The Impact of Intraoperative Blood Loss on the Long-term Prognosis after Curative Resection for Borrmann Type IV Gastric Cancer: A Retrospective Multicenter Study

122 Background: Several studies have reported that postoperative complications such as anastomotic leakage affect long-term prognosis after gastric cancer surgery. This study aimed to determine whether or not long-term outcomes were affected by the postoperative inflammatory complications in patients who underwent curative resection for gastric cancer. Methods: The patients were retrospectively selected from the medical records of consecutive patients who underwent curative gastrectomy with nodal dissection for gastric cancer at Yokohama City University and Kanagawa Cancer Center from January 2000 to August 2015. Inflammatory complications were evaluated according to the Clavien-Dindo classification. Overall survival (OS) was compared between postoperative inflammatory complications (IC) and no-complication (NC) groups. Results: A total of 2,254 patients were eligible for inclusion in the present study. One hundred seventy-five patients had IC group, while 2,079 patients had not. Operation time (p < 0.001), blood loss (p < 0.001) was significantly greater in the IC group. The incidence of postoperative inflammatory complication grade 2 or higher was 8.5% in which, pancreatic fistula (2.8%), anastomotic leakage (1.8%) were occurred. The mortality rate was 0.18%. The five-year OS rates of the IC and NC groups were 74.9% and 83.2%, respectively. The difference was statistically significant (p = 0.015). Multivariate Cox’s proportional hazard analyses demonstrated that the postoperative inflammatory complications were a significant prognostic factor for OS. Conclusions: Postoperative inflammatory complications have an obvious impact on the OS in curatively resected gastric cancer patients. It is necessary to reduce the incidence of postoperative complications.

Download Full-text

Intraoperatively assessed macroscopic serosal changes in patients with curatively resected advanced gastric cancer (GC): Clinical implications for prognosis and peritoneal recurrence.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.23 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 23-23

Author(s):

Changhoon Yoo ◽

Min-Hee Ryu ◽

Heung-Moon Chang ◽

Jeong Hwan Yook ◽

Young Soo Park ◽

...

Keyword(s):

Gastric Cancer ◽

Peritoneal Recurrence ◽

Phase Iii ◽

Diffuse Gastric Cancer ◽

Type Iv ◽

Borrmann Type ◽

Phase Iii Trials ◽

N Stage ◽

Borrmann Type Iv

23 Background: To validate the prognostic relevance of macroscopic serosal changes in patients with resected GC, we analyzed prospectively collected databases of two multicenter randomized phase III trials on adjuvant chemotherapy. Methods: In total, 655 patients in the control groups of AMC 0101 (NCT00296322) and 0201 (NCT00296335) trials were selected. Macroscopic serosal changes were determined according to disruptions in serosal continuity, such as changes in color or nodular texture by the operating surgeon. Correlations with recurrence-free survival (RFS), overall survival (OS), and time-to-peritoneal recurrence were analyzed. Results: About two-thirds of the patients were male (69%), and the median age was 55 years (range = 29–70 years). According to Lauren’s classification, 215 patients (33%) showed intestinal type. After a median follow-up period of 61.6 months (range = 2.6–113.9 months), the 5-year RFS and OS rates were 55.0% (95% CI = 51.2–58.9%) and 59.9% (95% CI = 56.2–63.6%), respectively. Intraoperatively assessed macroscopic serosal changes were identified in 432 patients (66%). This was significantly associated with multifocal or diffuse gastric cancer (p = 0.001), Borrmann type IV (p = 0.005), advanced pathological T stage (p < 0.001), advanced pathological N stage (p < 0.001), advanced pathological stage (p < 0.001), and total gastrectomy (p < 0.001). In multivariate analyses, which included prognostic factors of localized gastric cancer, macroscopically serosal changes were significantly associated with poor RFS (hazard ratio [HR] = 2.0, 95% CI 1.4–2.7; p < 0.001) and OS (HR = 2.1, 95% CI 1.5–3.0; p < 0.001). It was also significantly related with shorter time-to-peritoneal recurrence (HR = 2.9; 95% CI = 1.7–5.0; p< 0.001). Conclusions: Intraoperatively assessed macroscopic serosal changes confer a poor prognosis and increased peritoneal recurrence in patients with curatively resected GC. Macroscopic assessment of serosal changes may be a useful indicator that allows better risk stratification of patients with resected GC in terms of prognosis and peritoneal recurrence.

Download Full-text

145P A nomogram for predicting the benefit of adjuvant chemotherapy after resection in patients with Borrmann type IV gastric cancer

Annals of Oncology ◽

10.1016/j.annonc.2020.10.166 ◽

2020 ◽

Vol 31 ◽

pp. S1297

Author(s):

Q-Z. Qiu ◽

F-H. Wang ◽

Y-H. Tang ◽

C-H. Zheng ◽

P. Li ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Type Iv ◽

Borrmann Type ◽

Borrmann Type Iv

Download Full-text

Muscle RAS oncogene homolog (MRAS) recurrent mutation in Borrmann type IV gastric cancer

Cancer Medicine ◽

10.1002/cam4.959 ◽

2016 ◽

Vol 6 (1) ◽

pp. 235-244 ◽

Cited By ~ 1

Author(s):

Makiko Yasumoto ◽

Etsuko Sakamoto ◽

Sachiko Ogasawara ◽

Taro Isobe ◽

Junya Kizaki ◽

...

Keyword(s):

Gastric Cancer ◽

Recurrent Mutation ◽

Ras Oncogene ◽

Type Iv ◽

Borrmann Type ◽

Borrmann Type Iv

Download Full-text

Prognostic impact and implications of extracapsular lymph node spread in Borrmann type IV gastric cancer

Oncotarget ◽

10.18632/oncotarget.18400 ◽

2017 ◽

Vol 8 (57) ◽

pp. 97593-97601 ◽

Cited By ~ 2

Author(s):

Rui-Zeng Dong ◽

Jian-Min Guo ◽

Ze-Wei Zhang ◽

Yi-Min Zhou ◽

Ying Su

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Prognostic Impact ◽

Type Iv ◽

Borrmann Type ◽

Borrmann Type Iv

Download Full-text

A Transfer Learning Radiomics Nomogram for Preoperative Prediction of Borrmann Type IV Gastric Cancer From Primary Gastric Lymphoma

Frontiers in Oncology ◽

10.3389/fonc.2021.802205 ◽

2022 ◽

Vol 11 ◽

Author(s):

Bao Feng ◽

Liebin Huang ◽

Yu Liu ◽

Yehang Chen ◽

Haoyang Zhou ◽

...

Keyword(s):

Gastric Cancer ◽

Transfer Learning ◽

External Validation ◽

Gastric Lymphoma ◽

Clinical Model ◽

Primary Gastric Lymphoma ◽

Preoperative Prediction ◽

Type Iv ◽

Borrmann Type ◽

Borrmann Type Iv

ObjectiveThis study aims to differentiate preoperative Borrmann type IV gastric cancer (GC) from primary gastric lymphoma (PGL) by transfer learning radiomics nomogram (TLRN) with whole slide images of GC as source domain data.Materials and MethodsThis study retrospectively enrolled 438 patients with histopathologic diagnoses of Borrmann type IV GC and PGL. They received CT examinations from three hospitals. Quantitative transfer learning features were extracted by the proposed transfer learning radiopathomic network and used to construct transfer learning radiomics signatures (TLRS). A TLRN, which integrates TLRS, clinical factors, and CT subjective findings, was developed by multivariate logistic regression. The diagnostic TLRN performance was assessed by clinical usefulness in the independent validation set.ResultsThe TLRN was built by TLRS and a high enhanced serosa sign, which showed good agreement by the calibration curve. The TLRN performance was superior to the clinical model and TLRS. Its areas under the curve (AUC) were 0.958 (95% confidence interval [CI], 0.883–0.991), 0.867 (95% CI, 0.794–0.922), and 0.921 (95% CI, 0.860–0.960) in the internal and two external validation cohorts, respectively. Decision curve analysis (DCA) showed that the TLRN was better than any other model. TLRN has potential generalization ability, as shown in the stratification analysis.ConclusionsThe proposed TLRN based on gastric WSIs may help preoperatively differentiate PGL from Borrmann type IV GC.Borrmann type IV gastric cancer, primary gastric lymphoma, transfer learning, whole slide image, deep learning.

Download Full-text

A Patient with Advanced Gastric Cancer Presenting with Extremely Large Uterine Fibroid Tumor

Case Reports in Surgery ◽

10.1155/2014/760913 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4

Author(s):

Kwang-Kuk Park ◽

Song-I Yang

Keyword(s):

Gastric Cancer ◽

Surgical Resection ◽

Uterine Fibroid ◽

Abdominal Mass ◽

Abdominal Distension ◽

Metastatic Tumor ◽

Type Iv ◽

Uterine Tumors ◽

Borrmann Type ◽

Borrmann Type Iv

Introduction. Uterine fibroid tumors (uterine leiomyomas) are the most common benign uterine tumors. The incidence of uterine fibroid tumors increases in older women and may occur in more than 30% of women aged 40 to 60. Many uterine fibroid tumors are asymptomatic and are diagnosed incidentally.Case Presentation. A 44-year-old woman was admitted to our hospital with general weakness, dyspepsia, abdominal distension, and a palpable abdominal mass. An abdominal computed tomography scan showed a huge tumor mass in the abdomen which was compressing the intestine and urinary bladder. Gastroduodenal endoscopic and biopsy results showed a Borrmann type IV gastric adenocarcinoma. The patient was diagnosed with gastric cancer with disseminated peritoneal carcinomatosis. She underwent a hysterectomy with both salphingo-oophorectomy and bypass gastrojejunostomy. Simultaneous uterine fibroid tumor with other malignancies is generally observed without resection. But in this case, a surgical resection was required to resolve an intestinal obstruction and to exclude the possibility of a metastatic tumor.Conclusion. When a large pelvic or ovarian mass is detected in gastrointestinal malignancy patients, physicians try to exclude the presence of a Krukenberg tumor. If the tumors cause certain symptoms, surgical resection is recommended to resolve symptoms and to exclude a metastatic tumor.

Download Full-text