scholarly journals Palliative Radiotherapy for Gastric Cancer Bleeding: A Multi-Institutional Retrospective Study.

2022 ◽  
Author(s):  
Kazuya Takeda ◽  
Toru Sakayauchi ◽  
Masaki Kubozono ◽  
Yu Katagiri ◽  
Rei Umezawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Retrospective Study ◽  
Adverse Effects ◽  
Predictive Factors ◽  
Treatment Strategy ◽  
Palliative Radiotherapy ◽  
Hemoglobin Concentration ◽  
Biological Effective Dose

Abstract Background: Palliative radiotherapy for gastric cancer bleeding has been reported to be a safe and effective treatment, but predictive factors for achievement of hemostasis and overall survival have not been established.Methods: In this retrospective study, 120 courses of palliative radiotherapy for gastric cancer bleeding in 117 patients in 4 institutes in Japan were reviewed with approval of the ethical committee in each institute. The rate of achieving hemostasis was evaluated by 50% or more reduction of red blood cell transfusion before and after the start of radiotherapy, elevation of blood hemoglobin concentration in a period of 4 weeks from the start of radiotherapy or improvement of subjective or objective clinical symptoms in a period of 4 weeks from the start of radiotherapy. Predictive factors for overall survival and achieving hemostasis were investigated with the Cox hazards model.Results: The median overall survival period was 3.7 months. Multivariate analysis showed that absence of metastatic disease, higher biological effective dose, higher serum albumin level, lower blood urea nitrogen level and lower neutrophil-to-lymphocyte ratio (NLR) were associated with longer overall survival. Elevation of hemoglobin concentration in a period of 4 weeks from the start of radiotherapy (mean concentration: 8.2 g/dL vs. 8.9 g/dL, p=0.006) and decrease in the amount of red cell transfusion from a 4-week period before to a 4-week period after the start of radiotherapy (mean amount: 716 mL vs. 230 mL, p<0.0001) were observed. The overall rate of achievement of hemostasis was 59.6%. In multivariate analysis, higher biological effective dose was associated with achievement of hemostasis. Grade 2 or higher acute adverse effects related to radiotherapy were observed in 17.5% of cases in 120 treatment courses. Six cases (5.0%) had grade 3 or 4 adverse effects including gastric penetration in 1 patient and anorexia requiring total parental nutrition in 3 patients. No grade 5 adverse effects were observed.Conclusions: Palliative radiotherapy for gastric cancer bleeding seems to be an effective and safe treatment strategy. Higher treatment dose was associated with longer overall survival and a hemostatic effect. Some hematological parameters may predict overall survival, and they would be helpful for deciding the treatment strategy.

ERCC1 mRNA expression and XRCC1 polymorphism as predictive factors for overall survival in gastric cancer patients receiving platinum based chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 2512-2512 ◽  
Author(s):  
J. Wei ◽  
B. Liu ◽  
Z. Zou ◽  
X. Qian ◽  
W. Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Dna Repair ◽  
Survival Time ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Median Survival Time ◽  
Platinum Based Chemotherapy ◽  
Ercc1 Expression ◽  
Gastric Cancer Patients

2512 Background: DNA repair was considered to play the key role in the platinum chemotherapy. ERCC1, XPD and XRCC1, three major components of the DNA repair pathway, are critical to outcome for patients treated with platinum based chemotherapy. Methods: Overall survival times in 48 stage III (47.9%) and IV (52.1%) gastric cancer patients were investigated. mRNA was isolated from formalin- fixed paraffin-embeded pretreatment primary tumor specimens and the relative expression of ERCC1 to the internal reference geneβ-actin was measured using real-time quantitative reverse transcriptase polymerase chain reaction. Two single nucleotide polymorphisms (SNPs) (XPD Lys751Gln and XRCC1 Arg399Gln) were also investigated using 5’ nuclease allelic discrimination assay (TaqMan). Results: Median age was 55 years (range: 23 to 75 years); 35 males and 13 females; median survival time was 397 days. The median ERCC1 gene expression level from all 48 gastric tumors was 1.16, and the cutoff values for chemotherapy was 0.30. The median survival time for patients with lower ERCC1 expression (31 of 48 patients) was 496 days, compared with 218 days for patients with higher ERCC1 expression (P < 0.0001). SNP of XRCC1 Arg399Gln was measured in 47 gastric cancer patients (97.92%). Median overall survival time was longer in patients with favorite allele G in codon 399 of XRCC1 (40 of 47 patients) than in others (respectively 420 days vs 218 days, P = 0.017). No significant relationship was found between SNP of XPD Lys751Gln and outcome of gastric cancer patients. Conclusions: These findings suggested that intratumoral ERCC1 mRNA expression and polymorphism of XRCC1 might be prominent predictive factors for overall survival of gastric cancer patients treated with platinum based chemotherapy. Multi-center clinical trial has been suggested. No significant financial relationships to disclose.

The prognostic factors and the cause of death in patients with advanced or recurrent gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 215-215
Author(s):  
Sang Woo Lee ◽  
In Keun Choi ◽  
Chang Min Lee ◽  
Seung Young Kim ◽  
Jong Jin Hyun ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Bone Metastasis ◽  
Advanced Gastric Cancer ◽  
Causes Of Death ◽  
Palliative Surgery ◽  
Peritoneal Seeding ◽  
Recurrent Gastric Cancer

215 Background: The purpose of this study is to evaluate significant prognostic factor and compare the cause of death in patients with advanced or recurrent gastric cancer. Methods: We reviewed the medical records of 170 patients who had been diagnosed as advanced or recurrent gastric cancer between January 2006 and September 2013. The patients were divided into two groups. One group (advanced gastric cancer: AC) included 104 patients had undergone chemotherapy for advanced gastric cancer, and the other group (recurrent gastric cancer: RC) 66 for recurrence after surgical treatment. The causes of death and overall survival were compared between two groups, and the significant prognostic factors were investigated by multivariate analysis. Also, subgroup analysis was performed for 18 patients with gastrectomy for curative intent, and they were proved to have unresectable gastric cancer after surgery (non-palliative surgery for advanced gastric cancer: NS). Results: In the comparison for the causes of death, two groups showed no statistical difference, but AC group had more tendency to die because of bleeding ( p = 0.054) and infection ( p = 0.075). Overall survival of AC group did not differ from that of RC ( p = 0.901). In multivariate analysis, bone metastasis ( p = 0.013, HR = 1.923), peritoneal seeding ( p = 0.001, HR = 2.182) and the frequency of chemotherapy ( p < 0.001, HR = 0.887) were significantly associated with the overall survival. In a subgroup analysis, the overall survival of NS was significantly higher than AC ( p = 0.032). Conclusions: In the patients with advanced or recurrent gastric cancer, AC might have more possibility to die because of bleeding and infection than RC. Additionally, the prognosis of patients with advanced or recurrent gastric cancer was affected by the presence of bone metastasis, peritoneal seeding and frequency of chemotherapy. Non-palliative surgery for gastric cancer might show the better prognosis than AC in the specific conditions.

scholarly journals Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities

2015 ◽  
Vol 73 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Luiz Victor Maia Loureiro ◽  
Lucíola de Barros Pontes ◽  
Donato Callegaro-Filho ◽  
Ludmila de Oliveira Koch ◽  
Eduardo Weltman ◽  
...  
Keyword(s):  
Health Care ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Retrospective Study ◽  
Prognostic Factor ◽  
Waiting Time ◽  
Adjuvant Treatment ◽  
Extent Of Resection ◽  
Prognostic Impact

Objective To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT ≤ 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT > 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p < 0.001), extent of resection (p = 0.009) and the adjuvant treatment (p = 0.001). The KPS interacted with WT to RT (HR 0.128, 95%CI 0.034-0.476; p = 0.002), showing that the benefit of KPS on OS depends on the WT to RT. Conclusion No prognostic impact of WT to RT could be detected on the OS. Although there are no data to ensure that delays to RT are tolerable, we may reassure patients that the time-length to initiate treatment does not seem to influence the control of the disease, particularly in face of other prognostic factors.

scholarly journals Survival and predictive factors in dialysis patients with COVID-19 in Japan: a nationwide cohort study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kan Kikuchi ◽  
Masaomi Nangaku ◽  
Munekazu Ryuzaki ◽  
Tomoyuki Yamakawa ◽  
Oota Yoshihiro ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Predictive Factors ◽  
Mortality Risk ◽  
Japanese Society ◽  
Task Force ◽  
Rank Test ◽  
Dialysis Patients ◽  
Risk Of Mortality ◽  
Increased Risk

Abstract Background The Japanese Association of Dialysis Physicians, the Japanese Society for Dialysis Therapy, and the Japanese Society of Nephrology jointly established COVID-19 Task Force Committee and began surveying the number of newly infected patients. Methods This registry of the COVID-19 Task Force Committee was used to collect data of dialysis patients; a total of 1010 dialysis patients with COVID-19 were included in the analysis. Overall survival of patients was investigated with stratification by age group, complication status, and treatment. In addition, predictive factors for mortality were also investigated. The overall survival was estimated by Kaplan–Meier methods and compared by using log-rank test. Multivariate analysis was performed to identify the risk factor of mortality. For all statistical analyses, p < 0.05 was considered to be statistically significant. Results The mortality risk was increased with age (p < 0.001). The mortality risk was significantly higher in patients with peripheral arterial disease (HR: 1.49, 95% CI 1.05–2.10) and significantly lower in patients who were treated with remdesivir (HR: 0.60, 95% CI 0.37–0.98). Multivariate analysis showed increased risk of mortality with increment in BMI, and increment in CRP, and decreased risk with increment in albumin. Conclusion Dialysis patients have a high severity of illness and a high risk of mortality in cases of COVID-19. Treatment with remdesivir might be effective in shortening the duration of hospitalization and reducing the risk of mortality.

scholarly journals Prognostic Factors for Elderly Gastric Cancer Patients who Underwent Gastrectomy

2021 ◽  
Author(s):  
Shunji Endo ◽  
Tomoki Yamatsuji ◽  
Yoshinori Fujiwara ◽  
Masaharu Higashida ◽  
Hisako Kubota ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Performance Status ◽  
Postoperative Mortality ◽  
Prognostic Nutritional Index ◽  
Pathological Stage ◽  
Mortality And Morbidity ◽  
Operative Severity Score

Abstract Background: Patients with gastric cancer are aging in Japan. It is not clear which patients and which surgical procedures have survival benefits after gastrectomy. A multivariate analysis was performed.Methods: The medical records of 166 patients aged ≥80 years who underwent gastrectomy without macroscopic residual tumors were retrospectively reviewed. Univariate and multivariate analyses using Cox proportional hazard models were performed to detect prognostic factors for overall survival.Results: In univariate analyses, age (≥90 vs. ≥80, <85), performance status (3 vs. 0), the physiological score of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) (≥40 vs. ≥20, ≤29), Onodera’s prognostic nutritional index (<40 vs. ≥45), American Society of Anesthesiologists physical status (ASA-PS) (3, 4 vs. 1, 2), surgical approach (laparoscopic vs. open), extent of gastrectomy (total, proximal vs. distal), extent of lymphadenectomy (D1 vs. ≥D2), pathological stage (II-IV vs. I), and residual tumor (R1 vs. R0) were significantly correlated with worse overall survival. Multivariate analysis revealed that ASA-PS [3, 4 vs. 1, 2, hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.24-4.24], extent of gastrectomy (total vs distal, HR 2.17, 95% CI 1.10-4.31), (proximal vs. distal, HR 4.05, 95% CI 1.45-11.3), extent of lymphadenectomy (D0 vs. ≥D2, HR 12.4, 95% CI 1.58-97.7) and pathological stage were independent risk factors for mortality.Conclusions: ASA-PS was a useful predictor for postoperative mortality. Gastrectomy including cardia and excessive limitation of lymphadenectomy are best avoided.

c-erbB-2 Is of Independent Prognostic Relevance in Gastric Cancer and Is Associated With the Expression of Tumor-Associated Protease Systems

2000 ◽  
Vol 18 (11) ◽  
pp. 2201-2209 ◽  
Author(s):  
Heike Allgayer ◽  
Rudolf Babic ◽  
Klaus Uwe Gruetzner ◽  
Anwar Tarabichi ◽  
Friedrich Wilhelm Schildberg ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Relative Risk ◽  
Plasminogen Activator ◽  
Tumor Cells ◽  
Prognostic Value ◽  
Prognostic Parameter ◽  
Kaplan Meier ◽  
Pai 1

PURPOSE: The c-erbB-2 gene (encoding the protein p185) is overexpressed in diverse human cancers and has been implicated to be of prognostic value in gastric cancer. Recent studies suggest a role of p185 in tumor progression by specifically promoting the invasive capacity of tumor cells. Therefore, the present study was conducted with the following three objectives: (1) to support the prognostic value of c-erbB-2 in gastric cancer in a large prospective series using a monoclonal antibody and a highly sensitive immunohistochemical method; (2) to determine the association of c-erbB-2 expression with the expression of invasion-related genes; and (3) to perform the first overall multivariate analysis including c-erbB-2 and the invasion-related tumor-associated protease systems. PATIENTS AND METHODS: In a consecutive prospective series of 203 gastric cancer patients (median follow-up, 42 months), expression of c-erbB-2 and a panel of tumor-associated proteases and inhibitors by tumor cells were evaluated semiquantitatively (score 0 to 3) and analyzed for correlation (χ2 test, Bonferroni-corrected). Kaplan-Meier survival analysis and multivariate Cox analysis were performed to determine the relative prognostic impact of c-erbB-2 and the invasion-related parameters. RESULTS: Kaplan-Meier analysis (log-rank statistics) revealed a significant association of increasing expression of c-erbB-2 with shorter disease-free (P = .0023) and overall survival (P = .0160). High amounts of p185 were significantly associated with a high expression of urokinase-type plasminogen activator (uPA) (P < .010), uPA-receptor (P = .030), type-1 plasminogen activator inhibitor (PAI) (P < .010), type-2 PAI (P = .021), cathepsin D (P = .036), matrix metalloproteinase-2 (P = .024), α-1-antichymotrypsin (P = .025), and α-2-macroglobulin (P = .017). Multivariate analysis considering these proteases/protease inhibitors, in addition to α-1-antitrypsin, tissue plasminogen activator, plasminogen, α-2-antiplasmin, and antithrombin III, and established prognostic parameters revealed that, in addition to surgical curability, pT stage, pN stage, and PAI-1, c-erbB-2 is an independent prognostic factor for overall survival of curatively resected patients (n = 139; P = .049; relative risk, 1.54; 95% confidence interval, 1.08 to 1.67) and all patients (P = .028; relative risk 1.33; 95% CI, 1.28 to 1.38). CONCLUSION: c-erbB-2 is confirmed as a new independent, functional prognostic parameter for overall survival in gastric cancer, even when a panel of invasion-related factors, including the strong prognostic parameter PAI-1, are considered. The significant correlation of p185 with several tumor-associated proteases supports the hypothesis that c-erbB-2 is a promoter of invasion and metastasis. This strongly suggests that c-erbB-2 may be a promising target for anti-invasive therapy in gastric cancer.

HER2 evaluation in a specific gastric cancer population with the highest rate of mortality in Spain.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 60-60
Author(s):  
Esther Una Cidon
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Retrospective Study ◽  
Daily Practice ◽  
Radical Resection ◽  
Biological Factor ◽  
Advanced Stages ◽  
Her 2 ◽  
The Relationship

60 Background: Gastric Cancer (GC) still represents the second cause of cancer-related death worldwide. Radical resection is the mainstay of early stages treatment with few impact in overall survival (OS) in the advanced ones. HER-2 is the most relevant biological factor involved. Purpose: This study aims to show the relationship between HER-2 positivity and survival in patients with completely resected GC. Methods: Retrospective study of GC patients diagnosed in 2003-2005 at our institution. Surgical specimens underwent immunohistochemistry (IHC) and in cases +/++/+++ samples underwent also fluorescence in situ hibridysation (FISH) analyses of HER-2 and graduated according experts consensus. Results: 120 cases included. Overall expression detected in 7.5%. Correlation between HER-2 positive and female sex, advanced stages or histological grades or intestinal type was detected. Early recurrences higher in HER-2 positive (66.6% vs 35.4%, p 0.048). The median DFS for c-erbB-2 positive was 15 months (range 2-67 months) and OS was 25 months (range 10-67 months). In the case of patients with c-erbB-2 negative median DFS was 27 months (range 5-67 months) and OS for this sample is 47 months (range 29-67 months). Conclusions: These results emphasize the relevance of HER-2 positivity in GC as independent prognostic factor and supports its current analyses in daily practice.

scholarly journals Complete blood count-based inflammatory score (CBCS) is a novel prognostic marker for gastric cancer patients after curative resection

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jian-Xian Lin ◽  
Jun-Peng Lin ◽  
Jian-Wei Xie ◽  
Jia-bin Wang ◽  
Jun Lu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Roc Curve ◽  
Curative Resection ◽  
Blood Count ◽  
Complete Blood Count ◽  
Prognostic Score ◽  
Prognostic Impact ◽  
Inflammatory Score

Abstract Background We sought to investigate the prognostic value of complete blood count (CBC)-based biomarkers for patients with resectable gastric cancer (GC). Methods Patients with GC who underwent primary surgical resection between December 2008 and December 2013 were included. The estimated area under the curve (AUC) and multivariate Cox regression models were used to identify the best CBC-based biomarker. Time-dependent receiver operating characteristic (t-ROC) curve analysis was used to predict overall survival and compare the prognostic impact. Results In the 1810 patients analyzed, the median follow-up period was 51.0 months (range 1–101 months). Based on multivariate analysis, the lymphocyte-monocyte ratio (LMR) and hemoglobin (Hb) level were independent prognostic factors (both P < 0.05). Based on the LMR and Hb level, we established the CBC-based inflammatory score (CBCS). A higher CBCS was associated with older age, female sex, higher American Society of Anesthesiologists (ASA) score, proximal tumor location, larger tumor size, later stage and vascular involvement (all P < 0.05). Univariate analyses showed that a higher CBCS was also associated with worse overall survival (OS), which was consistent in each stage (all P < 0.05). Multivariate analysis revealed that the CBCS was a significant independent biomarker (P < 0.05). The AUC for the CBCS (0.627) was significantly higher than the AUCs for the LMR (0.573) and Hb level (0.605) (both P < 0.05). Furthermore, the t-ROC curve of the CBCS was superior to that of the prognostic nutritional index (PNI), systemic immune-inflammation index (SII), modified Glasgow prognostic score (mGPS) and C-reactive protein/albumin ratio (CRP/Alb) throughout the observation period. Conclusion The preoperative LMR and Hb level were optimal CBC-based biomarkers for predicting OS in GC patients after curative resection. Based on the LMR and Hb, we developed a novel and easily obtainable prognostic score called the CBCS, which may improve the prediction of clinical outcomes.

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