Determinant Factors on Differences in Survival for Gastric Cancer between the US and Japan Using Nationwide Databases: The Impact of Number of Lymph Nodes Examined

2018 ◽  
Author(s):  
Yuri Ito ◽  
Isao Miyashiro ◽  
Takashi Ishikawa ◽  
Kohei Akazawa ◽  
Keisuke Fukui ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Determinant Factors ◽  
The Us ◽  
The Impact

scholarly journals Impact of the Number of Lymph Nodes Examined on Differences in Survival for Surgically Treated Gastric Cancer Patients Between the US and Japan Using Nationwide Databases

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 94s-94s
Author(s):  
I. Miyashiro ◽  
Y. Ito ◽  
T. Ishikawa ◽  
K. Akazawa ◽  
H. Katai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Registry ◽  
Relative Survival ◽  
The United States ◽  
Population Based ◽  
Stage Migration ◽  
High Survival ◽  
The Us ◽  
The Impact

Background: Although incidence and mortality have decreased, gastric cancer (GC) is still a public health issue globally. The international collaborative study for cancer survival using population-based cancer registry showed that the survival of GC was higher in Korea and Japan than other countries, including the United States of America (US). Aim: We examined the determinant factors of the high survival in Japan, compared with the US, with particular focus on the impact of the number of lymph nodes (LNs) examined for surgically treated patients. Methods: We obtained data on 88,447 cases from the nationwide GC registration project, the Japanese Gastric Cancer Association (JGCA), from 2004-2007. We also obtained 18,995 GC cases from US population-based cancer registry data from the Surveillance, Epidemiology, and End Results Program (SEER), diagnosed from 2004-2010. We estimated five-year relative survival and applied a multivariate excess hazard model to compare the two countries. We considered the effect of LNs examined on differences in survival. Results: Five-year relative survival in Japan was 79.8%, compared with 40.1% in the US. After controlling for confounding factors, we still observed significantly higher survival in Japan. The distribution of number of LNs examined showed notable differences between two countries. In over 50% of patients in the US, only 1 to 15 LNs were examined. A higher number of LNs examined showed better survival in both countries. The differences in excess death from cancer between countries were reduced in the category when more than 30 LNs were examined. Conclusion: Although it is difficult to remove biases to compare the two countries, stage migration, related to the more detailed retrieving strategy for LNs in Japan, is a key explanation for high survival in Japan.

scholarly journals The impact of total retrieved lymph nodes on staging and survival of patients with pT3 gastric cancer

Cancer ◽  
2007 ◽  
Vol 110 (4) ◽  
pp. 745-751 ◽  
Author(s):  
Jia Yun Shen ◽  
Sungsoo Kim ◽  
Jae-Ho Cheong ◽  
Yong Il Kim ◽  
Woo Jin Hyung ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
The Impact

scholarly journals The Role of the Lymph Node Ratio in Advanced Gastric Cancer After Neoadjuvant Chemotherapy

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1914 ◽  
Author(s):  
Karol Rawicz-Pruszyński ◽  
Bogumiła Ciseł ◽  
Radosław Mlak ◽  
Jerzy Mielko ◽  
Magdalena Skórzewska ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Tumor Regression ◽  
Surgical Oncology ◽  
Independent Prognostic Factor ◽  
Tumor Diameter ◽  
Histological Subtype ◽  
The Impact

The ratio of positive lymph nodes (LNs) to the total LN harvest is called the LN ratio (LNR). It is an independent prognostic factor in gastric cancer (GC). The aim of the current study was to evaluate the impact of neoadjuvant chemotherapy (NAC) on the LNR (ypLNR) in patients with advanced GC. We retrospectively analyzed the data of patients with advanced GC, who underwent gastrectomy with N1 and N2 (D2) lymphadenectomy between August 2011 and January 2019 in the Department of Surgical Oncology at the Medical University of Lublin. The exclusion criteria were a lack of preoperative NAC administration, suboptimal lymphadenectomy (<D2 and/or removal of less than 15 lymph nodes), and a lack of data on tumor regression grading (TRG) in the final pathological report. A total of 95 patients were eligible for the analysis. A positive correlation was found between the ypLNR and tumor diameter (p < 0.001), post treatment pathological Tumour (ypT) stage (p < 0.001), Laurén histological subtype (p = 0.0001), and the response to NAC (p < 0.0001). A multivariate analysis demonstrated that the ypLNR was an independent prognostic factor in patients with intestinal type GC (p = 0.0465) and in patients with no response to NAC (p = 0.0483). In the resection specimen, tumor diameter and depth of infiltration, Laurén histological subtype, and TRG may reflect the impact of NAC on LN status, as quantified by ypLNR in advanced GC.

scholarly journals The log odds of negative lymph nodes/T stage: a new prognostic and predictive tool for resected gastric cancer patients

2021 ◽  
Author(s):  
Jiebin Xie ◽  
Yueshan Pang ◽  
Xun Li ◽  
Xiaoting Wu
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Clinicopathological Factors ◽  
Predictive Tool ◽  
T Stage ◽  
Log Odds ◽  
Gastric Cancer Patients ◽  
The Impact ◽  
Negative Lymph Nodes

Abstract Purpose When only the TNM classification is used to predict survival in gastric cancer (GC) patients, the impact of the degree of lymphadenectomy on the prognosis is neglected. This study aimed to establish a more effective nomogram based on the log odds of negative lymph nodes/T stage ratio (LONT) to predict survival in surgically treated GC patients. Methods The data of resected GC patients were extracted from the Surveillance, Epidemiology, and End Results Program (SEER) database. Univariate and multivariate Cox regression analyses were used to identify the significant prognostic factors. The prognostic performance was assessed using a calibration plot, concordance index (C-index), and area under the (time-dependent receiver operating characteristic) curve (AUC) to compare the predicted survival probability based on the nomogram score groups. Results The results showed LONT as an independent prognostic factor for cancer-specific survival (CSS) and overall survival (OS), independent of clinicopathological factors. After removing potential redundancy, only LONT, T stage, N stage, location and age were used in the final nomogram model. The model had a higher C-index (0.736 ± 0.012) and AUC (0.798) than the TNM staging system (0.685 ± 0.012 and 0.744). The nomogram score could predict a significant survival difference between any two adjacent groups in terms of CSS and OS. Conclusion High LONT is associated with improved survival of gastric cancer patients, independent of other clinicopathological factors. The prognostic nomogram model based on LONT could effectively predict CSS and OS for resectable GC patients.

scholarly journals Number of Lymph Nodes Removed and Survival after Gastric Cancer Resection: An Analysis from the US Gastric Cancer Collaborative

2015 ◽  
Vol 221 (2) ◽  
pp. 291-299 ◽  
Author(s):  
Sepideh Gholami ◽  
Lucas Janson ◽  
David J. Worhunsky ◽  
Thuy B. Tran ◽  
Malcolm Hart Squires ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Resection ◽  
The Us ◽  
Gastric Cancer Resection

scholarly journals Retrieval of 30 Lymph Nodes Is Mandatory for Selected Stage II Gastric Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Yong-He Chen ◽  
Jun Lu ◽  
Run-Cong Nie ◽  
Dan Liu ◽  
Ai-Hong Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Survival Benefit ◽  
Positive Lymph Node ◽  
Stage Ii ◽  
Clinicopathological Parameters ◽  
Ajcc Staging ◽  
Gastric Cancer Patients ◽  
The Impact

BackgroundAccording to the 8th edition AJCC staging manual, a least of 16 lymph nodes retrieval (LNRs) is the minimal requirement for lymph nodes (LNs) dissection of gastric cancer surgery. Previous studies have shown that increasing the number of LNRs (≥30) prolongs survival for selected patients. However, the necessity of retrieving 30 or more LN for stage II gastric cancer patients is still under debate.AimThis study aims to explore the impact of retrieving 30 or more lymph nodes on the survival of stage II cancer patients.MethodsA total of 1,177 patients diagnosed with stage II gastric cancer were enrolled in this study. The clinicopathological parameters and the impact of different LNRs (&lt;30 or ≥30) and positive lymph node ratio (NR) on overall survival (OS) were retrospectively analyzed.ResultsThe mean number of LNRs was 34 ± 15. A total of 44% (518/1,177) of patients had an LNRs &lt;30, while 56% (659/1,177) of patients had an LNRs ≥30. The 5-year survival rate was 81% for all patients, 76% for the LNRs &lt;30 group, and 86% for LNRs ≥30 group, respectively (P = 0.003). The survival benefit of retrieving 30 lymph nodes was significant in certain subgroups: age &gt;60 years/male/underwent total gastrectomy/stage IIB. For N+ patients, higher NR was significantly correlated with poor survival.ConclusionThe survival benefit of retrieving 30 LNs varies in different subgroups. An LNRs of 30 is mandatory for selected stage II gastric cancer patients.

scholarly journals Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era—A Single Institute Experience over a Decade

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Harsh Kanhere ◽  
Raghav Goel ◽  
Ben Finlay ◽  
Markus Trochsler ◽  
Guy Maddern
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Gastric Carcinoma ◽  
Lymph Nodes ◽  
Survival Data ◽  
Early Stage ◽  
Radical Gastrectomy ◽  
Perioperative Chemotherapy ◽  
Lymph Node Yield ◽  
The Impact

Background and Objectives. Most gastric cancer patients now undergo perioperative chemotherapy (POCT) based on the MAGIC trial results. POCT consists of neoadjuvant chemotherapy (NACT) as well as postoperative adjuvant chemotherapy. This study assessed the applicability of perioperative chemotherapy and the impact of radical gastrectomy encompassing a detailed lymph-node resection on outcomes of gastric cancer. Methods. Medical and pathology records of all gastric carcinoma resections were reviewed from 2006 onwards. Pathological details, number of lymph-nodes resected, and proportion of involved nodes, reasons for nonadministration of NACT, complications, recurrence, and survival data were analysed. Results. Only twenty-eight (37.8%) out of 74 patients underwent NACT and only nine completed POCT. NACT was declined due to comorbidities/patient refusal n=24, early stage n=14, and emergency presentation n=8. Patients receiving NACT were much younger. Anastomotic leaks, hospital-mortality, lymph-node yield, and proportion of involved lymph-nodes were similar in both groups. Thirty-two patients died due to recurrence with lymph-node involvement heralding higher recurrence risk and much poorer survival (HR 2.66; p=0.013). Conclusion. More than 60% patients with resectable gastric carcinoma did not undergo NACT. Radical gastrectomy with lymphadenectomy remained the cornerstone of treatment in this period.

Systematic review methodology for development: An example from microfinance

2018 ◽  
Vol 43 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Carina Van Rooyen ◽  
Ruth Stewart ◽  
Thea De Wet
Keyword(s):  
Systematic Review ◽  
International Development ◽  
Health Sector ◽  
Evidence Based ◽  
Systematic Review Methodology ◽  
Development Interventions ◽  
The Us ◽  
Sub Saharan ◽  
The Impact ◽  
Evidence Based Decision Making

Big international development donors such as the UK’s Department for International Development and USAID have recently started using systematic review as a methodology to assess the effectiveness of various development interventions to help them decide what is the ‘best’ intervention to spend money on. Such an approach to evidence-based decision-making has long been practiced in the health sector in the US, UK, and elsewhere but it is relatively new in the development field. In this article we use the case of a systematic review of the impact of microfinance on the poor in sub-Saharan African to indicate how systematic review as a methodology can be used to assess the impact of specific development interventions.

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