The survival outcome after hepatic resection in patients with liver metastasis from gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 161-161
Author(s):  
Taichi Tatsubayashi ◽  
Yuichiro Miki ◽  
Wataru Takagi ◽  
Fumiko Hirata ◽  
Hayato Omori ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Survival Rate ◽  
Liver Metastasis ◽  
Lymph Node Metastasis ◽  
Hepatic Resection ◽  
Treatment Strategy ◽  
Survival Outcome ◽  
Node Metastasis

161 Background: Optimal treatment strategy for patients with liver metastasis from gastric cancer (LMGC) has not yet been established. Although systemic chemotherapy remains mainstay of treatment for LMGC, complete resection of primary tumor and LMGC may improve survival outcome. Thus, the aim of this study is to investigate survival outcome and prognostic factors of patients who underwent hepatic resection for LMGC. Methods: From September 2002 to February 2014, 30 patients underwent hepatic resection for LMGC in our hospital. Indications of hepatic resection were as follows; (1) hepatic lesion is not more than three, (2) without extrahepatic metastasis other than lymph node metastasis, (3) adequate liver function. We investigated the overall median survival time (MST) and 5-year survival rate of all eligible patients. Univariate and multivariate analyses were performed to assess the association between each clinicopathological features and overall survival time. Results: There were 25 males and 5 females with a median age of 72 (range, 39-86). There were 16 synchronous LMGCs and 14 metachronous LMGCs. With respect to the number of LMGC, 22 patients had 1 lesion, 7 patients had 2 lesions, and 1 patient had 3 lesions. Overall MST and 5 year survival rates after hepatic resection were 2.8 years and 31.0%, respectively. The significant prognostic factors were age (70 years or older, p=0.029) and blood transfusion (p=0.013). Multivariate analysis showed that lymph node metastasis was an only independent indicator of poor prognosis (HR=6.13, p=0.026). Conclusions: Hepatic resection for patients with LMGC might be a promising treatment strategy, with 5-year survival rate of 31.0%. Lymph node metastasis was an only independent prognostic factor. A multi-institutional confirmatory study will be required to evaluate the role of hepatic resection in patients with LMGC.

scholarly journals A case of early gastric cancer with a single giant lymph node metastasis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Masato Yoshikawa ◽  
Misaki Tamario ◽  
Masayoshi Obatake ◽  
Koichi Sato ◽  
Shigehiko Yagi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Lymph Node ◽  
Gastrointestinal Tract ◽  
Liver Metastasis ◽  
Lymph Node Metastasis ◽  
Tubular Adenocarcinoma ◽  
Node Metastasis ◽  
Giant Tumor ◽  
Metastatic Process

Abstract Background Early gastric cancer (EGC) is often associated with lymphatic metastasis, but it is extremely rare to be found as a single giant lymph node. Cancer often becomes more malignant in metastatic lesions than in primary lesions, and retrodifferentiation to the fetal gastrointestinal tract during the metastatic process has been reported in gastric cancer. We report an extremely rare case of EGC with a 13-cm giant lymph node metastasis in which an adenocarcinoma with enteroblastic differentiation and yolk sac tumor-like components was observed. Case presentation The case was a 70-year-old man who visited his local doctor with right hypochondrial pain, which was identified by computed tomography (CT) as a giant mass. Upper endoscopy revealed a 30-mm-sized 0-IIc lesion in the greater curvature of the angular incisure and a 15-mm-sized 0-IIa lesion in the anterior wall of the lower body of the gastric body. Endoscopic biopsy revealed tubular adenocarcinoma in both lesions. The gastric lesion and the giant tumor were clinically regarded as independent lesions (gastrointestinal stromal tumor, [GIST], and EGCs), and distal gastrectomy and D1 + dissection were performed to comprehensively treat all lesions. Pathological examination revealed that the giant tumor was tubular adenocarcinoma with an intestinal phenotype and was considered a lymph node metastasis of EGCs. To exclude the possibility of metastasis of adenocarcinoma other than EGCs, postoperative positron emission tomography-computed tomography (PET-CT) and colonoscopy were performed; however, no primary site other than the stomach was found. Metastatic lymph nodes have an increased degree of atypia compared with the primary tumor, and yolk sac tumor-like carcinoma morphology was observed along with α-fetoprotein (AFP) and Spalt-like 4 (SALL4) expression in this case. It was considered that retrodifferentiation to a fetal phenotype occurred during the metastatic process. Liver metastasis occurred 6 months after surgery, and chemotherapy is currently being introduced. Conclusions We experienced a case of EGC with a single giant lymph node metastasis. Retrodifferentiation to the fetal gastrointestinal tract during metastasis was speculated to be involved in the formation of giant lymph node metastasis and liver metastasis in this case.

scholarly journals Prognosis of Stage IIB early gastric cancer has a unique and dismal property putatively requiring post operative adjuvant chemothrapy

2017 ◽  
Author(s):  
Hideki Ushiku ◽  
Keishi Yamashita ◽  
Akira Ema ◽  
Natsuya Katada ◽  
Kei Hosoda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Cancer Prognosis ◽  
Node Metastasis ◽  
Dismal Prognosis

Abstract Background Pathological T1 (pT1) gastric cancer showed excellent prognosis, however lymph node metastasis sometimes reflects patients with dismal prognosis. In this study, we investigated prognosis of pT1 gastric cancer with lymph node metastasis to identify prognostic factors. Patients and Methods Among 1,442 gastric cancer patients between 2002 and 2010, 73 (5%) of pT1 with lymph node metastasis were identified. Univariate prognostic factors were applied to multivariate Cox proportional hazards model. Results (1) Among the 1,442 patients, pT1 was composed of 333 patients with pT1a and 423 patients with pT1b, which included 9 (2.7%) and 64 cases (15.1%) with lymph node metastasis, respectively. (2) Ten (13.7%) patients of the 73 patients with lymph node metastasis showed tumor relapse.　　Univariate negative prognostic factors were tumor size (p=0.03), intraoperative bleeding (p=0.03), and perioperative transfusion (POT)(p=0.001), as well as 14th JGCA Stage (p<0.0001), and multivariate analysis identified 14th JGCA Stage (p=0.0004) and POT (p=0.03) as independent prognostic factors. (3) pT1 gastric cancer representing pN3 (Stage IIB) was rare (n=4) and unique entity from a prognostic point of view, exhibiting dismal prognosis (0% at 5 years). We thereafter identified 17 such cases from 5,204 gastric cancer including the earliest cases. Prognosis of such 17 patients was very unique, in that recurrences occurred even 5 years after curative operation, and the frequent recurrent sites were bone. Conclusion pT1 gastric cancer prognosis is robustly affected by pN3 and POT, and Stage IIB disease showed unique prognosis requiring special attention even after 5 years of operation.

scholarly journals Clinically Early Gastric Cancer: Features and Treatment Strategy

2016 ◽  
Vol 101 (11-12) ◽  
pp. 562-569
Author(s):  
Si-Hak Lee ◽  
Cheol Woong Choi ◽  
Su Jin Kim ◽  
Dae-Hwan Kim ◽  
Chang In Choi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Treatment Strategy ◽  
Treatment Strategies ◽  
Muscularis Propria ◽  
Clinicopathologic Features ◽  
Curative Gastrectomy ◽  
Node Metastasis

This study aimed to clarify the clinicopathologic features and explore treatment strategies for patients with pathologically confirmed advanced gastric cancer (AGC) diagnosed as clinically early gastric cancer (cEGC) before surgery. We included 955 patients who were treated by curative gastrectomy between 2008 and 2013; 42 patients had cEGC. The clinicopathologic features of the patients with cEGC were compared with those of patients with early gastric cancer (EGC); AGC; cancer of the muscularis propria (MP cancer, gastric cancer invading the muscularis propria of the stomach); or SM3 cancer (gastric cancer invading all 3 parts of the submucosal layer). Patients with cEGC had more tumor lymph node metastasis; more lymphatic invasion; and more perineural invasion (all P < 0.001) compared with those with EGC. Patients with cEGC had more tumor lymph node metastasis (P = 0.017) than did patients with SM3. Compared with patients with AGC or MP cancer, patients with cEGC were more likely to be operated on using a laparoscopic procedure and less likely to receive lymph node dissection. Multivariate analysis showed that gross type III [odds ratio (OR), 12.92; P < 0.001] and tumor location (middle body, OR, 2.691; P = 0.009) were significant predictors of cEGC before surgery. Although patients with cEGC had clinicopathologic features similar to those of patients with MP cancer, they were treated like patients with SM3 cancer (e.g., limited use of lymphadenectomy). These findings suggest that patients with cEGC should be given a more aggressive treatment strategy.

scholarly journals The Predictive and Prognostic Factors in Patients with Gastric Cancer Accompanied by Gastric Outlet Obstruction

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hongliang Zu ◽  
Huiling Wang ◽  
Chunfeng Li ◽  
Wendian Zhu ◽  
Yingwei Xue
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Outlet Obstruction ◽  
Clinicopathological Features ◽  
Depth Of Invasion ◽  
Node Metastasis ◽  
Distal Gastric Cancer

Purpose. This study is aimed at evaluating the clinicopathological features and prognostic significance of gastric outlet obstruction (GOO) in patients with distal gastric cancer. Methods. A retrospective review of 1564 individuals with distal gastric cancer from 2002 to 2010 was performed. In total, 157 patients had GOO. The clinicopathological features of the patients with GOO were compared with those of the patients without GOO. A Kaplan-Meier survival analysis and Cox proportional hazard model were used to assess the overall survival. Results. The patients with distal gastric cancer with GOO generally presented more aggressive pathologic features, a poorer nutritional status, more duodenal infiltration, and peritoneal dissemination than those with cancer without GOO. In the univariate analysis, curability, GOO, age, prealbumin, albumin, hemoglobin (Hb), the tumor size, the macroscopic type, lymph node metastasis, and the depth of invasion had a statistically significant influence on prognosis. The multivariate analysis showed that curability, GOO, the tumor size, lymph node metastasis, and the depth of invasion were independent prognostic factors. Conclusions. Gastric cancer with GOO exhibits aggressive biological features and has poor outcomes. The multivariate analysis showed that curability, GOO, the tumor size, lymph node metastasis, and the depth of invasion were independent prognostic factors. The gastric outlet status should be considered in the selection of surgical treatment methods for patients with gastric cancer.

Impact of c-erbB-2 Protein on 5-year Survival Rate of Gastric Cancer Patients after Surgery: A Cohort Study and Meta-analysis

2015 ◽  
Vol 103 (3) ◽  
pp. 249-254 ◽  
Author(s):  
Hao Wu ◽  
Zhenzhai Cai ◽  
Guangrong Lu ◽  
Shuguang Cao ◽  
He Huang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Survival Rate ◽  
Lymph Node Metastasis ◽  
Protein Expression ◽  
Meta Analysis ◽  
Clinicopathological Characteristics ◽  
Node Metastasis ◽  
Positive Expression ◽  
Significant Difference

Objective To explore the association of c-erbB-2 protein expression with clinicopathological characteristics and prognosis of gastric cancer (GC) after surgery. Methods A total of 133 patients undergoing surgical resection for GC between March 2006 and January 2009 in the Second Affiliated Hospital of Wenzhou Medical University were included in this study. c-erbB-2 protein expression was determined by immunohistochemistry. Afterwards, a meta-analysis was performed to further confirm the association between c-erbB-2 protein expression and GC by employing stringent inclusion and exclusion criteria. All data analyses were conducted with STATA 12.0 and SPSS 19.0. Results There was no significant difference in c-erbB-2 expression among patients with various parameters including age, gender and histological types (all p>0.05). Among 133 GC patients, 32 patients presented c-erbB-2-positive expression and 101 presented c-erbB-2-negative expression (24.1% vs. 75.9%). The c-erbB-2-positive expression rate was significantly higher in GC tissues of patients with lymph node metastasis than those without. Similarly, a significant increase in c-erbB-2 expression was observed in well/moderately differentiated GC tissues compared with poorly differentiated GC. Patients with negative c-erbB-2 expression had a higher 5-year survival rate than those with positive c-erbB-2 expression, which was consistent with the results of the meta-analysis (OR = 0.54, 95% CI 0.37-0.80, p = 0.002). Conclusions Our study demonstrated that high expression of c-erbB-2 protein was strongly associated with lymph node metastasis, histological differentiation and 5-year survival rate in GC patients after surgery.

Sign in / Sign up

Export Citation Format

Share Document