Gastric cancer burden: Evidence from a safety-net hospital.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 187-187
Author(s):  
Arnold Forlemu ◽  
Dimas Kosa ◽  
Dawood Findakly ◽  
Surabhi Amar
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Late Stage ◽  
Safety Net ◽  
Preventive Strategies ◽  
Diffuse Type ◽  
Stage Disease ◽  
Late Stage Disease ◽  
Gastric Cancer Patients

187 Background: Gastric cancer is a leading cause of cancer-related deaths worldwide, with more than eleven thousand estimated gastric cancer deaths expected to occur this 2020 in the United States (US). Understanding the burden and trends in gastric cancer across demographics and different locations in the US is crucial to develop effective preventive strategies. This study describes, characterizes, and identifies high risk group gastric cancer patients, who may benefit the most from preventive and management strategies. Methods: A retrospective study was conducted between 2010 to 2019 at our institution to identify patients diagnosed with gastric cancer during that period. Data on demographics, risk factors, mode of presentation, pathology, site, type, and stage of gastric cancer were obtained. Chi-square was used to compare categorical variables. Regression analysis was used to evaluate factors associated with late-stage disease and cancer type. Results: A total of 111 patients were analyzed in this study. The median age of gastric cancer patients was 52 years (range 27 to 87 years). Most of the patients were Hispanic (70.3%), non-citizens (59.5%), were uninsured (69.4%), and 67.6% were living below the federal poverty level (FPL). Also, 31.5% of the patients had a family history of cancer, had diffuse-type adenocarcinoma (61%), late-stage disease (76.6%), 52.4% of the cancers were in the distal portion of the stomach. Uninsured patients were more likely to die compared to insured patients, however, this difference was not statistically significant (64.9% vs 47.1%, p = 0.077). Age below 40, Hispanic ethnicity, being uninsured, and living below FPL were associated with higher rates of late-stage disease and diffuse-type cancer (p < 0.05). Conclusions: Our data suggest a younger age at gastric cancer diagnosis than the national average. Moreover young, and uninsured Hispanics presented with advanced gastric cancer and may represent a high-risk target population for preventive strategies.

Oncology patients in the health care safety net: Is it too late for early palliative care?

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 128-128
Author(s):  
Heather A. Harris ◽  
Anne Kinderman ◽  
Leslie Safier
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Late Stage ◽  
Safety Net ◽  
Early Palliative Care ◽  
Care Services ◽  
Stage Disease ◽  
Late Stage Disease ◽  
Palliative Care Services

128 Background: Studies have suggested that uninsured and Medicaid patients are more likely to present with late-stage cancer than Medicare patients, and may be more likely to be admitted urgently or emergently. However, studies of palliative care interventions for cancer patients suggest that the greatest impact can be achieved if these services begin “early” (≥ 90 days prior to death). In our urban public hospital, we examined where patients receive their initial cancer diagnosis, and at what stage they are diagnosed, in order to determine how to best implement community-based palliative care services. Methods: Retrospective cohort analysis of cancer patients diagnosed over a five year period. Hospital tumor registry data were used to determine the location of diagnosis (inpatient vs. outpatient), stage and type of cancer at diagnosis, and patient status at the end of the study period (alive vs. deceased). Results: Of the 2,928 patients diagnosed with cancer, 26% of patients (n = 759) were diagnosed while hospitalized. Patients who received their diagnosis while hospitalized were more likely to be diagnosed with stage 3-4 disease (49%, n = 372), vs. stage 0-1 (21%, n = 163). 25% of patients who received their diagnosis in the inpatient setting died within 90 days of initial diagnosis. Patients diagnosed in the outpatient setting were more likely to be diagnosed with stage 0-1 (40%, n = 865), vs. stage 3-4 (32%, n = 688). Patients diagnosed while hospitalized were 2.9 times more likely to be diagnosed with late stage disease, compared to those diagnosed as outpatients (95% CI 2.3-3.5, p < 0.0001). Conclusions: A large minority of patients received their cancer diagnosis while hospitalized, and were more likely to be diagnosed with late-stage disease. Additionally, a significant proportion of these patients died within 90 days of their initial diagnosis. In order to provide "early" palliative care for cancer patients in public hospitals, palliative care programs may need to offer initial consultation visits while patients are hospitalized, and then connect them with prompt outpatient follow-up. Safety net programs with palliative care services for cancer patients should emphasize continuity across inpatient and outpatient settings.

First-degree relatives of early-onset gastric cancer patients show a high risk for gastric cancer: phenotype and genotype profile

2013 ◽  
Vol 463 (3) ◽  
pp. 391-399 ◽  
Author(s):  
Ricardo Marcos-Pinto ◽  
Mário Dinis-Ribeiro ◽  
Fátima Carneiro ◽  
Xiaogang Wen ◽  
Carlos Lopes ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Early Onset ◽  
Genotype Profile ◽  
First Degree Relatives ◽  
Cancer Phenotype ◽  
Gastric Cancer Patients

The relationship between HER-2 and TOPO-2A gene expression and clinicopathologic results in gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14670-e14670
Author(s):  
Metin Ozkan ◽  
Esra Ermis Turak ◽  
Halit Karaca ◽  
Mevlude Inanc ◽  
Veli Berk ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Median Overall Survival ◽  
Intestinal Type ◽  
Negative Group ◽  
Diffuse Type ◽  
Her 2 ◽  
Gastric Cancer Patients

e14670 Background: HER-2 and Topo-2A genes are settled on a chromosome 17 and their co-amplification rates are high. In this study, early gastric cancer patients who received adjuvant chemo-radiotherapy and chemotherapy were evaluated with HER-2 and Topo-2A expression in association with clinical and histopathologic findings. Methods: A total of 103 gastric cancer patients were included the study. The HER-2 and Topo-2A levels were measured by immunohistochemistry in postoperative tumor materials. A standard evaluation method was admitted for HER-2 positivity, while Topo-2A nuclear staining 3+ and 4+ were considered as overexpression. Those with level 2+ or 3+ of HER-2, the FISH test were attempted. Results: The median follow-up was 19 months (ranges 2–70 months). Forty-six patients (44%) relapsed during follow-up whereas 60 patients (58%) had died. The median overall survival (mOS) was 23 months. Histopathologies of HER-2 positive patients were intestinal type in 7 (87.5%) and diffuse type in one (12.5%) patient. In the follow-up period 4 patients (50%) were died (mOS was 17 months in this group). Median overall survival was 23 months in HER-2 negative group (p=0.6). Histopathologies of Topo-2A positive patients were intestinal type in 9 (64.2%) and diffuse type in 5 (35.8%) patient. In the follow-up period 8 patients (57%) were died (mOS was 22 months in this group). Median overall survival was 23 months in Topo-2A negative group (p=0.8). Three patients (37.5%) who had HER-2 positive histopathologies also had Topo-2A positivity. Conclusions: Overexpression rates of HER-2 in gastric cancer were reported 6.8-34%. Racial differences and different scoring techniques thought to be impact the results. Co-amplification rate of HER-2 and Topo-2A was reported 34% in gastric cancer. In our study HER-2 and Topo-2A overexpression rates were 7.7% and 13.6% respectively and co-amplification of HER-2 with Topo-2A rate was 37.5% is also similar to the other studies. Stages of patients with HER-2 and Topo-2A overexpression were similar to the distribution of the overall patients. While intestinal subtypes showed a higher rate of HER-2 overexpression, the median survival times tend to be shorter in HER-2 positive patients.

Metabolomic discrimination of intestinal- and diffuse-type gastric cancer tissues using capillary electrophoresis time-of-flight mass spectrometry.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14635-e14635
Author(s):  
Masanori Terashima ◽  
Masatoshi Kusuhara ◽  
Masanori Tokunaga ◽  
Yutaka Tanizawa ◽  
Etsuro Bando ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Gastric Cancer ◽  
Capillary Electrophoresis ◽  
Cancer Patients ◽  
Time Of Flight ◽  
Diffuse Type ◽  
Flight Mass Spectrometry ◽  
Tumor Tissues ◽  
Gastric Cancer Patients ◽  
Diffuse Type Gastric Cancer

e14635 Background: Clinicopathological characteristics of gastric cancer patients strongly depend on histological type. In contrast with gene and protein expressions, metabolic properties of intestinal- and diffuse-type gastric cancer have been largely unknown. Here, we conducted metabolome analysis of paired non-tumor and tumor gastric tissues by using capillary electrophoresis and liquid chromatography combined with time-of-flight mass spectrometry (CE- and LC-TOFMS, respectively) in order to metabolomically characterize non-tumors (NTs), intestinal-type tumors (ITs), and diffuse-type tumors (DTs). Methods: Tumor and surrounding non-tumor tissues were surgically excised pair-wise from 27 gastric cancer patients (18 ITs and 9 DTs) who underwent gastrectomy at our institution between February and May 2011. Following tissue homogenization and metabolite extraction, we measured 254 and 138 metabolites, respectively, by CE-TOFMS and LC-TOFMS. Results: Metabolomic profiles of tumor tissues, especially ITs, were well-distinguished from those of NTs: Lactate and most glycolytic intermediate levels in ITs were significantly higher than those in NTs, which reaffirms the Warburg effect of cancer, but the significance was lesser in DTs. Levels of all the measured amino acids were significantly higher in ITs and relatively higher in DTs than in NTs, showing high capacities of cancer cells for protein synthesis. Although levels of ATP, GTP, and energy charge in ITs and DTs were lower than those in NTs, purine contents were rather higher in the tumors than in NTs, which may support their high demand for DNA replication. Moreover, reduced glutathione in DTs were the lowest among others, implying their potential vulnerability against oxidative stress. Conclusions: Metabolomic profiles of NTs, ITs, and DTs were discriminated by CE- and LC-TOFMS analyses: Considerably high lactate, amino acid, and purine levels highlighted the metabolome of tumors, especially of ITs. Relatively low energy and redox statuses of DTs, however, could be targeted for developing more effective cancer therapeutics.

Different Pathological Features and Prognosis in Gastric Cancer Patients Coming From High-Risk and Low-Risk Areas of Italy

2009 ◽  
Vol 250 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Daniele Marrelli ◽  
Corrado Pedrazzani ◽  
Giovanni Corso ◽  
Alessandro Neri ◽  
Marianna Di Martino ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Low Risk ◽  
Pathological Features ◽  
Risk Areas ◽  
Gastric Cancer Patients
Sign in / Sign up

Export Citation Format

Share Document