traditional algorithms. Compared with first-line treatment with decitabine and cisplatin, PTX in combination with decitabine sequential citabine maintenance regimens had better disease control rates, lower toxicity, and more effective improvements in patient quality of life and longer survival in patients with advanced gastric cancer.

scholarly journals Phase II trial of prophylactic hyperthermic intraperitoneal chemotherapy in patients with locally advanced gastric cancer after curative surgery

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Biao Fan ◽  
Zhaode Bu ◽  
Ji Zhang ◽  
Xianglong Zong ◽  
Xin Ji ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Advanced Gastric Cancer ◽  
Phase Ii Trial ◽  
Locally Advanced ◽  
Control Group ◽  
Radical Gastrectomy ◽  
Curative Surgery ◽  
Locally Advanced Gastric Cancer ◽  
Experimental Group

Abstract Background HIPEC is an emerging procedure to treat peritoneal metastasis of gastric cancer. Data about HIPEC in locally advanced gastric cancer is scarce. The purpose of this trial is to evaluate the safety and toxicity of prophylactic HIPEC with cisplatin for patients with locally advanced gastric cancer. Methods From March 2015 to November 2016, a prospective, randomized phase II trial was conducted. After radical gastrectomy, patients in the experimental group underwent HIPEC with cisplatin followed by adjuvant chemotherapy with SOX regime. Patients in the other group were treated with SOX regime alone. Postoperative complications and patient survival were compared. Results In total, 50 patients were eligible for analyses. No significant difference was found in the incidence of postoperative complications including anastomotic/intestinal leakage, liver dysfunction, bone marrow suppression, wound infection and ileus (P > 0.05). Mean duration of hospitalization after radical gastrectomy was 11.7 days. 12.2 days in experimental group and 10.8 days in control group respectively (P = 0.255). The percentage of patients with elevated tumor markers was 12.1% in experimental group, which was significantly lower than 41.2% in control group (P = 0.02). 3-year RFS of patients who treated with or without prophylactic HIPEC were 84.8 and 88.2% respectively (P = 0.986). In the multivariate analysis, pathological T stage was the only independent risk factor for the RFS of patients (P = 0.012, HR =15.071). Conclusion Additional intraoperative HIPEC with cisplatin did not increase postoperative complications for locally advanced gastric cancer after curative surgery. Prophylactic HIPEC with cisplatin was safe and tolerable, while it did not reduce the risk of peritoneal recurrence in this trial, supporting further studies to validate the efficacy of it. Trial registration Chinese Clinical Trial Registry, ChiCTR2000038331. Registered 18 September 2020 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=59692.

Short and long-term effects of two different surgery approaches for remnant gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 180-180
Author(s):  
Lin Chen ◽  
Yingkun Ren ◽  
Yajie Zheng
Keyword(s):  
Gastric Cancer ◽  
Hospital Stay ◽  
Radical Surgery ◽  
Survival Rates ◽  
Control Group ◽  
Remnant Gastric Cancer ◽  
Long Term Effects ◽  
Average Hospital ◽  
The Mean ◽  
Experimental Group

180 Background: To evaluate the short- and long-term effects of two different surgery approaches for remnant gastric cancer after distal gastrectomy. Methods: Clinical data of 48 remnant gastric cancer patients were collected retrospectively from the period of January 1st 2010 to December 31st 2012 in this matched-pair study. Twenty four patients in the experimental group underwent radical surgery in antegrade approach (starting from the esophagus to the gastrointestinal anastomosis), another 24 matched patients in the control group underwent radical surgery in retrograde approach (starting from the gastrointestinal anastomosis to the esophagus). Constants in the study were patient age, the operating surgeon, Borrmann type, TNM stage and operation range. Pearsonχ2 testor t-test were used to compare the clinicopathological characteristics between the two groups. Survival rates of 1- and 3-years were analyzed with Kaplan-Meier survival curve and compared with Log-rank test. Results: The 48 patients were treated successfully without any mortality during their hospital stay. The mean operative time and bleeding volume in the experimental and control groups were (126.6±5.7) min and (154.1±23.9)ml , and (168.3±11.7) min and (180.8±15.0)ml respectively. The difference in the mean operative times (t = -3.089, P = 0.005) and the mean bleeding volumes (t = -3.269, P = 0.004) were statistically significant. The average hospital stay after surgery and the average number of lymph nodes resected were (9.5±0.9) days and 18.7±1.6 in the experimental group,(9.2±0.8) day and 17.4±1.4 in the control group. There was no statistical differences between the two groups in terms of the average hospital stay (t = 0.692, P = 0.496) and the average number of resected lymph nodes (t = 2.101, P = 0.247). The overall 1- year and 3-years survival rates were 75%, 49% in the experimental group and 67%, 35% in the control group. There was also no statistical difference in the 1-year (P = 0.745) and 3-years (P = 0.878) survival rates. Conclusions: Compared with retrograde approach, performing radical surgery in antegrade way for remnant gastric cancer patients can shorten the operation time, reduce blood loss and simplify the operation procedure.

Short-term outcomes of laparoscopic D2 gastrectomy with complete mesogastrium excision (D2+CME) for advanced gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 43-43
Author(s):  
Daxing Xie ◽  
Jianping Gong
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Cells ◽  
Advanced Gastric Cancer ◽  
Surgical Outcomes ◽  
Soft Tissues ◽  
R0 Resection ◽  
D2 Lymphadenectomy ◽  
Short Term ◽  
The Mean

43 Background: D2 lymphadenectomy has been widely accepted as a standard procedure of surgical treatment for local advanced gastric cancer [1,2]. However, neither the dissection boundary nor the extent of the excision for perigastric soft tissues has been described [3-7]. Our previous researches demonstrate the existence of disseminated cancer cells in the mesogastrium [8, 9] and present an understandable mesogastrium model for gastrectomy [10]. Hence, the D2 lymphadenectomy plus complete mesogastrium excision (D2+CME) is firstly proposed in this study, aiming to assess the safety, feasibility and corresponding short-term surgical outcomes. Methods: All of these patients underwent laparoscopy assisted D2+CME radical gastrectomy with a curative R0 resection, and all the operation was performed by Prof. Jianping Gong, chief of GI surgery of Tongji Hospital, Huazhong University of Science and Technology. All participants provided informed written consent to participate in the study. This study was approved by the Tongji Hospital Ethics Committee. The standard surgical procedures in the video are described as follows. Reconstruction of the alimentary tract was done by extracorporeal anastomosis. Standard recovery protocols were followed in postoperative treatments. Results: 68 patients between September 2014 and March 2016 have been recruited with informed consent and underwent laparoscopic D2+CME by a single surgeon. The mean number of retrieved regional lymph nodes was 33.62±11.40 (ranges 14-55). The mean volume of blood loss was 12.44±22.89 ml (ranges 5-100). The mean laparoscopic surgery time was 127.82±17.63 mins (ranges 110-165). The mean hospitalization time was 16.5±3.3 days (ranges 8-28). No operative complication was observed during the hospitalization. Conclusions: The anatomical boundary of mesogastrium is well described and dissected within D2+CME surgical process. It proves to be safely feasible and repeatable with less blood lost, qualified lymph nodes, retrieval results, and other improved short-term surgical outcomes in advanced gastric cancer. Meanwhile, potential disseminated cancer cells fall into the mesogastrium can be eradicated by D2+CME. Clinical trial information: NCT01978444.

scholarly journals Carbon nanoparticle suspension could help get a more accurate nodal staging for patient with rectal cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wei Ge ◽  
Qiang Li ◽  
Wen-jia Liu ◽  
Xiao-Qi Zhang ◽  
Xiang-shan Fan ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Carbon Nanoparticles ◽  
Controlled Trial ◽  
Control Group ◽  
Study Group ◽  
Nodal Staging ◽  
Nanoparticle Suspension ◽  
Carbon Nanoparticle ◽  
The Mean ◽  
Carbon Nanoparticle Suspension

AbstractThis study aimed to evaluate whether carbon nanoparticles could improve the accuracy of nodal staging in colorectal cancer (CRC). We performed a randomized controlled trial with CRC at the department of general surgery, the affiliated hospital of Nanjing University Medical School. A total of 160 patients were recruited in this research and 132 patients were included in the safety analyses. Among these patients, 72 cases were classified into control group and 60 cases into study group. The mean number of lymph nodes harvested from patients in study group was 19.3 ± 6.7 (range from 4 to 38), which was higher than that in control group (15.1 ± 5.7 (range from 3 to 29)) (p < 0.001). The mean number of positive lymph nodes got from patients in study group was 1.7 ± 3.5 (range from 0 to 22), which was also higher than that in control group (0.7 ± 1.4 (range from 0 to 7)) (p = 0.045). In study group, there were 30 patients (50%) proved to be N0, and remaining 30 patients (50%) were N1 or N2. However, 50 patients (69.4%) were N0 and 22 patients (30.6%) were N1 or N2 in control group. The rate of N0 in control group was significantly higher than that in study group (p = 0.023). Injecting carbon nanoparticle suspension could get a more accurate nodal staging to receive enough chemoradiotherapy, improving prognosis. Besides, injecting carbon nanoparticles suspension at four points 5 cm, 10 cm, 15 cm and 20 cm away from the anus by “sandwich” method was a new try.Trial registration: This study was registered with ClinicalTrials.gov, number ChiCTR1900025127 on 12/8/2019.

scholarly journals Laparoscopic gastrectomy for stage II and III advanced gastric cancer: long‑term follow‑up data from a Western multicenter retrospective study

2021 ◽  
Author(s):  
Umberto Bracale ◽  
Giovanni Merola ◽  
Giusto Pignata ◽  
Jacopo Andreuccetti ◽  
Pasquale Dolce ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Advanced Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Postoperative Morbidity ◽  
Stage Ii ◽  
Long Term Results ◽  
The Mean

Abstract Introduction There has been an increasing interest for the laparoscopic treatment of early gastric cancer, especially among Eastern surgeons. However, the oncological effectiveness of Laparoscopic Gastrectomy (LG) for Advanced Gastric Cancer (AGC) remains a subject of debate, especially in Western countries where limited reports have been published. The aim of this paper is to retrospectively analyze short- and long-term results of LG for AGC in a real-life Western practice. Materials and methods All consecutive cases of LG with D2 lymphadenectomy for AGC performed from January 2005 to December 2019 at seven different surgical departments were analyzed retrospectively. The primary outcome was diseases-free survival (DFS). Secondary outcomes were overall survival (OS), number of retrieved lymph nodes, postoperative morbidity and conversion rate. Results A total of 366 patients with stage II and III AGC underwent either total or subtotal LG. The mean number of harvested lymph nodes was 25 ± 14. The mean hospital stay was 13 ± 10 days and overall postoperative morbidity rate 27.32%, with severe complications (grade ≥ III) accounting for 9.29%. The median follow-up was 36 ± 16 months during which 90 deaths occurred, all due to disease progression. The DFS and OS probability was equal to 0.85 (95% CI 0.81–0.89) and 0.94 (95% CI 0.92–0.97) at 1 year, 0.62 (95% CI 0.55–0.69) and 0.63 (95% CI 0.56–0.71) at 5 years, respectively. Conclusion Our study has led us to conclude that LG for AGC is feasible and safe in the general practice of Western institutions when performed by trained surgeons.

scholarly journals Clinical efficacy of immunotherapy combined with chemotherapy in patients with advanced gastric cancer, its effect on nutritional status and Changes of peripheral blood T lymphocyte subsets

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Wen-wen Li ◽  
Jin Jiao ◽  
Zhi-yu Wang ◽  
Ya-ning Wei ◽  
Yuan-fang Zhang
Keyword(s):  
Gastric Cancer ◽  
Nutritional Status ◽  
Advanced Gastric Cancer ◽  
Clinical Efficacy ◽  
T Lymphocyte ◽  
Peripheral Blood ◽  
Lymphocyte Subsets ◽  
Control Group ◽  
T Lymphocyte Subsets ◽  
Experimental Group

Objectives: To evaluate the clinical efficacy of immunotherapy combined with chemotherapy in patients with advanced gastric cancer and its effect on nutritional status and changes of peripheral blood T lymphocyte subsets. Methods: Sixty patients with locally advanced gastric cancer who were admitted by Affiliated Hospital of Hebei University from March 2020 to February 2021 were enrolled and randomly divided into two groups, with 30 cases in each group. The control group was treated with FOLFOX4 chemotherapy, while the experimental group was additively treated with cindilizumab on the basis of control group. The incidence of adverse reactions, clinical efficacy, improvement of nutritional and physical status, and changes in the levels of T lymphocyte subgroups in the two groups were compared and analyzed. Results: The total effective rate was 70% in the experimental group, which was better than 43.3% of the control group (p=0.04). The improvement rate of performance status (ECOG) score and nutritional indicators in the experimental group was significantly better than that in the control group (p<0.05). Moreover, the indicators of CD3+, CD4+, CD4+/CD8+ in the experimental group were significantly higher than those in the control group after treatment, with statistically significant differences (CD3+, p=0.01; CD4 +, p=0.02; CD4+/CD8+, p=0.01). Conclusion: Immunotherapy combined with chemotherapy has a significant effect on locally advanced gastric cancer patients, with significant improvement in physical strength and nutritional status, significant improvement in T lymphocyte function, and no obvious adverse reactions. It is worth promoting in clinical application. doi: https://doi.org/10.12669/pjms.37.7.4347 How to cite this:Li W, Jiao J, Wang Z, Wei Y, Zhang Y. Clinical efficacy of immunotherapy combined with chemotherapy in patients with advanced gastric cancer, its effect on nutritional status and Changes of peripheral blood T lymphocyte subsets. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4347 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Fluorescence image-guided lymphadenectomy using indocyanine green and near infrared technology during robotic gastrectomy: a prospective pilot study: IG-MIG Study

2019 ◽  
Vol 1 (1) ◽  
pp. 5-8
Author(s):  
Jacopo Desiderio ◽  
Anna Mariniello ◽  
Stefano Trastulli ◽  
Amilcare Parisi ◽  
Vito D'Andrea
Keyword(s):  
Gastric Cancer ◽  
Pilot Study ◽  
Lymph Nodes ◽  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Control Group ◽  
Cancer Type ◽  
Prospective Pilot Study ◽  
Experimental Group

Background: Gastric cancer is a worldwide challenge due to its spread, even epidemic in some areas, and the high mortality rates. Lymphadenectomy is considered the fundamental step during radical gastrectomy. In recent years, some researchers have tried to find a way to improve the surgical identifi cation of the lymphatic drainage routes and lymph node stations. This new surgical frontier is the so called “navigation surgery”. Among the diff erent reported solutions, lately, the indocyanine green (ICG) has drawn attention. It is a fluorescence dye, that can be detected in the near infrared spectral band (NIR). The development of specific fluorescence imaging devices has allowed surgeons to visualize tumors, vascular and lymphatic structures. The Da Vinci Xi robotic system has an integrated imaging technology that has been used in colo-rectal and hepatobiliary surgery. However, up to date, the combined use of fluorescence imaging and robotic technology has not been evaluated during lymphadenectomy in gastric cancer. Methods: General design: to evaluate the role of fluorescence imaging during robotic lymphadenectomy for gastric cancer. Type of study: interventional prospective pilot study. Duration: 18 months. Experimental group: patients undergoing dissection assisted by ICG. Control group: patients undergoing the same surgery without the injection of ICG. Primary outcomes: Fluorescent lymph nodes (FLNs) identification rate, accuracy of the procedure, comparison with the control group on the total number of lymph nodes retrieved. Sample size: 20 patients in the experimental group, 20 patients in the control group. Ethics: This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations. Trial registration number: NCT03931044

Rorschach Characteristics in Adolescents with Systemic Lupus Erythematosus

2006 ◽  
Vol 28 (1) ◽  
pp. 100-118 ◽  
Author(s):  
J. Santoantonio ◽  
L. Yazigi ◽  
E. I. Sato
Keyword(s):  
Lupus Erythematosus ◽  
Case Control Study ◽  
Activity Index ◽  
Disease Activity Index ◽  
Female Adolescents ◽  
Control Group ◽  
Intelligence Scale ◽  
The Mean ◽  
Experimental Group ◽  
Control Study

The purpose of this study was to investigate the personality characteristics in adolescents with SLE. The research design is a case-control study by means of the Rorschach Method and the Wechsler Intelligence Scale. Study group: 30 female adolescents with lupus, 12–17 years of age. The SLE Disease Activity Index was administered during the period of psychological evaluation. Control group: 32 nonpatient adolescents were matched for age, sex, and socioeconomic level. In the Wechsler Intelligence Scale the mean IQ of the experimental group was significantly lower than that of the control group (77 and 98, respectively, p < .001). In the Rorschach, the lupus patients showed greater difficulty in interpersonal interactions, although they displayed the resources to process affect and to cope with stressful situations. A positive moderate correlation (p = .069) between the activity index of the disease and the affect constriction proportion of the Rorschach was observed: the higher the SLEDAI score, the lower the capacity to process affect. There is a negative correlation between the activity index of the disease and the IQ (p = .001): with a higher activity index of the disease, less intellectual resources are available.

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