Value of Preoperative Inflammation-Based Prognostic Scores in Predicting Overall Survival and Disease-Free Survival in Patients with Gastric Cancer

PURPOSE: The efficacy of adjuvant chemotherapy in gastric cancer is controversial. We conducted a phase III, randomized, multicentric clinical trial with the goal of assessing the efficacy of the combination of mitomycin plus tegafur in prolonging the disease-free survival and overall survival of patients with resected stage III gastric cancer. PATIENTS AND METHODS: Patients with resected stage III gastric adenocarcinoma were randomly assigned, using sealed envelopes, to receive either chemotherapy or no further treatment. Chemotherapy was started within 28 days after surgery according to the following schedule: mitomycin 20 mg/m2 intravenously (bolus) at day 1 of chemotherapy; 30 days later, oral tegafur at 400 mg bid daily for 3 months. Disease-free survival and overall survival were estimated using the Kaplan-Meier analysis and the Cox proportional hazards model. RESULTS: Between January 1988 and September 1994, 148 patients from 10 hospitals in Catalonia, Spain, were included in the study. The median follow-up period was 37 months. The tolerability of the treatment was excellent. The overall survival and disease-free survival were higher in the group of patients treated with chemotherapy (P = .04 for survival and P = .01 for disease-free survival in the log-rank test). The overall 5-year survival rate and the 5-year disease-free survival rate were, respectively, 56% and 51% in the treatment group and 36% and 31% in the control group. CONCLUSION: Our positive results are consistent with the results of recent studies; which conclude that there is a potential benefit from adjuvant chemotherapy in resected gastric cancer.

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Phase II trial of adjuvant immunotherapy with autologous tumor-derived Gp96 vaccination in patients with gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.117 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 117-117

Author(s):

Lin Chen ◽

Kecheng Zhang ◽

Zheng Peng ◽

Bo Wei ◽

Hongqing Xi ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Immune Responses ◽

Phase Ii Trial ◽

Disease Free Survival ◽

Control Group ◽

Autologous Tumor ◽

Free Survival ◽

Experimental Group ◽

Disease Free

117 Background: Autologous, tumor-derived heat shock protein Gp96 peptides complexes have shown antitumor potential in various cancers. We conducted the first Phase II trial to evaluate the safety and efficacy of Gp96 vaccination in adjuvant settings for patients with gastric cancer. Methods: Consecutive patients from November 2012 to December 2015 were enrolled. Participants were allocated to the experimental group or control group, receiving Gp96 vaccination plus chemotherapy or chemotherapy alone respectively. The primary endpoints were disease-free survival and toxicity. The secondary outcomes were overall survival and tumor-specific immune responses. Results: Thirty-nine and forty patients received Gp96 vaccination plus chemotherapy and chemotherapy alone in the adjuvant settings respectively. Significant increased tumor-specific immune responses were observed after Gp96 vaccination. There were comparable disease-free survival ( p = 0.413; HR: 0.75; 95% CI: 0.37−1.48) and overall survival ( p = 0.485; HR: 0.68; 95% CI: 0.24−1.96) between experimental group and control group. In subgroup of patients with stage II and stage III gastric cancer, patients who have received Gp96 vaccination had improved disease-free survival compared those who have not ( p = 0.044; HR: 0.45; 95% CI: 0.22−0.96). Gp96 vaccination plus chemotherapy was well tolerated and no Gp96-related serious adverse event has been observed. Conclusions: Gp96 vaccination could elicit tumor-specific immune responses and could be safely used in adjuvant settings combined with chemotherapy. Patients with less aggressive diseases might benefit from Gp96 therapy.

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Clinical impact of postgastrectomy sarcopenia on the prognosis in patients with gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.311 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 311-311

Author(s):

Beom Jin Kim ◽

Eun Sun Lee ◽

Joong-Min Park ◽

In Gyu Hwang

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Muscle Mass ◽

Surgical Resection ◽

Disease Free Survival ◽

Clinical Impact ◽

Free Survival ◽

Significant Difference ◽

Fat Volume ◽

Disease Free

311 Background: There is a lack of research on newly developed sarcopenia postoperatively. The purpose of this study was to investigate the risk factors and the clinical impact of postgastrectomy sarcopenia on the prognosis in patients undergoing radical gastrectomy for gastric cancer (GC). Methods: We retrospectively reviewed clinicopathological data from 430 consecutive GC patients who underwent surgical resection at Chung-Ang University Hospital between January 2011 and December 2015. Their skeletal muscle mass and abdominal fat volume were measured by abdominal CT imaging. Results: A total of 425 patients were analyzed in the study. The mean age was 62 years old and male were 301 (70.8%). Of these, 42 patients (9.9%) were diagnosed as pre-operative sarcopenia. Compared with non-sarcopenic group, pre-operative sarcopenia groups showed more female, higher BMI, less alcoholic, and less smoking. However, there was no significant difference in 5 - year overall survival and disease free survival between the groups (p = 0.836 and p = 0.638, respectively). Among 381 non-sarcopenic patients, 48 patients (12.6%) were diagnosed as newly developed sarcopenia in one year after gastric resection. Compared with non-sarcopenic group, the newly developed sarcopenic group showed more male, more undifferentiated tumor, lower hemoglobin level, less alcoholic, less smoking, and presence of diabetes mellitus. However, there was no significant difference in the 5 - year overall survival and disease free survival among non-sarcopenic, sarcopenic, and newly developed sarcopenic groups (p = 0.521 and p = 0.534, respectively). The relationship between preoperative body fat volume and postoperative muscle mass showed a significant correlation (rho = 0.296, p < 0.001), but only BMI was significantly associated with long term survival. Conclusions: Although newly developed sarcopenia after surgery did not affect the survival rate, patients with nutritional risk of sarcopenia after surgical resection may require early evaluation of nutritional status and nutritional support.

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Analysis of Threshold Changes of Tumor Mutation Burden of Gastric Cancer and Its Relationship with Patients’ Prognosis

Journal of Oncology ◽

10.1155/2021/9026610 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Nan Zhang ◽

Peiyu Li ◽

Xin Wu ◽

Shaoyou Xia ◽

Xudong Zhao ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Pearson Correlation ◽

Disease Free Survival ◽

Free Survival ◽

Tumor Mutation Burden ◽

D2 Lymph Node Dissection ◽

Logistic Analysis ◽

Mutation Burden ◽

Disease Free

Objective. Gastric cancer is a malignant tumor originating from gastric mucosal epithelium. Here, we aimed to investigate the analysis of the threshold change of gastric cancer tumor mutation burden (TMB) and its relationship with the prognosis of patients. Methods. 256 patients with gastric cancer were selected as subjects. All patients were in the advanced stage and received surgical resection of D2 lymph node dissection. After the operation, a follow-up was performed for 24 months, and the disease-free survival and overall survival of patients were counted. The NGS molecular biological was detected to obtain gastric cancer tumor mutation burden (TMB) data. Pearson correlation analysis software was used to analyze the correlation between TMB threshold and disease-free survival or overall survival of patients with gastric cancer, and the multivariate logistic analysis was performed as well. Results. The disease-free survival period and the overall survival period of patients in the low-to-medium TMB group were both longer than those in the high TMB group. Pearson correlation analysis results showed that the TMB threshold was negatively correlated with the disease-free survival and overall survival of gastric cancer patients. Results from multivariate logistic analysis showed that high TMB thresholds have a greater impact on disease-free survival and overall survival of patients, but the impact of medium and low TMB thresholds on disease-free survival and overall survival of patients is weakened. Conclusions. The TMB threshold level has a predictive effect on the effect of surgical resection of D2 lymph node dissection, and high levels of TMB can significantly affect disease-free survival and overall survival of patients with advanced gastric cancer.

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Comprehensive Analysis of E2F Family Members in Human Gastric Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.625257 ◽

2021 ◽

Vol 11 ◽

Author(s):

Shengbo Li ◽

Xiaofan Yang ◽

Wenqing Li ◽

Zhenbing Chen

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Tumor Progression ◽

Cell Lines ◽

Family Members ◽

Disease Free Survival ◽

Mrna Levels ◽

Free Survival ◽

Expression Levels ◽

Disease Free

Gastric cancer (GC) is the second most common cancer and the third most frequent cause of cancer-related deaths in China. E2Fs are a family of transcription factors reported to be involved in the tumor progression of various cancer types; however, the roles of individual E2Fs are still not known exactly in tumor progression of GC. In this study, we examined the expression of E2Fs to investigate their roles in tumor progression in GC patients using multiple databases, including ONCOMINE, GEPIA2, Kaplan-Meier plotter, cBioPortal, Metascape, LinkedOmics, GeneMANIA, STRING and UCSC Xena. We also performed real-time polymerase chain reaction (RT-PCR) to validate the expression levels of individual E2Fs in several GC cell lines. Our results demonstrated that the mRNA levels of E2F1/2/3/5/8 were significantly higher both in GC tissues and cell lines. The expression levels of E2F1 and E2F4 were correlated with poor overall survival (OS), decreased post-progression survival (PPS), and decreased progression-free survival (FP) in patients with GC. However, overexpression of E2F2, E2F5, E2F7 and E2F8 is significantly associated with disease-free survival and overall survival in patients with GC. In addition, higher E2F3 and E2F6 mRNA expression was found to increase GC patients’ OS and PPS. 224 of 415 patients with STAD (54%) had gene mutations that were associated with longer disease-free survival (DFS) but not OS. Cell cycle pathway was closely associated with mRNA level of more than half of E2Fs (E2F1/2/3/7/8). There were close and complicated interactions among E2F family members. Finally, our results indicated the gene expressions of E2Fs had a positive relationship with its copy numbers. Taken together, E2F1/2/3/5/8 can serve as biomarkers for GC patients with high prognostic value for OS of GC patients or therapeutic targets for GC.

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Partial Versus Total Omentectomy in Patients with Gastric Cancer: A Systemic Review and Meta-Analysis

Cancers ◽

10.3390/cancers13194971 ◽

2021 ◽

Vol 13 (19) ◽

pp. 4971

Author(s):

Shion Wei Chai ◽

Suo-Hsien Wang ◽

Chih-Yuan Wang ◽

Yi-Chan Chen ◽

Ruey-Shyang Soong ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Meta Analysis ◽

Disease Free Survival ◽

Systemic Review ◽

Cochrane Library ◽

Free Survival ◽

Significant Difference ◽

Hospital Stays ◽

Disease Free

Background: Surgical treatment is the key to cure localized gastric cancer. There is no strong evidence that supports the value of omentectomy. Thus, a meta-analysis was conducted to compare the safety and efficiency of partial and total omentectomy in patients with gastric cancer. Methods: PubMed, Embase, and Cochrane Library databases were searched. All studies that compared total and partial omentectomy as treatments for gastric cancer were included. The primary outcomes were patients’ overall survival and disease-free survival, while the secondary outcomes were perioperative outcome and postoperative complications. Results: A total of nine studies were examined, wherein 1043 patients were included in the partial omentectomy group, and 1995 in the total omentectomy group. The partial omentectomy group was associated with better overall survival (hazard ratio: 0.80, 95% CI: 0.66 to 0.98, p = 0.04, I2 = 0%), shorter operative time, and lesser blood loss than the total omentectomy group. In addition, no statistically significant difference was observed in the number of dissected lymph nodes, length of hospital stays, complication rate, and disease-free survival. Conclusions: Our results show that, compared with total omentectomy in gastric cancer surgery, partial omentectomy had non-inferior oncological outcomes and comparable safety outcomes.

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Sa1234 OVERALL SURVIVAL, DISEASE-FREE SURVIVAL, AND RECURRENCE-FREE SURVIVAL FOR ENDOSCOPIC SUBMUCOSAL DISSECTION VERSUS GASTERECTOMY FOR EARLY GASTRIC CANCER, A METAANALYSIS

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2018.04.272 ◽

2018 ◽

Vol 87 (6) ◽

pp. AB175-AB176

Author(s):

Mohamed M. Abdelfatah ◽

Mohamed Barakat ◽

Yahya Ahmed ◽

Mohamed O. Othman

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Early Gastric Cancer ◽

Endoscopic Submucosal Dissection ◽

Disease Free Survival ◽

Recurrence Free Survival ◽

Free Survival ◽

Submucosal Dissection ◽

Disease Free

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Tumor-Stroma Ratio is an independent predictor for overall survival and disease free survival in gastric cancer patients

The Surgeon ◽

10.1016/j.surge.2017.05.007 ◽

2017 ◽

Vol 15 (6) ◽

pp. 329-335 ◽

Cited By ~ 11

Author(s):

Paolo Aurello ◽

Giammauro Berardi ◽

Diego Giulitti ◽

Antonio Palumbo ◽

Simone Maria Tierno ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Independent Predictor ◽

Disease Free Survival ◽

Tumor Stroma ◽

Free Survival ◽

Gastric Cancer Patients ◽

Disease Free

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Hand-assisted laparoscopic versus open surgery for radical gastrectomy in the treatment of advanced distal gastric cancer: long-term overall and disease-free survival (final results of a single-center study)

Journal of International Medical Research ◽

10.1177/03000605211047700 ◽

2021 ◽

Vol 49 (9) ◽

pp. 030006052110477

Author(s):

Guode Luo ◽

Xiaohua Wang ◽

Yajiao Li ◽

Guangyu Chen ◽

Yongkuan Cao ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Open Surgery ◽

Survival Rates ◽

Disease Free Survival ◽

Radical Gastrectomy ◽

Free Survival ◽

Distal Gastric Cancer ◽

Disease Free

Objective To compare the surgical effects and long-term efficacy of hand-assisted laparoscopic surgery (HALS) and open surgery (OS) in radical gastrectomy for advanced distal gastric cancer. Methods One hundred twenty-four patients who were admitted to the Department of Gastrointestinal Surgery of the West War Zone General Hospital from May 2008 to April 2012 were randomly divided into a HALS group (n = 62) and an OS group (n = 62). After surgery, 113 patients were followed up for 5 and 8 years, and 11 patients were lost to follow-up. The 5- and 8-year overall survival and disease-free survival rates of the two groups were compared and analyzed. Results The 5- and 8-year overall survival rates were 31.90% and 18.40% in the HALS group and 32.50% and 18.60% in the OS group, respectively. The 5- and 8-year disease-free survival rates were 21.50% and 13.00% in the HALS group and 21.90% and 13.10% in the OS group, respectively. No significant differences were found. Conclusion Hand-assisted laparoscopic radical gastrectomy for advanced distal gastric cancer has the advantages of less severe trauma, less intraoperative blood loss, more rapid postoperative recovery, and equivalent long-term efficacy compared with OS.

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