Gastric Cancer Surgical Experience from a single expert Western center: case series results

2020 ◽  
Author(s):  
Luigina graziosi ◽  
elisabetta marino ◽  
Stefano Avenia ◽  
Maria Cristina Vannoni ◽  
Annibale Donini
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Locally Advanced ◽  
Case Series ◽  
Disease Free Survival ◽  
Curative Surgery ◽  
Free Survival ◽  
Entire Cohort ◽  
Time Period ◽  
Disease Free

Abstract Background Surgical treatment plays a key role in the cure of gastric cancer. Our aim was to analyze changes in epidemiology and outcome, over a time period of 15 years.Methods 410 patients operated between January 2004 and December 2018 were enrolled. Patients were subdivided into 3 groups. The entire cohort was evaluated, and a more detailed analysys was made in patients that underwent a curative surgery. Survival outcomes and oncological surgical outcomes have been described and correlated with Overall Survival.Results Results showed an increase trend in gastric cancer operation over the time period analyzed (p< 0.05). Overall and disease free survival did not vary in the different time periods. In patients treated with the intent to cure: 5- and 10-Year survivals were respectively: 44% and 34.7%; 5- and 10 years disease free survival were 50.7 and 49.4%. Type of lymphadenectomy and number of lymphondal harvested changed significantly over the time (p < 0.05). Conclusions Our result showed an increasing trend in number of surgery for gastric adenocarcinoma in our center, probably due to the increasing in absolute number of cases in Italy and worldwide. We have also show that tumor location is shifting towards a distal location in the last period. Moreover in the last period there is also an improving trend in overall survival, probably due to a more aggressive surgery adopted and also due to an improved learning curve. Gastric surgery must be done in an experienced center to obtain oncological outcomes; in selected cases an extended lymphadenectomy could give survival benefit to patients with locally advanced gastric cancer.

scholarly journals Gastric Cancer Surgical Experience from a single expert Western center: case series results

2020 ◽  
Author(s):  
Luigina Graziosi ◽  
Elisabetta Marino ◽  
Stefano Avenia ◽  
Maria Cristina Vannoni ◽  
Annibale Donini
Keyword(s):  
Gastric Cancer ◽  
Locally Advanced ◽  
Case Series ◽  
Disease Free Survival ◽  
Gastric Surgery ◽  
Curative Surgery ◽  
Free Survival ◽  
Entire Cohort ◽  
Time Period ◽  
Disease Free

Abstract Background Surgical treatment plays a key role in the cure of gastric cancer. Our aim was to analyzed changes both in outcomes and in the epidemiology, over a time period of 15 years.Methods410 patients operated between January 2004 and December 2018 were enrolled. Patients were subdivided into 3 groups. The entire cohort was evaluated, and a more detailed analysys was made in patients that underwent a curative surgery. Survival outcomes and oncological surgical outcomes have been described and correlated with Overall Survival. Results Results showed an increase trend in gastric cancer operation over the time period analyzed ( p< 0.05).Overall and disease free survival did not vary in the different time periods. In patients treated with the intent to cure: 5- and 10-Year survivals were respectively: 44% and 34.7%; 5- and 10 years disease free survival were 50.7 and 49.4%. Type of lymphadenectomy and number of lymphondal harvested changed significantly over the time (p < 0.05). Conclusions Gastric surgery must be done in an experienced center to obtain oncological outcomes; in selected cases an extended lymphadenectomy could give survival benefit to patients with locally advanced gastric cancer.

Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer

2017 ◽  
Vol 213 (4) ◽  
pp. 748-753 ◽  
Author(s):  
Paolo Aurello ◽  
Giammauro Berardi ◽  
Simone Maria Tierno ◽  
Gian Luca Rampioni Vinciguerra ◽  
Fabio Socciarelli ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Advanced Gastric Cancer ◽  
Perineural Invasion ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Free Survival ◽  
Locally Advanced Gastric Cancer ◽  
Disease Free

Overexpression of NUAK1 is associated with disease-free survival and overall survival in patients with gastric cancer

2014 ◽  
Vol 31 (7) ◽  
Author(s):  
Xiao-tian Ye ◽  
Ai-jun Guo ◽  
Peng-fei Yin ◽  
Xian-dong Cao ◽  
Jia-cong Chang
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Value of Preoperative Inflammation-Based Prognostic Scores in Predicting Overall Survival and Disease-Free Survival in Patients with Gastric Cancer

2014 ◽  
Vol 21 (6) ◽  
pp. 1998-2004 ◽  
Author(s):  
Paolo Aurello ◽  
Simone Maria Tierno ◽  
Giammauro Berardi ◽  
Federico Tomassini ◽  
Paolo Magistri ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Prognostic Scores ◽  
Free Survival ◽  
Disease Free

A prospective, randomized, controlled, multicenter study of apatinib combined with S-1 plus docetaxel as adjuvant therapy for locally advanced gastric cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16019-e16019
Author(s):  
Zhili Shan ◽  
Feng Guo ◽  
Hong Chen ◽  
Dapeng Li ◽  
Zhongqi Mao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Free Survival ◽  
Randomized Controlled ◽  
Locally Advanced Gastric Cancer ◽  
Group A ◽  
Group B ◽  
Disease Free

e16019 Background: Postoperative adjuvant chemotherapy is commonly given after the curative resection of gastric cancer (GC) in both Eastern and Western countries. Several studies have investigated the feasibility and safety of S-1 plus docetaxel or S-1 plus cisplatin. However, the best choice of adjuvant treatment for patients with gastric cancer is still debated. Apatinib, an oral small molecular of VEGFR-2 TKI, has been confirmed to improve OS and PFS with acceptable safety profile in patients with advanced gastric cancer refractory to two or more lines of prior chemotherapy. In this study, we aimed to evaluate the efficacy and safety of apatinib combined with S-1/docetaxel for locally advanced gastric cancer (T3-4aN+M0). Methods: This is a prospective, randomized, controlled, multicenter clinical study. Patients with locally advanced gastric cancer, pathological stage T3-4aN+M0 who underwent D2 lymphadenectomy without prior anti-cancer therapy were included. All these patients were assigned to group A or B. Patients in group A received 6 cycles (21 days a cycle) of adjuvant therapy using S-1 (80-120mg/d, d1-14), and docetaxel (40mg/m2, d1). Group B received the same regimen with the addition of apatinib (250mg, qd.). The primary endpoint was disease-free survival (DFS). The final analysis cutoff date was 30 November, 2020. Results: A total of 45 patients were enrolled from January 2019 to November, 2010 and assigned to group A (21) or group B (24). The DFS was not reached in both of the groups. The 1-year disease-free survival rate was 60% in group A and 90% in the group B, while the difference was not significant. The main AEs in group A were anemia (55%), nausea (50%) and neutropenia (40%); The most common AEs in group B were anemia (45%) neutropenia (40%) and diarrhea (25%). There were no treatment-related deaths. The longest administered time of apatinib with no progression was 457 days. And the median time to receive apatinib was 329 days. Conclusions: Combination of apatinib with S-1/docexal chemotherapy shows clinical benefits in locally advanced gastric cancer (T3-4aN+M0), with tolerable toxicity. The study is still ongoing to reach our final endpoint, DFS. Clinical trial information: ChiCTR2000038900.

Randomized Clinical Trial of Adjuvant Mitomycin Plus Tegafur in Patients With Resected Stage III Gastric Cancer

1999 ◽  
Vol 17 (12) ◽  
pp. 3810-3815 ◽  
Author(s):  
Lluís Cirera ◽  
Anna Balil ◽  
Eduard Batiste-Alentorn ◽  
Ignasi Tusquets ◽  
Teresa Cardona ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Trial ◽  
Overall Survival ◽  
Survival Rate ◽  
Adjuvant Chemotherapy ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Free Survival ◽  
Resected Stage ◽  
Disease Free

PURPOSE: The efficacy of adjuvant chemotherapy in gastric cancer is controversial. We conducted a phase III, randomized, multicentric clinical trial with the goal of assessing the efficacy of the combination of mitomycin plus tegafur in prolonging the disease-free survival and overall survival of patients with resected stage III gastric cancer. PATIENTS AND METHODS: Patients with resected stage III gastric adenocarcinoma were randomly assigned, using sealed envelopes, to receive either chemotherapy or no further treatment. Chemotherapy was started within 28 days after surgery according to the following schedule: mitomycin 20 mg/m2 intravenously (bolus) at day 1 of chemotherapy; 30 days later, oral tegafur at 400 mg bid daily for 3 months. Disease-free survival and overall survival were estimated using the Kaplan-Meier analysis and the Cox proportional hazards model. RESULTS: Between January 1988 and September 1994, 148 patients from 10 hospitals in Catalonia, Spain, were included in the study. The median follow-up period was 37 months. The tolerability of the treatment was excellent. The overall survival and disease-free survival were higher in the group of patients treated with chemotherapy (P = .04 for survival and P = .01 for disease-free survival in the log-rank test). The overall 5-year survival rate and the 5-year disease-free survival rate were, respectively, 56% and 51% in the treatment group and 36% and 31% in the control group. CONCLUSION: Our positive results are consistent with the results of recent studies; which conclude that there is a potential benefit from adjuvant chemotherapy in resected gastric cancer.

Pelvic Irradiation With Concurrent Chemotherapy Versus Pelvic and Para-Aortic Irradiation for High-Risk Cervical Cancer: An Update of Radiation Therapy Oncology Group Trial (RTOG) 90-01

2004 ◽  
Vol 22 (5) ◽  
pp. 872-880 ◽  
Author(s):  
Patricia J. Eifel ◽  
Kathryn Winter ◽  
Mitchell Morris ◽  
Charles Levenback ◽  
Perry W. Grigsby ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Disease Stage ◽  
Tumor Diameter ◽  
Free Survival ◽  
Stage Ib ◽  
Disease Free

Purpose To report mature results of a randomized trial that compared extended-field radiotherapy (EFRT) versus pelvic radiotherapy with concomitant fluorouracil and cisplatin (CTRT) in women with locoregionally advanced carcinomas of the uterine cervix. Patients and Methods Four hundred three women with cervical cancer were randomly assigned to receive either EFRT or CTRT. Patients were eligible if they had stage IIB to IVA disease, stage IB to IIA disease with a tumor diameter ≥ 5 cm, or positive pelvic lymph nodes. Patients were stratified by stage and by method of lymph node evaluation. Results The median follow-up time for 228 surviving patients was 6.6 years. The overall survival rate for patients treated with CTRT was significantly greater than that for patients treated with EFRT (67% v 41% at 8 years; P < .0001). There was an overall reduction in the risk of disease recurrence of 51% (95% CI, 36% to 66%) for patients who received CTRT. Patients with stage IB to IIB disease who received CTRT had better overall and disease-free survival than those treated with EFRT (P < .0001); 116 patients with stage III to IVA disease had better disease-free survival (P = .05) and a trend toward better overall survival (P = .07) if they were randomly assigned to CTRT. The rate of serious late complications of treatment was similar for the two treatment arms. Conclusion Mature analysis confirms that the addition of fluorouracil and cisplatin to radiotherapy significantly improved the survival rate of women with locally advanced cervical cancer without increasing the rate of late treatment-related side effects.

Phase II trial of adjuvant immunotherapy with autologous tumor-derived Gp96 vaccination in patients with gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 117-117
Author(s):  
Lin Chen ◽  
Kecheng Zhang ◽  
Zheng Peng ◽  
Bo Wei ◽  
Hongqing Xi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Immune Responses ◽  
Phase Ii Trial ◽  
Disease Free Survival ◽  
Control Group ◽  
Autologous Tumor ◽  
Free Survival ◽  
Experimental Group ◽  
Disease Free

117 Background: Autologous, tumor-derived heat shock protein Gp96 peptides complexes have shown antitumor potential in various cancers. We conducted the first Phase II trial to evaluate the safety and efficacy of Gp96 vaccination in adjuvant settings for patients with gastric cancer. Methods: Consecutive patients from November 2012 to December 2015 were enrolled. Participants were allocated to the experimental group or control group, receiving Gp96 vaccination plus chemotherapy or chemotherapy alone respectively. The primary endpoints were disease-free survival and toxicity. The secondary outcomes were overall survival and tumor-specific immune responses. Results: Thirty-nine and forty patients received Gp96 vaccination plus chemotherapy and chemotherapy alone in the adjuvant settings respectively. Significant increased tumor-specific immune responses were observed after Gp96 vaccination. There were comparable disease-free survival ( p = 0.413; HR: 0.75; 95% CI: 0.37−1.48) and overall survival ( p = 0.485; HR: 0.68; 95% CI: 0.24−1.96) between experimental group and control group. In subgroup of patients with stage II and stage III gastric cancer, patients who have received Gp96 vaccination had improved disease-free survival compared those who have not ( p = 0.044; HR: 0.45; 95% CI: 0.22−0.96). Gp96 vaccination plus chemotherapy was well tolerated and no Gp96-related serious adverse event has been observed. Conclusions: Gp96 vaccination could elicit tumor-specific immune responses and could be safely used in adjuvant settings combined with chemotherapy. Patients with less aggressive diseases might benefit from Gp96 therapy.

Can CRM status on MRI predict survival in locally advanced rectal cancers: Experience from the Indian subcontinent.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15167-e15167
Author(s):  
Jay Rashmi Anam ◽  
Mihir Chandarana ◽  
Supreeta Arya ◽  
Ashwin Luis Desouza ◽  
Vikas S. Ostwal ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Predictive Value ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Free Survival ◽  
Mri Scans ◽  
Rectal Cancers ◽  
The Impact ◽  
Disease Free

e15167 Background: Neoadjuvant chemoradiation has become the standard approach for treatment of locally advanced rectal cancers. Magnetic Resonence Imaging (MRI) is the staging modality of choice in rectal carcinoma. Recent reports have studied the impact of MRI on local recurrence and survival both in treatment naïve and post treatment settings Methods: A retrospective analysis of prospective database was performed over a period of 1 year. All pretreatment patients with carcinoma of rectum were included in the study. The status of CRM on MRI was compared to that on the histopathology and as a predictor of recurrence and survival. For analysis, the MRI scans done for patients at presentation were labeled as MRIT. This included all patients irrespective of further treatment received. Patients who were treated with NACTRT had two MRI scans. The MRI at presentation in this subset of patients was labeled as MRI1 and the reassessment MRI after NACTRT was labeled as MRI2. Thus, MRI1 represented a subset of MRIT with locally advanced tumors treated with NACTRT. All the sets of MRI scans were analyzed separately for prediction of CRM involvement and for their effect on local recurrence and survival rates. Results: 221 patients were included with a median follow-up 30 months. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRIT, MRI1 and MRI2 to predict CRM status were 50%, 62.3%, 96.5%, 5.6% and 61.8%, 50%, 55%, 95%, 6% and 54.7% and 77.8%, 63.7%, 98%, 11%, 64.5% respectively. On multivariate analysis pathological positive margins alone predicted a poor overall survival (OS) whereas involved CRM on pathology and pretreatment MRI predicted poorer disease free survival and OS Conclusions: CRM status on pathology remains the most important prognostic factor to impact overall survival, disease free survival and local recurrence. CRM status on MRI at presentation alone has significant impact on disease free survival and local recurrence. Although MRI done after neoadjuvant treatment may not predict survival, it has a role in helping modify the surgical approach with a goal to achieve a negative CRM on pathology.

Clinical impact of postgastrectomy sarcopenia on the prognosis in patients with gastric cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 311-311
Author(s):  
Beom Jin Kim ◽  
Eun Sun Lee ◽  
Joong-Min Park ◽  
In Gyu Hwang
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Muscle Mass ◽  
Surgical Resection ◽  
Disease Free Survival ◽  
Clinical Impact ◽  
Free Survival ◽  
Significant Difference ◽  
Fat Volume ◽  
Disease Free

311 Background: There is a lack of research on newly developed sarcopenia postoperatively. The purpose of this study was to investigate the risk factors and the clinical impact of postgastrectomy sarcopenia on the prognosis in patients undergoing radical gastrectomy for gastric cancer (GC). Methods: We retrospectively reviewed clinicopathological data from 430 consecutive GC patients who underwent surgical resection at Chung-Ang University Hospital between January 2011 and December 2015. Their skeletal muscle mass and abdominal fat volume were measured by abdominal CT imaging. Results: A total of 425 patients were analyzed in the study. The mean age was 62 years old and male were 301 (70.8%). Of these, 42 patients (9.9%) were diagnosed as pre-operative sarcopenia. Compared with non-sarcopenic group, pre-operative sarcopenia groups showed more female, higher BMI, less alcoholic, and less smoking. However, there was no significant difference in 5 - year overall survival and disease free survival between the groups (p = 0.836 and p = 0.638, respectively). Among 381 non-sarcopenic patients, 48 patients (12.6%) were diagnosed as newly developed sarcopenia in one year after gastric resection. Compared with non-sarcopenic group, the newly developed sarcopenic group showed more male, more undifferentiated tumor, lower hemoglobin level, less alcoholic, less smoking, and presence of diabetes mellitus. However, there was no significant difference in the 5 - year overall survival and disease free survival among non-sarcopenic, sarcopenic, and newly developed sarcopenic groups (p = 0.521 and p = 0.534, respectively). The relationship between preoperative body fat volume and postoperative muscle mass showed a significant correlation (rho = 0.296, p < 0.001), but only BMI was significantly associated with long term survival. Conclusions: Although newly developed sarcopenia after surgery did not affect the survival rate, patients with nutritional risk of sarcopenia after surgical resection may require early evaluation of nutritional status and nutritional support.

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