Prognostic factors in patients with advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy: a cohort study

Abstract Background: Prognostic factors for the survival of patients with advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy remain controversial. The aim of this study was to reveal the clinical factors that predict prognosis in this patient population.Methods: We retrospectively reviewed the medical records of HER2-positive gastric cancer patients treated with trastuzumab-based chemotherapy in our institution. Clinical features and laboratory test results considered prognostic factors were re-examined. Overall survival (OS) was estimated using the Kaplan-Meier method, univariate analysis was performed with the log-rank test, and multivariate analysis using Cox’s proportional hazard regression model.Results: A total of 133 patients with advanced HER2-positive gastric cancer were enrolled. The median OS in this cohort was 18.7 months. Four prognostic factors: visceral metastasis (lung or liver), and levels of haemoglobin (Hb) (< 11.6 g/dL), lactate dehydrogenase (LDH) (> 222 mg/dL), and C-reactive protein (CRP) (> 0.14 mg/dl) were identified as independent prognostic factors. After classifying the patients in three groups according to their number of prognostic factors, namely low (0,1), moderate (2,3), and high (4) risk, OS curves were separated into three categories with median OS of 32.0, 18.7, and 10.1 months, respectively (p=0.00025). Compared to the low-risk group, hazard ratios for the moderate- and high-risk groups were 1.75 (95% CI: 1.05–2.93) and 3.49 (95% CI: 1.81–6.71), respectively.Conclusion: Visceral metastasis and abnormal Hb, LDH, and CRP test results were associated with unfavourable OS. These findings are helpful for the management of advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy.

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Prognostic Factors in Patients with Advanced HER2-Positive Gastric Cancer Treated With Trastuzumab-Based Chemotherapy: A Cohort Study

10.21203/rs.3.rs-121123/v1 ◽

2020 ◽

Author(s):

Shoko Marshall ◽

Takeru Wakatsuki ◽

Daisuke Takahari ◽

Tomohiro Matsushima ◽

Naoki Ishizuka ◽

...

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Univariate Analysis ◽

Risk Groups ◽

Rank Test ◽

Test Results ◽

Visceral Metastasis ◽

Her2 Positive ◽

Laboratory Test Results ◽

Gastric Cancer Patients

Abstract Background: Prognostic factors for the survival of patients with advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy remain controversial. The aim of this study was to reveal the clinical factors that predict prognosis in this patient population.Methods: We retrospectively reviewed the medical records of HER2-positive gastric cancer patients treated with trastuzumab-based chemotherapy in our institution. Clinical features and laboratory test results considered prognostic factors were re-examined. Overall survival (OS) was estimated using the Kaplan-Meier method, univariate analysis was performed with the log-rank test, and multivariate analysis using Cox’s proportional hazard regression model.Results: A total of 133 patients with advanced HER2-positive gastric cancer were enrolled. The median OS in this cohort was 18.7 months. Four prognostic factors: visceral metastasis (lung or liver), and levels of haemoglobin (Hb) (< 11.6 g/dL), lactate dehydrogenase (LDH) (> 222 mg/dL), and C-reactive protein (CRP) (> 0.14 mg/dl) were identified as independent prognostic factors. After classifying the patients in three groups according to their number of prognostic factors, namely low (0,1), moderate (2,3), and high (4) risk, OS curves were separated into three categories with median OS of 32.0, 18.7, and 10.1 months, respectively (p=0.00025). Compared to the low-risk group, hazard ratios for the moderate- and high-risk groups were 1.75 (95% CI: 1.05–2.93) and 3.49 (95% CI: 1.81–6.71), respectively.Conclusion: Visceral metastasis and abnormal Hb, LDH, and CRP test results were associated with unfavourable OS. These findings are helpful for the management of advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy.

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Prognostic Factors in Patients with Advanced HER2-Positive Gastric Cancer Treated With Trastuzumab-Based Chemotherapy: A Cohort Study

10.21203/rs.3.rs-115871/v2 ◽

2020 ◽

Author(s):

Shoko Marshall ◽

Takeru Wakatsuki ◽

Daisuke Takahari ◽

Tomohiro Matsushima ◽

Naoki Ishizuka ◽

...

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Univariate Analysis ◽

Risk Groups ◽

Rank Test ◽

Test Results ◽

Visceral Metastasis ◽

Her2 Positive ◽

Laboratory Test Results ◽

Gastric Cancer Patients

Abstract Background: Prognostic factors for the survival of patients with advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy remain controversial. The aim of this study was to reveal the clinical factors that predict prognosis in this patient population.Methods: We retrospectively reviewed the medical records of HER2-positive gastric cancer patients treated with trastuzumab-based chemotherapy in our institution. Clinical features and laboratory test results considered prognostic factors were re-examined. Overall survival (OS) was estimated using the Kaplan-Meier method, univariate analysis was performed with the log-rank test, and multivariate analysis using Cox’s proportional hazard regression model.Results: A total of 133 patients with advanced HER2-positive gastric cancer were enrolled. The median OS in this cohort was 18.7 months. Four prognostic factors: visceral metastasis (lung or liver), and levels of haemoglobin (Hb) (< 11.6 g/dL), lactate dehydrogenase (LDH) (> 222 mg/dL), and C-reactive protein (CRP) (> 0.14 mg/dl) were identified as independent prognostic factors. After classifying the patients in three groups according to their number of prognostic factors, namely low (0,1), moderate (2,3), and high (4) risk, OS curves were separated into three categories with median OS of 32.0, 18.7, and 10.1 months, respectively (p=0.00025). Compared to the low-risk group, hazard ratios for the moderate- and high-risk groups were 1.75 (95% CI: 1.05–2.93) and 3.49 (95% CI: 1.81–6.71), respectively.Conclusion: Visceral metastasis and abnormal Hb, LDH, and CRP test results were associated with unfavourable OS. These findings are helpful for the management of advanced HER2-positive gastric cancer treated with trastuzumab-based chemotherapy.

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ELISA study of matrix metalloproteinases 2, 7, 9 and their type 2 tissue inhibitor in the tumors of gastric cancer patients: clinical and pathologic correlations

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2018-46-4-323-329 ◽

2018 ◽

Vol 46 (4) ◽

pp. 323-329

Author(s):

E. S. Gershtein ◽

A. A. Ivannikov ◽

V. L. Chang ◽

N. A. Ognerubov ◽

М. M. Davydov ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Prognostic Factors ◽

Matrix Metalloproteinases ◽

Tumor Progression ◽

Cancer Patients ◽

Univariate Analysis ◽

Gastric Cancer Tissue ◽

Cancer Tissue ◽

Gastric Cancer Patients

Background: Over the last 10 years the incidence of gastric cancer has declined significantly. Nevertheless, it remains one of the most prevalent malignancies both in Russia and worldwide. Therefore, the problems of early diagnostics, prognosis and individualized treatment choice are still on the agenda. Much attention is paid to the evaluation of molecular biological characteristics of the tumor, as well as to the development of multiparametric prognostic systems for gastric cancer based on its identified characteristics. An important place among potential tumor biological markers belongs to matrix metalloproteinases (MMPs) involved into all the stages of tumor progression, first of all, into the regulation of invasion and metastasizing.Aim: Comparative quantitative evaluation of some MMP family members (MMP-2, 7, and 9) and one of the tissue MMP inhibitors (TIMP-2) levels in the tumors and adjacent histologically unchanged mucosa in gastric cancer patients, the analysis of their associations with the main clinical and pathological features of the disease and its prognosis.Materials and methods: Sixty six (66) primary gastric cancer patients (32 male and 34 female) aged 24 to 82 years (median, 61 year) were recruited into the study. Twenty two (22) patients were with stage I of the disease, 11 with stage II, 28 with stage III, and 5 with stage IV. The concentrations of the proteins studied were measured in the tumor and unchanged mucosa extracts by standard direct ELISA kits (Quantikine®, R&D Systems, USA).Results: Tumor MMP-2, 7 and 9 levels were significantly increased, compared to those in the adjacent histologically unchanged mucosa, in 80, 70 and 72% of gastric cancer patients, respectively, while the increase of TIMP-2 level found in 61% of the tumors was not statistically significant. Tumor MMP-2 and TIMP-2 content was increasing significantly with higher T index – size and advancement of the primary tumor (p < 0.01 and p < 0.05 respectively). Tumor MMP-2 level was also increasing in parallel with the N index (regional lymph node involvement; p < 0.01); it was significantly higher in the patients with distant metastases than in those without them (p < 0.05). Tumor MMP-9 and MMP-7 concentrations were not significantly associated with the indices of the tumor progression. The patients were followed up for 1 to 85 months (median, 18.3 months). According to the univariate analysis, high (> 32.6 ng/mg protein) MMP-2 and low MMP-7 (< 1.1 ng/mg protein) levels in the gastric cancer tissue represent statistically significant unfavorable prognostic factors for overall survival. Increased TIMP-2 level is associated with a non-significant decrease in the overall survival (p > 0.05), whereas the MMP-9 level was unrelated to the gastric cancer prognosis. Only T index (p = 0.0034) and tumor MMP-7 content (p = 0.026) remained independent prognostic factors in the multivariate regression analysis.Conclusion: The majority of gastric cancer patients demonstrate a significant increase in the expression of three MMP family members, i.e. gelatinases (MMP-2 and 9), and matrilysin (MMP-7), in the tumors, as compared to adjacent histologically unchanged mucosa. Only MMP-2 levels were associated with the disease progression, increasing with higher TNM system indices. High MMP-2 and low MMP-7 content in the gastric cancer tissue are significant unfavorable prognostic factors for the overall survival in the univariate analysis, but only MMP-7 has retained its independent prognostic value in the multivariate assessment.

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Prognostic Significance of Serum Uric Acid and Gamma-Glutamyltransferase in Patients with Advanced Gastric Cancer

Disease Markers ◽

10.1155/2019/1415421 ◽

2019 ◽

Vol 2019 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Shanshan Yang ◽

Xinjia He ◽

Ying Liu ◽

Xiao Ding ◽

Haiping Jiang ◽

...

Keyword(s):

Gastric Cancer ◽

Uric Acid ◽

Prognostic Factors ◽

Advanced Gastric Cancer ◽

Cancer Patients ◽

Serum Uric Acid ◽

Univariate Analysis ◽

Prognostic Significance ◽

Gamma Glutamyltransferase ◽

Gastric Cancer Patients

Purpose. In this study, we aim to evaluate the prognostic role of serum uric acid and gamma-glutamyltransferase in advanced gastric cancer patients. Methods. A total of 180 patients pathologically diagnosed with advanced gastric cancer were included in this retrospective study. We used time-dependent receiver operating characteristic (ROC) curves to identify the optimal cut-off value of serum uric acid (UA) and gamma-glutamyltransferase (GGT). Survival analysis was performed using the Kaplan–Meier method and log-rank test, and multivariate Cox regression analyses were applied. A nomogram was formulated, and the calibration and discrimination of the nomogram were determined by calibration curve and concordance index (C-index). We validated the results using bootstrap resampling and a separate study on 60 patients collected from 2015 to 2017 using the same criteria in other medical center. Results. Both higher serum uric acid (>228 μmol/L) and higher gamma-glutamyltransferase (>14 U/L) had worse OS and PFS. Univariate analysis indicated that serum uric acid (UA) (p<0.001 and p<0.001) and gamma-glutamyltransferase (GGT) (p<0.001 and p=0.044) were significantly related to overall survival (OS) and progression-free survival (PFS), respectively. Multivariate analysis revealed serum uric acid (UA) and gamma-glutamyltransferase (GGT) were independent prognostic factors for OS (p=0.012, p=0.001). The optimal agreement between actual observation and nomogram prediction was shown by calibration curves. The C-indexes of the nomogram for predicting OS and PFS were 0.748 (95% CI: 0.70-0.79) and 0.728 (95% CI: 0.6741-0.7819), respectively. The results were confirmed in the validation cohort. Conclusion. We observed that both serum UA and GGT were poor prognostic factors in patients with advanced gastric cancer. And we also formulated and validated a nomogram which can predict individual survival for advanced gastric cancer patients.

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Association between intratumoral HER2 heterogeneity (IHH) and trastuzumab (T-mab) efficacy in HER2 positive–gastric cancer (GC).

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.92 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 92-92

Author(s):

Takeru Wakatsuki ◽

Noriko Yamamoto ◽

Keisho Chin ◽

Mariko Ogura ◽

Eiji Shinozaki ◽

...

Keyword(s):

Gastric Cancer ◽

Statistical Tests ◽

Progression Free Survival ◽

Clinical Impact ◽

Heterogeneous Group ◽

Rank Test ◽

Her2 Positive ◽

Kaplan Meier ◽

Significant Difference ◽

The Difference

92 Background: ToGA study showed superiority of adding T-mab to standard chemotherapy and a positive correlation between HER2 expression levels and the T-mab efficacy. In gastric cancer IHH is frequently recognized but its clinical impact on T-mab efficacy is unclear. Methods: Patients who were treated with T-mab and had surgical specimens available for IHC test were retrospectively examined. When all tumor cells overexpressed HER2 protein by IHC, the tumor was defined as non-HER2-heterogeneous. The others were defined as HER2-heterogeneous. Progression-free survival (PFS) and overall survival (OS) were estimated using by Kaplan-Meier methods and compared by the log-rank test. The level of significance was set to p<0.05 and all statistical tests were two-sided. Results: 23 patients were enrolled. Their median age was 68 years and 83% were male. PS 0, GEJ cancer, intestinal type histology, visceral metastasis (lung or liver), and previous chemotherapy were found in 57%, 35%, 83%, 57%, and 57% of them, respectively. After a median follow-up of 11.3 months, the median OS, PFS, and overall response rate were 14.4 months, 10.8 months, and 62.5%, respectively. All tumors were IHC3+, and 13 were non-HER2-heterogeneous and 10 were HER2-heterogeneous. There was no significant difference in clinicopathological features between the two groups. Median PFS in non-HER2-heterogeneous group (21.9 months) was significantly longer than that in HER2-heterogeneous group (8.6 months), (HR: 0.24 [0.06-0.91], P=0.024). Median OS in non-HER2-heterogeneous group was not reached while that in HER2-heterogeneous group was 12.9 months (HR: 0.29 [0.06-1.42], P=0.102). A higher rate of response to T-mab was seen in non-HER2-heterogeneous group than in HER2-heterogeneous group, though the difference was not statistically significant (75% vs. 50%, p=0.608). Conclusions: IHH might have robust clinical impact on T-mab efficacy for HER2 positive GC. These findings should be validated by independent large cohorts and further molecular correlative analyses are warranted.

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Determination of Affected Factor on Survival Rates In Referral Gastric Cancer Patients to Imam Khomeini Clinic in Hamadan Province from 2004-2017

Journal of Shahid Sadoughi University of Medical Sciences ◽

10.18502/ssu.v27i12.2832 ◽

2020 ◽

Author(s):

Fatemeh Gohari-Ensaf ◽

Zeinab Berangi ◽

Mohamad Abbasi ◽

Ghodratollah Roshanaei

Keyword(s):

Gastric Cancer ◽

Survival Rate ◽

Screening Program ◽

Survival Rates ◽

Tumor Stage ◽

Rank Test ◽

Significance Level ◽

Kaplan Meier ◽

One Year ◽

Gastric Cancer Patients

Introduction: Gastric cancer is the fourth most common cancer and the second leading cause of death in the world. Despite the recent advances in controlling and treating the disease, the survival rate of this cancer is relatively low. Various factors can affect the survival of the patients with gastric cancer. The aim of this study was to determine the survival rates and the effective factors in the patients with gastric cancer. Methods: The study population included all the patients diagnosed with gastric cancer in Hamadan Province who were referred to Hamadan Imam Khomeini Specialized Clinic between 2004 to 2017. Patients were followed up by periodical referrals and/or telephone contact. The survival rate of the patients was calculated using Kaplan-Meier method and effective survival factors with Cox proportional regression. Data were analyzed using SPSS 23 software at a significance level of 0.05. Results: Out of the 350 patients with gastric cancer, 74.3% were male and 25.7% were female. One-year, three-year and five-year survival rates were 67%, 36% and 27%, respectively. The log -rank test showed that age, type of tumor, stage of disease, type of Surgery and metastasis of the disease were effective on the survival of patients. In Cox's multivariate analysis, the only age variables at the time of diagnosis and chemotherapy were survival variables. (P<0.05). Conclusion: The results of this study showed that age variable is a strong factor in survival, so it is essential to diagnose the disease at the early age and early stages of the disease using a screening program.

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Prognostic factors of trastuzumab-based chemotherapy in patients with advanced HER2 positive gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.41 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 41-41

Author(s):

Shoko Marshall ◽

Takeru Wakatsuki ◽

Tomohiro Matsushima ◽

Hiroki Osumi ◽

Mariko Ogura ◽

...

Keyword(s):

Gastric Cancer ◽

Performance Status ◽

Univariate Analysis ◽

Locally Advanced ◽

Laboratory Data ◽

Progression Free Survival ◽

Metastatic Lesion ◽

Her2 Positive ◽

Visceral Metastases ◽

Gastric Cancer Patients

41 Background: Prognostic factor in patients with HER2 positive gastric cancer who received trastuzumab (T-mab) based chemotherapy remains unclear. The aim of this study is to reveal the clinical factors which predict prognosis in T-mab based chemotherapy. Methods: We retrospectively reviewed HER2 positive gastric cancer patients treated with T-mab based chemotherapy in our institute from March 2011 to June 2016. Patients’ demographics according to the ToGA study and laboratory data were examined. Results: Total of 143 patients were enrolled. Median follow-up period was 14.9 months, and median progression-free survival (PFS) and overall survival (OS) were 11.2 months (95% CI: 8.6-13.9) and 20.9 months (95% CI: 16.6-25.2), respectively. In univariate analysis, performance status (0 vs. 1-2), present of measurable lesion, presence of visceral metastases, No. of metastatic lesion (1-4 vs. > 4), LDH, ALP, Alb, median CEA (≧ 13.6 mg/ml vs. < 13.6mg/ml), and median Neutrophil/Lymphocyte (N/L) ratio (≧ 3.11 vs. < 3.11) were significantly associated with PFS. Regarding OS, extension of disease (locally advanced vs. metastatic), presence of visceral metastases, No. of metastatic lesions, Hb, ALP, Alb, CRP, median CEA and median N/L ratio were significant. In multivariate analysis, CEA levels (HR 0.54: 95%CI 0.34-0.86, p = 0.010) and ALP (HR 0.57: 95%CI 0.33-0.99, p = 0.046) retained to be significant in regard to PFS. Patients with < median CEA level had a median PFS of 13.1 months vs. 7.2 months with ≧ median CEA level. Patients with normal level of ALP showed a median PFS of 12.8 months vs. 5.9 months with abnormal ALP level. With respect to OS, CEA levels (HR 0.59: 95%CI 0.34-1.03, p = 0.061) and N/L ratio (HR 0.55: 95%CI 0.29-1.06, p = 0.074) were marginally significant. Patients with < median CEA level had a median OS of 27.6 months vs. 17.6 months with ≧ median CEA level. Patients with > median N/L had a median OS of 24.5 months vs. 16.5 month with ≧ median N/L. Conclusions: Lower CEA levels and normal ALP levels were associated with favorable PFS, and lower CEA and N/L ratio were marginally associated with favorable OS.

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Prognostic Factors for North American Adult T Cell Leukemia Lymphoma: Defining Risk Groups Using a Four-Point Score Prognostic System

Blood ◽

10.1182/blood-2020-141428 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 38-39

Author(s):

Shafia Rahman ◽

Alvaro Alvarez Soto ◽

Lindor Qunaj ◽

Kenny Ye ◽

Kith Pradhan ◽

...

Keyword(s):

Prognostic Factors ◽

T Cell ◽

Research Funding ◽

Risk Groups ◽

Rank Test ◽

Private Company ◽

Advisory Committees ◽

Prognostic System ◽

Adult T Cell Leukemia ◽

Kaplan Meier

Introduction: Adult T cell leukemia lymphoma (ATLL) is a rare T cell neoplasm caused by the human T-lymphotropic virus (HTLV-1) virus. Although there are indolent subtypes it is often a highly aggressive and chemotherapy refractory malignancy. We follow one of the largest cohorts in the United States and in this study, we sought to elucidate the prognostic factors associated with inferior survival. Methods: A retrospective analysis of patients diagnosed with ATLL at Montefiore Medical Center was conducted. Subjects included were censored at last point of contact. Variables collected included age, gender, race, ethnicity, ATLL subtype, white blood cell count (WBC), absolute lymphocyte count (ALC), corrected calcium level, lymphadenopathy (LAD) (two or more non-contiguous sites). Associations between WBC, ALC, corrected calcium level, LAD and median overall survival (mOS) were assessed using the Kaplan-Meier method with log-rank test. A four-point prognostic system was designed assigning one point to each: WBC > 11,000; ALC>4000; Corrected Ca≥10.5 and presence of LAD. Three risk groups were assigned based on the number of risk factors as follows: low (0-1 points), intermediate (2 points) and high (3-4 points) (Table 2). Association between these groups and OS was investigated using the Kaplan-Meier method with log-rank test. Results: A total of 61 ATLL subjects were included in this study (table 1). Hypercalcemia (Ca ≥10.5) was observed in 60.6% of subjects at diagnosis and was associated with inferior mOS (234 days) when compared to calcium < 10.5 (747days) (p=0.046), Figure 1A. WBC >11,000 had a strong association with inferior survival (175 days) compared to patients with a WBC ≤11,000 (666 days) (p= 0.0067) (Figure 1B). ALC > 4000 was also associated with inferior mOS (222 days) compared to ALC ≤4000 (666 days) (p=0.015) (Figure 1C). LAD was associated with mOS (188 days) compared with no LAD (847 days) (p=0.022) (Figure 1D). Based on these observations, we designed a prognostic system (0-4 points) (see above) to risk stratify newly diagnosed ATLL patients into: low (0-1 points), intermediate (2 points) and high (3-4 points) risk (Table 2). We divided our cohort into the above-mentioned risk groups and calculated their mOS. Kaplan Meier analysis (Figure 2) revealed a distinct mOS difference between the groups based on their risk score: Low: 419 days, Intermediate: 234 days and High: 181.5 days (p= 0.0042). Conclusions: We identify hypercalcemia (Ca≥10.5), leukocytosis (WBC> 11,000), lymphocytosis (ALC> 4000) and generalized LAD as poor prognostic factors in newly diagnosed ATLL. Using readily available information from basic laboratory and clinical parameters we propose a prognostic system to identify high risk individuals. Further validation will be needed using larger cohorts of this very rare disease. Disclosures Steidl: Aileron Therapeutics: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Stelexis Therapeutics: Consultancy, Current equity holder in private company, Membership on an entity's Board of Directors or advisory committees; Pieris Pharmaceuticals: Consultancy; Bayer Healthcare: Research Funding. Verma:stelexis: Current equity holder in private company; BMS: Consultancy, Research Funding; acceleron: Consultancy, Honoraria; Janssen: Research Funding; Medpacto: Research Funding. Janakiram:Takeda, Fate, Nektar: Research Funding. Shah:Celgene/BMS: Research Funding; Physicians Education Resource: Honoraria.

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Morbidity associated to advanced gastric cancer and its impact on overall survival.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.327 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 327-327

Author(s):

Mónica Isabel Meneses Medina ◽

Ana Karen Valenzuela ◽

Jorge Humberto Hernandez-Felix ◽

Haydee Cristina Verduzco-Aguirre ◽

Vanessa Rosas Camargo ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Nodes ◽

Advanced Gastric Cancer ◽

Univariate Analysis ◽

Rank Test ◽

P Value ◽

High Morbidity ◽

Regional Lymph Nodes ◽

Oncological Treatment ◽

Kaplan Meier

327 Background: Advanced gastric cancer (GC) is a disease with high morbidity and poor prognosis. We hypothesize that different sites of metastasis have different impact in terms of symptoms and complications. We sought to evaluate if site specific morbidity in our patients impacted treatment and survival. Methods: Medical records from patients with advanced GC treated from Jan 2005 to Dec 2015 were retrospectively reviewed. Morbidity was defined as having any symptom by metastases in a specific site. OS was estimated by Kaplan Meier method and compared by Log-rank test. P value < 0.05 was considered significant. Results: We included 180 consecutive patients, median age at diagnosis was 56 years (21-90), 55% were women. Most common sites of metastases were: peritoneum 76.1%, non-regional lymph nodes 38.9%, liver 22.8%, lung 26.7%, bone 9.4% and ovary 12.8%. Regarding morbidity, at diagnosis 68% of patients presented morbidity by the primary tumor: obstruction 56%, bleeding 27%, obstruction and bleeding 3%, other 14%. Disease by peritoneum caused morbidity in 30%, by lung in 8%, by ovarian in 4.4%, by lymph nodes in 3.3%, and by other sites in 5.6% of patients. OS in the global cohort was: 3.53 months (2.2 to 4.8), nevertheless by univariate analysis we found that OS was affected by morbidity at some sites as it is show in table. More patients with peritoneal morbidity could not receive treatment vs those without peritoneal morbidity (p = 0.042). Conclusions: We found that morbidity in peritoneum, lung and ovary adversely affected prognosis of patients with advanced GC. Moreover, peritoneal morbidity preclude patients from receiving oncological treatment. [Table: see text]

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