Is preoperative screening colonoscopy useful in patients with gastric cancer?

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 290-290
Author(s):  
Yusuke Koseki ◽  
Makoto Hikage ◽  
Ko Ikegame ◽  
Kouta Itamoto ◽  
Yujiro Isobe ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Early Stage ◽  
Gastric Surgery ◽  
Colorectal Adenomas ◽  
Screening Colonoscopy ◽  
Double Cancer ◽  
Independent Risk Factors ◽  
T Classification

290 Background: In patients with gastric cancer (GC), the most common double cancer is colorectal cancer (CRC). However, the meaning of screening colonoscopy has not been established. The aim of this retrospective study was to evaluate the useful of screening colonoscopy in preoperative patients with GC. Methods: This study included 689 patients who received screening colonoscopy before gastric surgery between 2012 and 2016. Multivariate analysis using logistic regression model was conducted to elucidate independent risk factors of CRC. Then, we investigated the clinicopathological factors for CRC. Results: Colorectal adenomas and CRC were observed in 315 patients (46%) and 37 patients (5.4%), respectively. The clinical T classification of the CRC were as follows; Tis: 24 patients (65%), T1: 8 patients (21%), T2: 2 patients (6%), and T3: 3 patients (8%). In multivariate analysis, male (OR 5.04, 95% C.I. 1.29-19.6, p = 0.020) was revealed as risk factor for affecting CRC. The treatments for CRC were as follows; EMR was performed in 27 patients, simultaneous resection with GC was performed in 9 patients, resection after gastrectomy was performed in 1 patient, respectively. Pathological stage of CRC was as follows; Stage 0: 24 patients, Stage I: 10 patients, and Stage IIA: 3 patients, respectively. As for the patients who underwent surgery for CRC, all of them received radical colectomy. No patient died for CRC who received colonoscopy before gastric surgery. Conclusions: Screening colonoscopy is useful for GC patients. Because most of the synchronous CRC were found early stage and curatively treated.

scholarly journals Sub-Classification of Cirrhosis Affects Surgical Outcomes for Early Hepatocellular Carcinoma Independent of Portal Hypertension

2021 ◽  
Vol 11 ◽  
Author(s):  
Er-lei Zhang ◽  
Jiang Li ◽  
Jian Li ◽  
Wen-qiang Wang ◽  
Jin Gu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Surgical Outcomes ◽  
Early Stage ◽  
Surgical Mortality ◽  
Tumor Capsule ◽  
B Virus ◽  
Independent Risk Factors

Severity of liver cirrhosis is distinct from clinical portal hypertension because there exist different degrees of liver cirrhosis in hepatocellular carcinoma (HCC) patients without significant clinical portal hypertension. Whether severity of cirrhosis affects surgical outcomes for HCC patients in absence of portal hypertension or not remains unclear. This study aims to analyze the effect of cirrhotic severity on surgical outcomes for HCC patients with hepatitis B virus (HBV) infection in absence of portal hypertension. This retrospective study enrolled 166 patients who underwent curative resection for a single HCC ≤5 cm in absence of portal hypertension between February 2011 and December 2013. Liver cirrhosis was sub-classified into no/mild (no/F4A) and moderate/severe (F4B/F4C) according to the Laennec scoring system. The surgical outcomes and complications were analyzed. The surgical mortality was zero in this study. Major complications were apparently higher in the F4B/F4C group than in the no/F4A group (17.0% vs 7.4%, p <0.001). The 1-year, 3-year and 5-year overall survival (OS) rates were 98.5, 88.1 and 80%, respectively, in the no/F4A group, which were significantly higher than those in the F4B/F4C group (98.0, 69.2 and 54.7%, p = 0.001). Microscopic vascular invasion, absence of tumor capsule and severity of liver cirrhosis were independent risk factors of surgical outcomes for HCC patients without portal hypertension. In conclusion, severity of liver cirrhosis affected surgical outcomes for early-stage HCC patients independent of portal hypertension.

The impact of the preoperative waiting period on the survival in patients with clinical stage II / III gastric cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 27-27
Author(s):  
Furukawa Kenichiro ◽  
Rie Makuuchi ◽  
Keiichi Fujiya ◽  
Noriyuki Nishiwaki ◽  
Hayato Omori ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Clinical Stage ◽  
Lymph Node Status ◽  
Multiple Cancer ◽  
Waiting Period ◽  
Japanese Classification ◽  
The Impact

27 Background: Although prolonged preoperative waiting period (PWP) for gastric cancer (GC) may influence the prognosis, the relationship between PWP and survival outcome has not been elucidated. The aim of this study is to identify the impact of PWP on survival in patients with clinical stage (cStage) II / III GC. Methods: A total of 483 patients who underwent surgery for cStage II / III GC according to Japanese classification of GC, 14th edition, between January 2002 and December 2012 were included. The patients who underwent endoscopic submucosal dissection or neoadjuvant chemotherapy, or who had multiple cancer, special histological types of tumor, or urgent symptoms were excluded. We defined PWP as the period from the date of endoscopy for initial diagnose to that of surgery. Patients were divided into two groups according to PWP; short waiting period group (SWPG, PWP ≤ 60 days, n = 357) and long waiting period group (LWPG, PWP > 60 days, n = 126). Survival outcomes were compared between the groups and multivariate analysis for overall survival (OS) was conducted to identify independent prognostic factors. Results: The median PWP was 49 (21-323) days. In LWPG, patients were significantly older (P = 0.001) and had more comorbidities (P = 0.042) than those in SWPG. Preoperative lymph node status was significantly lower in LWPG (P = 0.031), although there were no differences in tumor depth and cStage between the groups. There was no difference in OS between the groups (5-year OS, SWPG: 61.0%, LWPG: 63.2%, P = 0.612). Multivariate analysis for OS identified age, BMI, histological type, and cStage as independent prognostic factors. Conclusions: Preoperative waiting period appears to have no influence on survival in patients with cStage II / III GC.

Predictive Value of Nomogram Based on Kyoto Classification of Gastritis to Diagnosis of Gastric Cancer

2021 ◽  
Author(s):  
Jiejun Lin ◽  
Huang Su ◽  
Yaqi Guan ◽  
Qingjie Zhou ◽  
Jie Pan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Calibration Curve ◽  
Predictive Value ◽  
Predictive Accuracy ◽  
Bootstrap Method ◽  
Characteristic Curve ◽  
Training Set ◽  
Validation Set

Abstract Background and Aim. It is of importance to predict the risk of gastric cancer (GC) for endoscopists because early detection of GC determines the determines the selection of best treatment strategy and the prognosis of patients. The aim of the study was to evaluate the utility of a predictive nomogram based on Kyoto classification of gastritis for GC. Methods. It was a retrospective study that included 2639 patients who received esophagogastroduodenoscopy and serum pepsinogen (PG) assay from January 2020 to November 2020 at the Endoscopy Center of the Department of Gastroenterology, Wenzhou Central Hospital. Routine biopsy was conducted to determine the benign and malignant lesions pathologically. All cases were randomly divided into the training set (70%) and the validation set (30%) by using bootstrap method. A nomogram was formulated according to multivariate analysis of training set. The predictive accuracy and discriminative ability of the nomogram were assessed by concordance index (C-index), area under the curve (AUC) of receiver operating characteristic curve (ROC) as well as calibration curve and were validated by validation set.Results. Multivariate analysis indicated that age, sex, PG I/II ratio and Kyoto classification scores were independent predictive variables for GC. The C-index of the nomogram of the training set was 0.79 (95% CI: 0.74 to 0.84) and the AUC of ROC is 0.79. The calibration curve of the nomogram demonstrated an optimal agreement between predicted probability and observed probability of the risk of GC. In the validation set, the C-index was 0.86 (95% CI: 0.79 to 0.94) with a calibration curve of better concurrence.Conclusion. The nomogram formulated was proven to be of high predictive value for GC.

scholarly journals Effects of Clavien-Dindo classification on long-term survival of patients with advanced gastric cancer after radical resection:A propensity score-matched study

2021 ◽  
Author(s):  
Wenwu Yan ◽  
Jun Du ◽  
Qingyi Li ◽  
Changsheng Yao ◽  
Mengxiang Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Propensity Score ◽  
Radical Resection ◽  
Survival Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Independent Risk Factors

Abstract Background The impact of postoperative complications (POCs) classified by the Clavien-Dindo (C-D) system on long-term survival after radical resection in patients with advanced gastric cancer (AGC) is not yet clear.Methods This study analyzed 531 patients with AGC who underwent radical resection in an institution between January 2015 and December 2017. Patients were divided into two groups according to the occurrence of POCs and recorded according to C-D classifications.The long-term survival outcomes of the entire cohort after propensity score matching (PSM) were compared.Results After PSM, there was no significant difference in baseline data between the complications (C) group (n = 92) and the non-complications (NC) group (n = 92). Survival analysis showed that the 5-year overall survival (OS) and relapse-free survival (RFS) were lower in the C group (48.9% vs. 62.0%, p = 0.040; 38.5% vs. 54.9%, p = 0.005; respectively). Subgroup analysis showed that severe complications (C-D grade > II) were associated with a decrease in 5-year OS and RFS compared with the matched NC group (40.0% vs. 62.0%, p = 0.008; 29.4% vs. 54.9%, p = 0.001; respectively). Multivariate analysis confirmed adjuvant chemotherapy, tumor size, and complications were independent risk factors for poor survival outcomes. Further multivariate analysis showed that older age, combined excision, and comorbidities were independent risk factors for POCs.Conclusions Severe complications reduced the survival outcome of patients.Older age, combined excision, and comorbidities were independent risk factors for POCs. More attention should be paid to perioperative management of patients with high risk factors for complications.

A multivariate analysis of risk factors for colorectal adenomas: Results from screening colonoscopy in 3,114 Japanese

2003 ◽  
Vol 124 (4) ◽  
pp. A169
Author(s):  
Yutaka Yamaji ◽  
Hirotsugu Watabe ◽  
Goichi Togo ◽  
Makoto Okamoto ◽  
Haruhiko Yoshida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Colorectal Adenomas ◽  
Screening Colonoscopy

scholarly journals Correlative Analysis Between Adverse Events of Preoperative Chemotherapy and Postoperative Complications of Gastric Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhouqiao Wu ◽  
Yiding Wang ◽  
Shiyang Hou ◽  
Qi Wang ◽  
Bailong Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Preoperative Chemotherapy ◽  
Correlative Analysis ◽  
Significant Difference ◽  
Before And After ◽  
Independent Risk Factors

Background and Objectives: This study aims to explore the safety of preoperative chemotherapy and clarify whether preoperative chemotherapy with oxaliplatin + S-1 (SOX) regimen and its adverse events are associated with higher risks of postoperative complications.Methods: We included consecutive patients with gastric cancer who underwent gastrectomy in our department between July 1 2018, and January 31 2020. Patients with preoperative SOX regimen chemotherapy were included in the analysis.Results: In the 343 included patients, 77 cases underwent preoperative chemotherapy. In total, surgical complications were found in 117 patients (34.1%), and there was no significant difference between the patients with and without preoperative chemotherapy before and after propensity score matching (p > 0.05, respectively). Multivariate analysis showed that preoperative comorbidities (p = 0.026) and the preoperative cT4b (p = 0.028) were independent risk factors in postoperative complications. In patients with preoperative chemotherapy, neither the occurrence of adverse events nor their severity was associated with postoperative complications (p > 0.05). However, the patients who received five to six cycles were more prone to postoperative complications than those who received three to four cycles (62.5 vs. 27.9%, OR = 4.306, 95% Cl = 1.282–14.464, p = 0.018).Conclusions: Occurrence of postoperative complications was not influenced by preoperative SOX chemotherapy. However, increased cycles of chemotherapy may lead to higher incidence of postoperative complications.

scholarly journals The Characteristics, Prognosis, and Risk Factors of Lymph Node Metastasis in Early Gastric Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Xuan Li ◽  
Shiyu Liu ◽  
Jin Yan ◽  
Lei Peng ◽  
Meihong Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Depth Of Invasion ◽  
Node Metastasis ◽  
Independent Risk Factors ◽  
Male Sex

Background. Lymph node metastasis (LNM) is the most important risk factor for endoscopic treatment in early gastric cancer (EGC) patients. We aimed to investigate the rate of LNM, the risk factors, and the prognosis of EGC patients with LMN. Methods. A total of 10,039 patients who underwent gastrectomy with lymphadenectomy were reviewed between January 2010 and December 2015 at Jiangsu Province Hospital in China. Among them, we identified 1004 (10%) EGCs. First, endoscopic and clinicopathological features related to LNM were analyzed, and then risk factors for LNM were identified using univariate and multivariate analysis. Finally, the short- and long-term outcomes were compared between the groups. Results. LNM occurred in 123 (12.3%) EGCs. Most of EGCs were male (n=720, 71.7%) and mean age was 59.65 ± 11.09 years. The rate of H. pylori infection was 78.0% (783/1004). LNM was significantly associated with age, sex, location, lesion size, macroscopic type, depth of invasion, differentiation type, histological morphology, lymphovascular invasion (LVI), and TMN stage. By multivariate analysis, significant independent risk factors for LNM in EGC were identified as following: male sex (OR 2.365, P=0.035), age ≦ 40 (OR 0.055, P=0.012), depressed type (OR 2.721, P=0.013), submucosa invasion (OR 2.987, P=0.032), LVI (OR 5.186, P=0.003), tumor located in corpora (OR 8.904, P=0.047), and in angle (OR 12.998, P=0.024). 86.5% were successfully followed up for 3 years. The overall 1- and 3-year survival rates in LNM group were 100% and 91.1%, respectively, and those with no LNM were 100% and 100%, respectively. Conclusion. EGCs were investigated in 10.0% of gastric cancer, which LNM occurred in 12.3% of EGC. Independent risk factors of LNM included male sex, age (>40), the depth of invasion, LVI, and tumor located in corpora or angle. The 3-year overall survival rate was greater in EGC patients without LNM.

scholarly journals Predictive value of risk score using Kyoto classification of gastritis a few years prior to diagnosis of early gastric cancer

JGH Open ◽  
2020 ◽  
Author(s):  
Yo Fujimoto ◽  
Yasumi Katayama ◽  
Yoshinori Gyotoku ◽  
Ryosuke Oura ◽  
Ikuhiro Kobori ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Risk Score ◽  
Predictive Value

scholarly journals IgG4-related gastric disease with plasma cell-rich obliterative arteritis accompanied by early-stage gastric cancer: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Masayoshi Obatake ◽  
Koichi Sato ◽  
Shigehiko Yagi ◽  
Hiromi Ohtani ◽  
Katsumi Kito
Keyword(s):  
Gastric Cancer ◽  
Plasma Cell ◽  
Early Stage ◽  
Vascular Lesions ◽  
Gastric Disease ◽  
Inflammatory Disorder ◽  
Obliterative Phlebitis ◽  
Regional Lymph Node Dissection ◽  
Serum Igg4 ◽  
Storiform Fibrosis

Abstract Background Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated inflammatory disorder that can involve multiple organs. It is characterized by IgG4-positive plasma cell-rich storiform fibrosis and obliterative phlebitis associated with a high serum IgG4 level. There are few reports of gastric IgG4-RD, especially those detected prior to systemic or other organ involvement. Case presentation: A 70-year-old man was diagnosed with type 0–IIc gastric cancer at the anterior wall of the gastric corpus by upper gastrointestinal endoscopy. In addition, a submucosal tumor (SMT) 7 mm in diameter was found at the greater curvature of the angulus. Laparoscopic distal gastrectomy with regional lymph node dissection was performed. Pathology revealed a poorly differentiated adenocarcinoma in the type 0–IIc lesion and storiform fibrosis with infiltration of a large number of IgG4-positive plasma cells in the SMT. Postoperative laboratory testing showed elevation of serum IgG4 levels; thus, we diagnosed the SMT as IgG4-RD. Intriguingly, the gastric IgG4-RD lesion demonstrated IgG4-positive plasma cell-rich arteritis as well as typical obstructive phlebitis. The patient has been followed for 2 years after surgery without recurrence of cancer, but skin lesions of IgG4-RD have appeared. Conclusion We report a rare case of IgG4-RD presenting as a gastric SMT, accompanied by early-stage gastric cancer. Our case may support a newly proposed relationship between IgG4-RD and malignancies. The gastric IgG4-RD lesion showed arteritis as well as obliterative phlebitis, potentially providing novel insight into IgG4-related vascular lesions.

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