Impact of S-1 plus cisplatin neoadjuvant chemotherapy in scirrhous gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 198-198
Author(s):  
Chikara Kunisaki ◽  
Hirochika Makino ◽  
Jun Kimura ◽  
Ryo Takagawa ◽  
Amane Kanazawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Neoadjuvant Chemotherapy ◽  
Pathological Response ◽  
Curative Gastrectomy ◽  
Scirrhous Gastric Cancer ◽  
Lavage Cytology ◽  
Gastric Cancer Patients

198 Background: This study aimed to address the therapeutic outcome for scirrhous gastric cancer patients by evaluating the effect of neoadjuvant chemotherapy prior to gastrectomy. Methods: Two cycles of a 3 week regime of the fluoropyrimidine, S-1 (40 mg/m2, orally, twice daily), with cisplatin (60 mg/m2, intravenously, day 8) were administered to patients, separated by a 2 week rest period. Surgery was performed 3 weeks later in the neoadjuvant group (n=27). We compared overall survival and prognostic factors in these patients with a non-neoadjuvant group (n=19). Results: For all patients, univariate analysis identified non-curative gastrectomy and positive lavage cytology as adverse prognostic factors; extended lymph node dissection was a positive prognostic factor. Multivariate analysis showed that non-curative resections independently influenced prognosis (hazard ratio=2.902, p=0.011). In the SP group, positive lavage cytology indicated significantly worse prognoses. In the 15 patients who also underwent curative gastrectomies after SP chemotherapy, the pathological response grade was a significant prognostic factor for 5-year survival. Additionally, lymph node metastasis tended to be an adverse prognostic factor. Conclusions: After SP neoadjuvant chemotherapy, a grade 2-3 pathological response may predict favorable outcomes in scirrhous gastric cancer patients receiving curative gastrectomy, but further studies are needed to confirm these results.

scholarly journals Prognostic Factors for Gastrectomy in Elderly Patients

2014 ◽  
Vol 99 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Shunji Endo ◽  
Yukinobu Yoshikawa ◽  
Nobutaka Hatanaka ◽  
Tsutomu Dousei ◽  
Terumasa Yamada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Clinical Characteristics ◽  
Gastric Resection ◽  
Univariate Analysis ◽  
Curative Gastrectomy ◽  
Surgical Interventions ◽  
Survival Sex ◽  
Gastric Cancer Patients

Abstract The decision to undergo surgery for gastric cancer patients aged ≥85 years should be made carefully. We retrospectively reviewed the prognostic factors of gastrectomy for 64 patients aged ≥85 years who had undergone curative gastrectomy for gastric cancer. The effects of various clinical characteristics and surgical interventions on survival were retrospectively analyzed. Univariate analysis revealed that sex (male/female; P = 0.001), the extent of gastric resection (total/distal; P = 0.028), the extent of lymph node dissection (D2/<D2; P = 0.019), and blood loss (P = 0.005) were significant prognostic factors for overall survival. Multivariate analysis demonstrated that sex was the only independent prognostic factor. For pneumonia-specific survival, sex was also the only prognostic factor by multivariate analysis.Prognoses of males aged ≥85 years after gastrectomy were significantly worse than those of females, as they were more likely to die of pneumonia.

Prognostic Factors for Para-aortic Lymph Node Dissection After Neoadjuvant Chemotherapy for Gastric Cancer

2020 ◽  
Vol 40 (4) ◽  
pp. 2351-2357
Author(s):  
SHUNJI ENDO ◽  
MASAKAZU IKENAGA ◽  
TERUMASA YAMADA ◽  
SHIGEYUKI TAMURA ◽  
YO SASAKI
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Aortic Lymph Node

Lymph node ratio and survival for gastric cancer: A retrospective analysis of the SEER database

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4561-4561
Author(s):  
R. Shridhar ◽  
G. W. Dombi
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Seer Database ◽  
Node Negative ◽  
Node Ratio ◽  
Gastric Cancer Patients

4561 Purpose: To determine the prognostic significance of the lymph node ratio (ratio of number of positive lymph nodes to number of dissected lymph nodes) in gastric cancer patients. Methods: We retrospectively analyzed 10,176 gastric patients from 1990–2003 who underwent curative gastrectomy from the SEER database. Survival curves were calculated according to the Kaplan-Meier method and analyzed with log-rank test. Multivariate analysis of prognostic factors related to survival was performed by the Cox proportional hazard model. Results: The lymph node ratio (LNR) was a strong predictor of survival. LNR was equally predictive of survival whether the analysis was restricted to patients with <15 lymph nodes dissected or >15 lymph nodes dissected. Survival of patients with a LNR of 0.1–5% was not significantly different than node negative patients; however, survival of patients with a LNR of 5–10% was significantly different than node negative patients. Multivariate analysis showed that LNR, T-stage, tumor size, and number of lymph nodes positive were independent prognostic predictors of death and that LNR was the strongest predictor for death. Multivariate analysis showed that the number of lymph nodes dissected was an independent prognostic factor for survival. Moreover, LNR was an independent prognostic factor for N1 and N2 patients by AJCC staging. LNR trended toward significance in AJCC N3 patients. Conclusions: LNR was the strongest predictor of death in gastric cancer patients when compared to T-stage, number of lymph nodes positive, and tumor size. LNR is equally predictive regardless of the adequacy of the lymph node dissection. No significant financial relationships to disclose.

Long-term follow-up of advanced gastric cancer patients who achieved a pathologic complete response with neoadjuvant chemotherapy.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 133-133
Author(s):  
Haruhiko Cho ◽  
Takaki Yoshikawa
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Pathological Response ◽  
Term Survival ◽  
Gastric Cancer Patients ◽  
The Impact

133 Background: Adjuvant chemotherapy (AC) after D2 gastrectomy has become a standard treatment for stage 2/3 gastric cancer in Japan and Korea; however, the results remain unsatisfactory due to insufficient risk reduction in patients with stage 3 disease and low compliance. Although the administration of neoadjuvant chemotherapy (NAC) is a promising approach associated with a high rate of compliance and a downstage effect, the long-term survival benefits of this modality are unclear. Moreover, the impact of the pathological response on survival has not been evaluated. Based on the hypothesis that the pathological response grade is associated with survival, we conducted a search for reports of a pathological complete response (pCR) obtained with NAC. Methods: A total of 27 gastric cancer patients who achieved a pCR following NAC therapy were identified using PubMed and the Japanese medical search engine “Ichu-shi,” with the search words “gastric cancer,” “NAC,” and “pCR.” A questionnaire regarding the patients’ prognoses was posted in 23 institutions in Japan in July 2013. Results: Answers regarding 22 patients were obtained from 20 institutions. The subjects included 13 males and nine females. The mean age was 67.5 years. Tumors with stage 3/4 (95.4%: 21/22) and a diffuse-type histology (61.9%: 13/21) were dominant. S1/CDDP was the most frequently selected NAC regimen. A total of 77.2% (17/22) of the patients required combined resection of adjacent organs, and all patients underwent R0 resection and D2 lymphadenectomy. At present, 86.3% (19/22) of the patients are alive without recurrence; none of the ten patients who received postoperative AC demonstrated any recurrence, while three of twelve patients who did not receive postoperative AC developed recurrence, and two patients died of the disease after surgery (at 71 months and nine months, respectively). The overall and recurrence-free survival rates at three/five years were 95.5%/85.1% and 90.9%/75.1%, respectively. Conclusions: Patients with gastric cancer who achieve a pCR with NAC are rare; however, their prognoses are excellent. It is therefore important to develop a NAC regimen focusing on a high pCR rate.

scholarly journals Study of Survival in Gastric Cancer with Emphasis on Lymph Node Status as an Independent Prognostic Factor

2019 ◽  
Vol 4 (4) ◽  
pp. 185-189
Author(s):  
Nicolae Suciu ◽  
Orsolya Bauer ◽  
Zalán Benedek ◽  
Radu Ghenade ◽  
Marius Coroș ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Vascular Invasion ◽  
Lymph Node Ratio ◽  
Independent Prognostic Factor ◽  
Lymph Node Status ◽  
Node Ratio ◽  
Gastric Cancer Patients

Abstract Background: Lymph node status in gastric cancer is known as an independent prognostic factor that guides the surgical and oncological treatment and independently influences long-term survival. Several studies suggest that the lymph node ratio has a greater importance in survival than the number of metastatic lymph nodes. Aim: The aim of this study was to evaluate the clinical and morphological factors that can influence the survival of gastric cancer patients, with an emphasis on nodal status and the lymph node ratio. Material and methods: We conducted a retrospective study in which 303 patients with gastric cancer admitted to the Department of Surgery of the Mureș County Hospital between 2008 and 2018 were screened for study enrolment. Data were obtained from the records of the department and from the histopathological reports. The examined variables included: age, gender, tumor localization, T stage, histological type, grade of differentiation, surgical procedure, lympho-vascular invasion, excised lymph nodes, metastatic lymph nodes, lymph node ratio. After screening, the study included a total number of 100 patients, for which follow-up data was available. Results: The mean age of the study population was 66.43 ± 10 years, and 71% were males. The average survival period was 21.42 months. Statistical analysis showed that the localization of the tumor (p = 0.021), vascular invasion (p ---lt---0.001), T (p = 0.004) and N (p ---lt---0.001) stages, type of surgery (partial gastrectomy 59% vs. total gastrectomy 41%, p = 0.005), as well as the lymph node ratio (p ---lt---0.001) were prognostic factors for survival in patients with gastric cancer undergoing surgical therapy. Conclusions: The survival of gastric cancer patients is significantly influenced by tumor localization, T stage, vascular invasion, type of surgery, N stage and the lymph node ratio based on univariate analysis. Also, the lymph node ratio proved to be an independent prognostic factor for survival.

scholarly journals Risk evaluation of splenic hilar or splenic artery lymph node metastasis and survival analysis for patients with proximal gastric cancer after curative gastrectomy: a retrospective study

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Peng Ding ◽  
Ziming Gao ◽  
Chen Zheng ◽  
Junqing Chen ◽  
Kai Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Metastases ◽  
Splenic Artery ◽  
Proximal Gastric Cancer ◽  
Curative Gastrectomy ◽  
Node Metastases ◽  
Gastric Cancer Patients

Abstract Background As splenectomy and spleen-preserving lymphadenectomy are performed only in some proximal gastric cancer patients, it is difficult to identify patients who have undergone radical gastrectomy with or without splenic hilar (No.10) or splenic artery (No.11) lymph node metastases. We aimed to determine the risk factors for No.10 and No.11 lymph node metastases and evaluate the survival significance of No.10 and No.11 lymph node dissection in advanced proximal gastric cancer patients. Methods A total of 873 advanced proximal gastric cancer patients who underwent curative gastrectomy with or without splenectomy or pancreaticosplenectomy were analyzed retrospectively. The clinicopathological characteristics of 152 patients who underwent splenectomy or pancreaticosplenectomy were analyzed to determine the risk factors for No.10 and No.11 lymph node metastases. The survival difference between patients with No.10 and No.11 lymph node dissections and those who did not undergo these dissections were compared. Results Patients with No.10 and No.11 lymph node metastases had very poor prognoses. Tumor invasion of the greater curvature and No.2 and No.4 lymph node metastases were independent risk factors for No.10 and No.11 lymph node metastases. No survival differences were evident between patients with No.10 and No.11 lymph node metastases who underwent No.10 and No.11 lymph node dissections and those who did not undergo these dissections but were at high risks of No.10 and No.11 lymph node metastases. Conclusions Splenic hilar or splenic artery lymph node dissection was not associated with increased survival, in proximal gastric cancer patients without direct cancer invasion of the spleen and pancreas, regardless of whether splenectomy, pancreaticosplenectomy, or spleen-preserving lymphadenectomy was performed.

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