S1424 Gastric Cancer: Epidemiology and Diagnosis in the Black Population at a Tertiary Medical Center

Backgrounds/Aims. Watson for Oncology (WFO) is a cognitive technology that processes medical information by analyzing the latest evidence and guidelines. However, studies of the concordance rate between WFO and clinicians for advanced gastric cancer (AGC) are lacking.Methods. We retrospectively reviewed 65 patients with AGC who consulted WFO and the Gachon Gil Medical Center multidisciplinary team (GMDT) in 2016 and 2017. The recommendations of WFO were compared with the opinions of the GMDT. WFO provided three treatment options: recommended (first treatment option), for consideration (second treatment option), and not recommended.Results. In total, 65 patients (mean age 61.0 years; 44 males and 21 females) were included in the study. The concordance rate between WFO and the GMDT was 41.5% (27/65) at the recommended level and 87.7% (57/65) at the for consideration level. The main causes of discordance between WFO and the GMDT were as follows. First, WFO did not consider the medical history. Second, WFO recommended the use of agents that are considered outdated in Korea. Third, some patients wanted to be involved in a clinical trial. Fourth, some patients refused to use the biologic agents recommended by WFO for financial reasons as they were not covered by medical insurance.Conclusions. The concordance rate at the recommended level was relatively low but was higher at the for consideration level. Discordances arose mainly from the different medical circumstances at the Gachon Gil Medical Center (GMC) and the Memorial Sloan Kettering Cancer Center (MSKCC), the main WFO consulting center. The utility of WFO as a tool for supporting clinical decision making could be further improved by incorporating regional guidelines.

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Gastric cancer: epidemiology, prevention, and therapy

Helicobacter ◽

10.1111/hel.12518 ◽

2018 ◽

Vol 23 ◽

pp. e12518 ◽

Cited By ~ 52

Author(s):

Marino Venerito ◽

Riccardo Vasapolli ◽

Theodoros Rokkas ◽

Peter Malfertheiner

Keyword(s):

Gastric Cancer ◽

Cancer Epidemiology ◽

Prevention And Therapy

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Unexpected CDH1 Mutations Identified on Multigene Panels Pose Clinical Management Challenges

JCO Precision Oncology ◽

10.1200/po.16.00021 ◽

2017 ◽

pp. 1-12 ◽

Cited By ~ 7

Author(s):

Katrina Lowstuter ◽

Carin R. Espenschied ◽

Duveen Sturgeon ◽

Charité Ricker ◽

Rachid Karam ◽

...

Keyword(s):

Gastric Cancer ◽

Medical Management ◽

Cancer Genetics ◽

Medical Center ◽

Academic Medical Center ◽

Lifetime Risk ◽

Diffuse Gastric Cancer ◽

Mutation Carriers ◽

Cdh1 Mutation ◽

Testing Criteria

Purpose Mutations in the CDH1 gene confer up to an 80% lifetime risk of diffuse gastric cancer and up to a 60% lifetime risk of lobular breast cancer. Testing for CDH1 mutations is recommended for individuals who meet the International Gastric Cancer Linkage Consortium (IGCLC) guidelines. However, the interpretation of unexpected CDH1 mutations identified in patients who do not meet IGCLC criteria or do not have phenotypes suggestive of hereditary diffuse gastric cancer is clinically challenging. This study aims to describe phenotypes of CDH1 mutation carriers identified through multigene panel testing (MGPT) and to offer informed recommendations for medical management. Patients and Methods This cross-sectional prevalence study included all patients who underwent MGPT between March 2012 and September 2014 from a commercial laboratory (n = 26,936) and an academic medical center cancer genetics clinic (n = 318) to estimate CDH1 mutation prevalence and associated clinical phenotypes. CDH1 mutation carriers were classified as IGCLC positive (met criteria), IGCLC partial phenotype, and IGCLC negative. Results In the laboratory cohort, 16 (0.06%) of 26,936 patients were identified as having a pathogenic CDH1 mutation. In the clinic cohort, four (1.26%) of 318 had a pathogenic CDH1 mutation. Overall, 65% of mutation carriers did not meet the revised testing criteria published in 2015. All three CDH1 mutation carriers who had risk-reducing gastrectomy had pathologic evidence of diffuse gastric cancer despite not having met IGCLC criteria. Conclusion The majority of CDH1 mutations identified on MGPT are unexpected and found in individuals who do not fit the accepted diagnostic testing criteria. These test results alter the medical management of CDH1-positive patients and families and provide opportunities for early detection and risk reduction.

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Gastric Cancer Epidemiology in Norte De Santander, Colombia. 2007-2011

Annals of Oncology ◽

10.1093/annonc/mdu165.14 ◽

2014 ◽

Vol 25 ◽

pp. ii17

Author(s):

Yepes Castaño Maira ◽

Yañez Gutierrez Claudia

Keyword(s):

Gastric Cancer ◽

Cancer Epidemiology

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The five-year-survival rate for gastric cancer. A statistical study from the syracuse medical center

Cancer ◽

10.1002/1097-0142(195307)6:4<756::aid-cncr2820060414>3.0.co;2-2 ◽

1953 ◽

Vol 6 (4) ◽

pp. 756-759 ◽

Cited By ~ 4

Author(s):

A. B. Raffl ◽

G. E. Kelley

Keyword(s):

Gastric Cancer ◽

Survival Rate ◽

Statistical Study ◽

Medical Center

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Retrospective Evaluation of Factors Affecting Lymph Node Retrieval Following Gastrectomies with Oncologic Intent

Rambam Maimonides Medical Journal ◽

10.5041/rmmj.10434 ◽

2021 ◽

Vol 12 (2) ◽

pp. e0012

Author(s):

Steven Fuchs ◽

◽

Itamar Ashkenazi ◽

◽

Keyword(s):

Gastric Cancer ◽

Lymph Nodes ◽

Total Gastrectomy ◽

Medical Center ◽

Proximal Gastrectomy ◽

Univariate Analysis ◽

Related Factors ◽

Factors Affecting ◽

Lymph Node Retrieval ◽

Gastric Cancer Patients

Background: Adequate lymphadenectomy is an important factor affecting survival in gastric cancer patients. Retrieval and examination of at least 15 lymph nodes is recommended in order to properly stage gastric malignancies. The objectives of this study were to evaluate the proportion of patients undergoing inadequate lymphadenectomies and possible risk factors for inadequate surgery. Methods: This was a retrospective study that included patients, 18 years and older, who underwent gastrectomies with oncologic intent in the Hillel Yaffe Medical Center. We analyzed the association of demographic, clinical, and pathological variables with adequate number of lymph nodes. Results: The retrieval of less than 15 lymph nodes was reported in 51% (53/104) patients undergoing gastrectomies with oncologic intent. The extent of surgery was the only variable associated with inadequate lymphadenectomy on univariate analysis: subtotal/proximal versus total gastrectomy (P=0.047). Differ¬ences observed for previous surgery (P=0.193), T stage (P=0.053), N stage (P=0.051), and lymphovascular invasion (P=0.14) did not reach significance. Subtotal/proximal gastrectomy resulted in inadequate resec¬tion of lymph nodes in 56% of the patients, while this occurred in only 30% of the patients undergoing total gastrectomy (relative risk 1.865; 95% CI 0.93, 3.741). Logistic regression confirmed that only subtotal/prox¬imal versus total gastrectomy was associated with inadequate number of lymph nodes resected (P=0.043). Discussion and Conclusion: In this study we analyzed the association of patient, tumor, and surgery-related factors on adequate lymphadenectomy in patients undergoing gastrectomies for possible gastric cancer. Larger extent of the surgery (total, rather than subtotal/proximal gastrectomy) was revealed to be the only indicator positively associated with adequate lymphadenectomy.

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