scholarly journals Clinical Significance of the Pre-albumin Level in Gastric Cancer Patients who Receive Curative Treatment

Author(s):  
toru aoyama ◽  
Masato Nakazono ◽  
Kenki Segami ◽  
Shinsuke Nagasawa ◽  
Kazuki Kano ◽  
...  

Abstract Background We investigated the clinical influence of the prealbumin level on the gastric cancer survival and recurrence after curative treatment.Methods This study included 447 patients who underwent curative treatment for gastric cancer between 2013 and 2017. The risk factors for the overall survival (OS) and recurrence-free survival (RFS) were identified. Results A prealbumin level of 20 mg/dl was regarded as the optimal point of classification, considering the 3- and 5-year survival rates. The OS rates at 3 and 5 years after surgery were 80.7% and 65.0% in the low-prealbumin group, respectively, and 93.1% and 87.9% in the high-prealbumin group, respectively, a statistically significant difference (p<0.001). The RFS rates at 3 and 5 years after surgery were 71.7% and 68.0% in the low-prealbumin group, respectively, and 90.1% and 84.7% in the high-prealbumin group, respectively, a statistically significant difference (p=0.031). A multivariate analysis demonstrated that the prealbumin level was a significant independent risk factor for the OS and RFS. In addition, the rate of introduction of adjuvant chemotherapy was significantly lower and the frequency of peritoneal recurrence and lymph node recurrence significantly higher in the low-prealbumin group than in the high-prealbumin group. Conclusion Prealbumin is a risk factor for the survival in patients who undergo curative treatment for gastric cancer. It is necessary to develop an effective plan of perioperative care and surgical strategy according to the prealbumin level.

Author(s):  
Toru Aoyama ◽  
Masato Nakazono ◽  
Kenki Segami ◽  
Shinsuke Nagasawa ◽  
Kazuki Kano ◽  
...  

Abstract Background We investigated the clinical influence of the prealbumin level on the gastric cancer survival and recurrence after curative treatment. Methods This study included 447 patients who underwent curative treatment for gastric cancer between 2013 and 2017. The risk factors for the overall survival (OS) and recurrence-free survival (RFS) were identified. Results A prealbumin level of 20 mg/dl was regarded as the optimal point of classification, considering the 3- and 5-year survival rates. The OS rates at 3 and 5 years after surgery were 80.7% and 65.0% in the low-prealbumin group, respectively, and 93.1% and 87.9% in the high-prealbumin group, respectively, a statistically significant difference (p < 0.001). The RFS rates at 3 and 5 years after surgery were 71.7% and 68.0% in the low-prealbumin group, respectively, and 90.1% and 84.7% in the high-prealbumin group, respectively, a statistically significant difference (p = 0.031). A multivariate analysis demonstrated that the prealbumin level was a significant independent risk factor for the OS and RFS. In addition, the rate of introduction of adjuvant chemotherapy was significantly lower and the frequency of peritoneal recurrence and lymph node recurrence significantly higher in the low-prealbumin group than in the high-prealbumin group. Conclusion Prealbumin is a risk factor for the survival in patients who undergo curative treatment for gastric cancer. It is necessary to develop an effective plan of perioperative care and surgical strategy according to the prealbumin level.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Dong-Jiao Guo ◽  
Kun Yang ◽  
Wei-Han Zhang ◽  
Xiao-Long Chen ◽  
Xin-Zu Chen ◽  
...  

Background. To evaluate prognostic value of metastatic No.8p LNs in patients with gastric cancer.Methods. From August 2002 to December 2011, a total of 284 gastric cancer patients who underwent gastrectomy with No.8p LNs dissection were analyzed retrospectively in this study. Patients were divided into two groups according to the status of No.8p LNs. Clinicopathological features were collected to conduct the correlation analysis. Follow-up was carried out up to December 31st, 2014. Overall survival was analyzed.Results. Out of 284 patients, metastatic No.8p LNs were found in 24 (8.5%) patients. Compared with other 260 cases, these patients suffered morphologically larger tumor (P=0.003), node stage (P=0.000), and metastatic stage (P=0.000). The 3-year overall survival rate was 26% in No.8p-positive group and 53% in No.8p-negative group. No significant difference of cumulative survival rates existed between the No.8p-positive group and No.8p-negative stage IV group (26% versus 28%,P=0.923). Patients with other distant metastasis or not in No.8p+ group had similar cumulative survival rates (24% versus 28%,P=0.914).Conclusions. Positive No.8p LNs were a poor but not an independent prognostic factor for patients with GC and should be recognized as distant metastasis.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuo-meng Xiao ◽  
Ping Zhao ◽  
Zhi Ding ◽  
Rui Xu ◽  
Chao Yang ◽  
...  

Abstract Background Proximal gastrectomy with double-tract reconstruction (DTR) has been used for upper third gastric cancer as a function-preserving procedure. However, the safety and feasibility of laparoscopic proximal gastrectomy (LPG) with DTR remain uncertain. This study compared open proximal gastrectomy (OPG) with DTR and LPG with DTR for proximal gastric cancer. Methods Sixty-four patients who had undergone OPG with DTR and forty-six patients who had undergone LPG with DTR were enrolled in this case–control study. The clinical characteristics, surgical outcomes and postoperative nutrition index were analysed retrospectively. Results The operation time was significantly longer in the LGP group than in the OPG group (258.3 min vs 205.8 min; p = 0.00). However, the time to first flatus and postoperative hospital stay were shorter in the LPG group [4.0 days vs 3.5 days (p = 0.00) and 10.6 days vs 9.2 days (p = 0.001), respectively]. No significant difference was found between the two groups in the number of retrieved lymph nodes, complications or reflux oesophagitis. The nutrition status was assessed using the haemoglobin, albumin, prealbumin and weight levels from pre-operation to six months after surgery. No significant difference was found between the groups. Conclusion LPG with DTR can be safely performed for proximal gastric cancer patients by experienced surgeons.


2021 ◽  
Author(s):  
Juliana Fernandes ◽  
Beatriz Machado ◽  
Cassio Cardoso-Filho ◽  
Juliana Nativio ◽  
Cesar Cabello ◽  
...  

Abstract Background This study aims to assess breast cancer survival rates after one decade of mammography in a large urban area of Brazil. Methods It is a population-based retrospective cohort of women with breast cancer in Campinas, São Paulo, from 2010 to 2014. Age, vital status and stage were accessed through the cancer and mortality registry, and patients records. Statistics used Kaplan-Meier, log-rank and Cox's regression. Results Out of the 2,715 cases, 665 deaths (24.5%) were confirmed until early 2020. The mean age at diagnosis was 58.6 years. Women 50-69 years were 48.0%, and stage I the most frequent (25.0%). The overall mean survival was 8.4 years (8.2-8.5). The 5-year survival (5yOS) for overall, 40-49, 50-59, 60-69, 70-79 years was respectively 80.5%, 87.7%, 83.7%, 83.8% and 75.5%. The 5yOS for stages 0, I, II, III and IV was 95.2%, 92.6%, 89.4%, 71.1% and 47.1%. There was no significant difference in survival in stage I or II (p=0.058). Compared to women 50-59 years, death's risk was 2.3 times higher for women 70-79 years and 26% lower for women 40-49 years. Concerning stage I, the risk of death was 1.5, 4.1 and 8.6 times higher, and 34% lower, respectively, for stage II, III, IV and 0. Conclusions In Brazil, breast cancers are currently diagnosed in the early stages, although advanced cases persist. Survival rates may reflect improvements in screening, early detection and treatment. The results can reflect the current status of other regions or countries with similar health care conditions.


2020 ◽  
Author(s):  
Jia-Bin Wang ◽  
You-Xin Gao ◽  
Ning-Zi Lian ◽  
Yu-Bin Ma ◽  
Ping Li ◽  
...  

Abstract Background: We previously demonstrated that CDK5RAP3 acts as a tumour suppressor in gastric cancer through negative regulation of the Wnt/β-catenin signalling pathway, but its function in chemotherapeutic responsiveness of gastric cancer has not been investigated. In this study, we aimed to examine the clinical significance of CDK5RAP3 to predict chemotherapeutic responsiveness in gastric cancer.Methods: A collection of 188 pairs of tumour tissue microarray specimens from Fujian Medical University were employed for the discovery set, and 310 tumour tissue samples of gastric cancer patients were employed for the internal validation set. Eight-five tumour tissue samples from Qinghai University Hospital were used as the external validation set 1. Transcriptomic and clinical data of 299 gastric cancer patients from TCGA were used as the external validation set 2. CDK5RAP3 expression, microsatellite instability (MSI) status, and tumour-infiltrating lymphocytes (TIL) were examined with immunohistochemistry. Clinical outcomes of patients were compared with Kaplan-Meier curves and the Cox model.Results: In a multi-centre evaluation, increased CDK5RAP3 indication of better prognosis depends mainly on MSI-L/MSS status or TILhigh. High CDK5RAP3 expression predicts sensitive therapeutic responsiveness to postoperative adjuvant chemotherapy in gastric cancer. In a stratification analysis based on CDK5RAP3 combined with TIL or MSI status, patients with CKD5RAP3low TILlow showed no significant difference in prognosis after receiving chemotherapy, whereas patients with CKD5RAP3low TILhigh, CKD5RAP3high TILlow, and CKD5RAP3high TILhigh had better responsiveness to chemotherapy. In addition, patients with CKD5RAP3high MSI-L/MSS status benefitted the most from adjuvant chemotherapy among all patients evaluated. Conclusions: CKD5RAP3 can be used as an effective marker to evaluate individualized chemotherapy regimens in gastric cancer patients dependent on their TIL and MSI status.


2013 ◽  
Vol 23 (2) ◽  
pp. 66-70
Author(s):  
Albertas Daukša ◽  
Antanas Gulbinas ◽  
Aurelija Kazlauskaitė ◽  
Johannes Oldenburg ◽  
Osman El-Maarri

Gastric cancers are usually diagnosed at an advanced stage in the progression of the disease, thus reducing the survival chances of the patients. Non-invasive early detection would greatly enhance therapy and survival rates. For this aim, we investigated tumor suppressor genes CDKN2A/p16, RARBeta, TNFRSF10C, APC, ACIN1, DAPK1, 3OST2, BCL2 and CD44 for methylation changes in peripheral blood leukocytes of gastric cancer patients. This study shows that methylation changes in peripheral blood leukocyte DNA could provide a promising method for the early detection of gastric cancer. However, larger studies are essential to explore the clinical usefulness of a peripheral blood leukocyte DNA methylation based tests for non-invasive early detection of gastric cancer.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4525-4525 ◽  
Author(s):  
K. Chin ◽  
H. Iishi ◽  
H. Imamura ◽  
O. Kobayashi ◽  
H. Imamoto ◽  
...  

4525 Background: Irinotecan has single agent activity and combination activity with S-1 reportedly in phase I/II studies with advanced gastric cancer patients (pts). S-1, oral fluoropyrimidine, also has activity on gastric cancer. A multicenter, randomized phase III trial comparing IRIS to S-1 alone in advanced gastric cancer was conducted. Methods: Pts with previously untreated gastric cancer were randomized to Arm A (oral S-1 80 mg/m2/day from day 1 to 28 followed by a 14-day rest period), or Arm B (oral S-1 80 mg/m2/day from day 1 to 21 and intravenous irinotecan 80 mg/m2 on days 1 and 15 followed by a 14-day rest). Treatment was continued unless disease progression was observed. Inclusion criteria: PS (ECOG) of 0 to 2; adequate major organ functions. Primary endpoint was overall survival. Results: From June 2004 to November 2005, 326 pts were randomized to arm A (162 pts) and arm B (164 pts). Pts characteristics (arm A vs. arm B) were as follows: median age: 63 vs. 63 years, PS 0–1: 97% vs. 97%, and distribution of subtype of intestinal/diffuse/others: 44%/55%/1% vs. 41%/58%/1%. Among 187 RECIST-evaluable pts (93 vs 94) reviewed by independent review panel, best response rates were 26.9% for arm A and 41.5% for arm B(p=0.035). Among 319 toxicity-evaluable patients (161 vs 158), grade 3 or 4 toxicities for arm A vs arm B (% of pts) were as follows: neutropenia 9.3% vs 26.6%, diarrhea 5.6% vs 15.8%, anorexia 9.9% vs 15.8%, nausea 3.7% vs 7.0%, vomiting 0.6% vs 2.5%. Conclusions: IRIS is effective, and well tolerated in pts with advanced gastric cancer. Survival analysis is underway. No significant financial relationships to disclose.


2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 31-31
Author(s):  
Baek-Yeol Ryoo ◽  
Min-Hee Ryu ◽  
Sook Ryun Park ◽  
Myoung Joo Kang ◽  
Kwon-Oh Park ◽  
...  

31 Background: The incidence of TE in gastric cancer patients (pts) is known to be high. But because the previous reports were retrospectively analyzed in heterogeneous population, they give us only limited information. We therefore conducted a prospective study to investigate the incidence of TE and prognostic factors related with TE in AGC pts receiving chemotherapy. Methods: We checked D-dimer and coagulation battery at the start of chemotherapy and every 3 months thereafter. If there developed symptoms or signs of TE, or if D-dimer elevated 5 μg/mL or more we checked imaging studies to detect TE. The chemotherapy regimen mainly included fluoropyrimidine plus platinum-based for 1st-line, taxane-based for 2nd-line, and irinotecan-based for 3rd-line chemotherapy. Results: Between Nov 2009 and Apr 2012, 241 pts were analyzed. They received median 9 (range 1 - 42) cycles of chemotherapy. During the median observational duration of 16.7 months, 32 events (13.3%, 95% CI; 8.9 - 17.7%) of TE were detected. The types of TE were as follows; deep vein thrombosis (DVT) only in 18 (56.3%), pulmonary embolism (PE) only in 4 (12.5%), DVT and PE in 5 (15.6%), cerebral infarction in 4 (12.5%), and intra-abdominal arterial thrombosis 1 (3.1%) pts. The 1-year and 2-year cumulative incidences of TE were 15.0% (95% CI, 9.6 - 20.0%) and 20.0% (95% CI, 12.1 - 26.9%), respectively. The incidence rate of TE was 14.1 (95% CI, 9.6 - 19.9) events/100 person-years. In univariate analysis, the previous gastrectomy history, baseline CA72-4 level and baseline D-dimer level were statistically significant risk factor related with TE development. But in multivariate analysis, baseline D-dimer level was the only independent risk factor associated with TE development (Hazard ratio 2.46 [95% CI, 1.08 - 5.63], P= 0.033). Among 32 pts with baseline D-dimer 5.0 μg/mL or higher, 8 pts (25.0%) developed TE, while for pts whose baseline D-dimer was lower than 5.0 μg/mL, 24 out of 209 pts (11.5%) developed TE. Conclusions: The incidence rate of TE in AGC pts receiving chemotherapy was 14.1 (95% CI, 9.6 - 19.9) events/100 person-years. D-dimer was an important prognostic factor related with TE development. Clinical trial information: NCT01047618.


2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 19-19 ◽  
Author(s):  
Hayato Omori ◽  
Yuichiro Miki ◽  
Wataru Takagi ◽  
Fumiko Hirata ◽  
Taichi Tatsubayashi ◽  
...  

19 Background: Peritoneal recurrence is often observed in gastric cancer patients without serosal invasion. It is difficult for pathologists to evaluate whether tumor cells penetrate serosa or not, because the subserosa layer is very thin. We evaluated the incidence and risk factors of peritoneal recurrence in serosa -negative gastric cancer patients to clarify the mechanism of peritoneal recurrence in these patients. Methods: A total of 1,745 gastric cancer patients underwent R0 resection from 2002 to 2009 were enrolled. The incidence of peritoneal recurrence according to tumor depth was analyzed. In serosa-nagative patients, the univariate and multivariate analysis were performed to identify the risk factors for peritoneal recurrence. Results: Peritoneal recurrence was observed in 64 (3.7 %) out of 1,745 patients. The incidence of peritoneal recurrence according to depth of tumor invasion was in 0 / 466 in T1a, 5 / 567 (0.88 %) in T1b, 4 / 187 (2.1 %) in T2, 31 / 360 (7.9 %) in T3, 20 / 108 (15.9 %) in T4a, and 4 / 12 (25 %) in T4b, respectively (p<0.001). As for the risk factor for peritoneal recurrence in T3 patients, histologically undifferentiated type, negative lymphatic invasion, scirrhous type, invasive infiltrating growth pattern were the significant factors identified by univariate analysis. Only the invasive infiltrating growth pattern (OR3.44 p0.038) was selected as significant independent risk factor for peritoneal recurrence by multivariate analysis. In T1b / T2 patients, massive lymph node metastasis (N3a, 3b), scirrhous type were the significant factor for peritoneal recurrence by univariate analysis. Only massive lymph node metastasis (OR25.1 p<0.001) was selected as the significant independent risk factor by multivariate analysis. Conclusions: The incidence of peritoneal recurrence increases in proportion to the tumor depth. Invasive infiltrating growth pattern was selected as an independent risk factor for peritoneal recurrence in T3 patients, while it was massive lymph node metastasis in T1b / T2 patients. The results suggest the possibility that microscopic serosal invasion in T3 tumor and lymphatic progression in T1b / T2 tumor may contribute to peritoneal recurrence in gastric cancer.


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