Clinical significance of conversion surgery for gastric cancer with peritoneal dissemination: A retrospective study

Objective: Although chemotherapy has been clinically recommended as the initial treatment for patients with peritoneal dissemination of gastric cancer, poor prognosis has been noted among the same patients. However, the prognostic significance of conversion surgery after chemotherapy remains unclear. The present study therefore aimed to assess the clinical impact of conversion surgery among patients with peritoneal dissemination of gastric cancer. Methods: A total of 93 patients with peritoneal dissemination of gastric cancer undergoing chemotherapy between February 2002 and October 2019 were retrospectively enrolled and subsequently divided into progressive disease (PD) and non-PD groups based on tumor response to chemotherapy. Results: Among the included patients, 17 developed distant metastases at another site besides peritoneal dissemination. Based on tumor response, 24 and 69 patients were determined to have PD and non-PD, respectively, with the former having significantly poorer prognosis than the latter (p < 0.0001). A total of 19 patients underwent conversion surgery after chemotherapy, with the presence or absence of conversion surgery being significantly correlated with age, first-line chemotherapy regimen, and tumor response (p = 0.0134, p = 0.0337, and p = 0.0024, respectively). Patients in the non-PD group who underwent conversion surgery or chemotherapy alone had 3-year overall survival rates of 55.6 and 6.6%, respectively. Multivariate analysis identified conversion surgery alone as an independent prognostic factor in the non-PD group (p < 0.0001). Conclusion: Our retrospective study demonstrated that conversion surgery for gastric cancer with peritoneal dissemination might improve the prognosis of responders who developed no peritoneal dissemination after chemotherapy.

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Prognostic significance of surgery after chemotherapy in patients with type 4 gastric cancer

10.21203/rs.3.rs-39822/v1 ◽

2020 ◽

Author(s):

Takaaki Arigami ◽

Daisuke Matsushita ◽

Keishi Okubo ◽

Takako Tanaka ◽

Ken Sasaki ◽

...

Keyword(s):

Gastric Cancer ◽

Multivariate Analysis ◽

Tumor Response ◽

Prognostic Significance ◽

Distant Metastases ◽

Clinical Indication ◽

R0 Resection ◽

Prognostic Impact ◽

Chemotherapeutic Regimen ◽

Response To Chemotherapy

Abstract Background The majority of patients with type 4 gastric cancer have distant metastases with extremely poor prognosis. Consequently, considering a therapeutic strategy that improves the prognosis of these patients is clinically important. The present study aimed to assess the clinical indication and prognostic impact of surgery in patients with type 4 gastric cancer who underwent chemotherapy. Methods A total of 67 patients with type 4 gastric cancer who underwent chemotherapy were retrospectively enrolled. All patients were grouped into progressive disease (PD) and non-PD groups by tumor response to chemotherapy. Results Distant metastases occurred in 58 patients. With regard to tumor response, 16 and 51 patients had PD and non-PD, respectively. The prognosis was significantly poorer in patients with PD than in those with non-PD (p < 0.0001). Among 23 patients who underwent surgery after chemotherapy, 21 had a R0 resection. The presence or absence of surgery was significantly correlated with age, first-line chemotherapeutic regimen, lymph node metastasis, clinical stage, number of distant metastatic sites, peritoneal dissemination, and tumor response (p = 0.0412, p = 0.0096, p = 0.0024, p = 0.0059, p = 0.0128, and p = 0.0020, and p = 0.0066, respectively). Multivariate analysis selected tumor response and surgery as an independent prognostic factor (p = 0.0001 and p = 0.0009, respectively). Moreover, multivariate analysis for the surgery group demonstrated that metastatic nodal status (N0-1 vs N2-3) and residual tumor status (R0 vs R1-2) were significant independent prognostic factors (p = 0.0258 and p = 0.0458, respectively). Conclusion Our retrospective study suggests that surgery after chemotherapy for type 4 gastric cancer may improve the prognosis of responders with N0-1 status and a curative R0 resection.

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Prognostic Significance of Surgery After Chemotherapy in Patients with Type 4 Gastric Cancer: A Retrospective Study

10.21203/rs.3.rs-60967/v1 ◽

2020 ◽

Author(s):

Takaaki Arigami ◽

Daisuke Matsushita ◽

Keishi Okubo ◽

Takako Tanaka ◽

Ken Sasaki ◽

...

Keyword(s):

Gastric Cancer ◽

Multivariate Analysis ◽

Retrospective Study ◽

Tumor Response ◽

Distant Metastases ◽

Clinical Indication ◽

R0 Resection ◽

Prognostic Impact ◽

Chemotherapeutic Regimen ◽

Response To Chemotherapy

Abstract Background: The majority of patients with type 4 gastric cancer have distant metastases with extremely poor prognosis. Consequently, considering a therapeutic strategy that improves the prognosis of these patients is clinically important. The present study aimed to assess the clinical indication and prognostic impact of surgery in patients with type 4 gastric cancer who underwent chemotherapy.Methods: A total of 67 patients with type 4 gastric cancer who underwent chemotherapy were retrospectively enrolled. All patients were grouped into progressive disease (PD) and non-PD groups by tumor response to chemotherapy.Results: Distant metastases occurred in 58 patients. With regard to tumor response, 16 and 51 patients had PD and non-PD, respectively. The prognosis was significantly poorer in patients with PD than in those with non-PD (p < 0.0001). Among 23 patients who underwent surgery after chemotherapy, 21 had a R0 resection. The presence or absence of surgery was significantly correlated with age, first-line chemotherapeutic regimen, lymph node metastasis, clinical stage, number of distant metastatic sites, peritoneal dissemination, and tumor response (p = 0.0412, p = 0.0096, p = 0.0024, p = 0.0059, p = 0.0128, p = 0.0020, and p = 0.0066, respectively). Multivariate analysis selected tumor response and surgery as an independent prognostic factor (p = 0.0001 and p = 0.0009, respectively). Moreover, multivariate analysis for the surgery group demonstrated that metastatic nodal status (N0-1 vs. N2-3) and residual tumor status (R0 vs. R1-2) were significant independent prognostic factors (p = 0.0258 and p = 0.0458, respectively).Conclusions: Our retrospective study suggests that surgery after chemotherapy for type 4 gastric cancer may improve the prognosis of responders with N0-1 status and a curative R0 resection.

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Prognostic significance of surgery after chemotherapy in patients with type 4 gastric cancer: a retrospective study

10.21203/rs.3.rs-60967/v2 ◽

2020 ◽

Author(s):

Takaaki Arigami ◽

Daisuke Matsushita ◽

Keishi Okubo ◽

Takako Tanaka ◽

Ken Sasaki ◽

...

Keyword(s):

Gastric Cancer ◽

Multivariate Analysis ◽

Retrospective Study ◽

Tumor Response ◽

Distant Metastases ◽

Clinical Indication ◽

R0 Resection ◽

Prognostic Impact ◽

Chemotherapeutic Regimen ◽

Response To Chemotherapy

Abstract Background: The majority of patients with type 4 gastric cancer have distant metastases with extremely poor prognosis. Consequently, considering a therapeutic strategy that improves the prognosis of these patients is clinically important. The present study aimed to assess the clinical indication and prognostic impact of surgery in patients with type 4 gastric cancer who underwent chemotherapy.Methods: A total of 67 patients with type 4 gastric cancer who underwent chemotherapy were retrospectively enrolled. All patients were grouped into progressive disease (PD) and non-PD groups by tumor response to chemotherapy.Results: Distant metastases occurred in 58 patients. With regard to tumor response, 16 and 51 patients had PD and non-PD, respectively. The prognosis was significantly poorer in patients with PD than in those with non-PD (p < 0.0001). Among 23 patients who underwent surgery after chemotherapy, 21 had a R0 resection. The presence or absence of surgery was significantly correlated with age, first-line chemotherapeutic regimen, lymph node metastasis, clinical stage, number of distant metastatic sites, peritoneal dissemination, and tumor response (p = 0.0412, p = 0.0096, p = 0.0024, p = 0.0059, p = 0.0128, p = 0.0020, and p = 0.0066, respectively). Multivariate analysis selected tumor response and surgery as an independent prognostic factor (p = 0.0001 and p = 0.0009, respectively). Moreover, multivariate analysis for the surgery group demonstrated that metastatic nodal status (N0-1 vs. N2-3) and residual tumor status (R0 vs. R1-2) were significant independent prognostic factors (p = 0.0258 and p = 0.0458, respectively).Conclusions: Our retrospective study suggests that surgery after chemotherapy for type 4 gastric cancer may improve the prognosis of responders with N0-1 status and a curative R0 resection.

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Conversion surgery of Stage IV gastric cancer with peritoneal dissemination after nivolumab

International Cancer Conference Journal ◽

10.1007/s13691-021-00503-0 ◽

2021 ◽

Author(s):

Yuji Toyota ◽

Kunio Okamoto ◽

Norimitsu Tanaka ◽

Hugh Shunsuke Colvin ◽

Yuta Takahashi ◽

...

Keyword(s):

Gastric Cancer ◽

Peritoneal Dissemination ◽

Stage Iv ◽

Conversion Surgery ◽

Stage Iv Gastric Cancer

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The coexpression and prognostic significance of c-MET, fibroblast growth factor receptor 2, and human epidermal growth factor receptor 2 in resected gastric cancer: a retrospective study

OncoTargets and Therapy ◽

10.2147/ott.s111778 ◽

2016 ◽

Vol Volume 9 ◽

pp. 5919-5929 ◽

Cited By ~ 3

Author(s):

Yongxu Jia ◽

Tengfei Li ◽

Dandan Zhang ◽

Zongmin Fan ◽

Huijie Fan ◽

...

Keyword(s):

Gastric Cancer ◽

Epidermal Growth Factor Receptor ◽

Retrospective Study ◽

Growth Factor ◽

Fibroblast Growth Factor Receptor ◽

Prognostic Significance ◽

Growth Factor Receptor ◽

Fibroblast Growth ◽

Epidermal Growth ◽

Resected Gastric Cancer

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Prognostic Significance of Pre- and Postoperative Lymphocyte Counts in Patients with Gastric Cancer

Digestive Surgery ◽

10.1159/000486581 ◽

2018 ◽

Vol 36 (2) ◽

pp. 137-143 ◽

Cited By ~ 9

Author(s):

Hiroaki Saito ◽

Yusuke Kono ◽

Yuki Murakami ◽

Yuji Shishido ◽

Hirohiko Kuroda ◽

...

Keyword(s):

Gastric Cancer ◽

Elderly Patients ◽

Lymphocyte Count ◽

Operating Characteristic ◽

Survival Rates ◽

Prognostic Significance ◽

Venous Invasion ◽

Prognostic Indicator ◽

Characteristic Analysis ◽

Patient Prognosis

Background: Although preoperative lymphopenia is reportedly a prognostic factor in cancer patients, the association between postoperative lymphopenia and patient prognosis has not been widely studied. Methods: We enrolled 352 patients who underwent surgery for gastric cancer (GC) between January 2005 and April 2013 to analyze correlations among pre- and postoperative lymphocyte counts (LCs) and prognosis in GC patients. Results: Pre- and postoperative (obtained 1 day after surgery) LCs were significantly correlated (r = 0.496, p < 0.0001). Pre- and postoperative LCs of elderly patients were significantly lower than those of non-elderly patients. Postoperative lymphocyte count was significantly lower in patients with a differentiated tumor than in those with an undifferentiated tumor. Based on the results of receiver operating characteristic analysis, patients were classified into subgroups as: preoperative LC ≥1,676 (pre-LCHigh), preoperative LC <1,676 (pre-LCLow); and as postoperative LC ≥855 (post-LCHigh), and postoperative LC <855 (post-LCLow). Five-year overall survival rates significantly differed between pre-LCHigh (82.5%) and pre-LCLow (71.6%) groups (p = 0.023); and also between the post-LCHigh (81.5%) and post-LCLow (69.5%) groups (p = 0.0072). The 5-year disease specific survival rates were 91.3 and 82.4% in patients with post-LCHigh and those with post-LCLow, respectively, and differences were statistically significant (p = 0.015). Multivariate analysis indicated that postoperative lymphocyte count was an independent prognostic indicator, along with age, gender, tumor size, lymph node metastasis, and venous invasion. Conclusions: Postoperative lymphocyte count is a useful predictive factor for prognosis in GC patients.

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Trifluridine/tipiracil increases survival rates in peritoneal dissemination mouse models of human colorectal and gastric cancer

Oncology Letters ◽

10.3892/ol.2017.6258 ◽

2017 ◽

Vol 14 (1) ◽

pp. 639-646 ◽

Cited By ~ 4

Author(s):

Norihiko Suzuki ◽

Fumio Nakagawa ◽

Teiji Takechi

Keyword(s):

Gastric Cancer ◽

Mouse Models ◽

Peritoneal Dissemination ◽

Survival Rates

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Clinical significance of serum tumor marker for advanced gastric cancer with palliative chemotherapy: A retrospective study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15524 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15524-e15524

Author(s):

Yahui Zhu ◽

Baorui Liu ◽

Jia Wei ◽

Juan Du ◽

Ju Yang ◽

...

Keyword(s):

Gastric Cancer ◽

Retrospective Study ◽

Advanced Gastric Cancer ◽

Tumor Markers ◽

Statistical Significance ◽

Survival Rates ◽

Hepatic Metastases ◽

Predictive Biomarkers ◽

Clinical Value ◽

Gastric Cancer Patients

e15524 Background:The predictive value of tumor markers has been previously reported a lot. However, the studies focused on advanced gastric cancer are few. In this study, we tried to investigate the relationship between the tumor markers of advanced gastric cancer and clinical characteristics, therapeutic effect of chemotherapy, and prognosis. Methods:A retrospective study including 146 advanced gastric cancer who had not received any previous anticancer therapy was performed. Blood samples for CEA, AFP, CA125, CA72-4, CA242 and CA19-9 were taken from patients before chemotherapy and monthly during their treatments. Statistical analysis was performed to predict the clinical value of these tumor markers. Results:CEA yielded an ROC value of 0.621 in predicting lymph node metastasis in gastric cancer, which was significantly higher than any of other markers. CA125 had the highest sensitivity, specificity and accuracy in gastric cancer patients with peritoneal metastasis. AFP and CEA were more frequently positive in patients with hepatic metastases. The response rate of Decreasing group, Stable group and Increasing group based on CA19-9, CEA, CA72-4, CA125 and CA242 levels achieved statistical significance. Positive cases of CA125, CA242, CA19-9 and CA72-4 showed poor prognosis, and significant differences in 3 year-survival rates were observed for CA125 and CA242. Conclusions:We found that different tumor markers in gastric cancer indicated different metastasis sits. CEA, CA242, CA19-9, CA125 and CA72-4 are predictive biomarkers in evaluating the effectiveness of chemotherapy. The elevated CA125, CA242, CA19-9 and CA72-4 levels at diagnosed had association with shorter overall survivals, especially CA125 and CA242.

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