scholarly journals Surgical resection of synchronous liver metastases in gastric cancer patients. A propensity score-matched study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tomaz Jagric ◽  
Matjaz Horvat
Keyword(s):  
Gastric Cancer ◽  
Liver Resection ◽  
Propensity Score ◽  
Liver Metastases ◽  
Metastatic Gastric Cancer ◽  
Control Group ◽  
R0 Resection ◽  
Gastric Cancer Patients ◽  
Matched Study ◽  
Synchronous Liver Resection

AbstractBackgroundThe aim of the study was to determine the value of synchronous liver resection in patients with oligo-metastatic gastric cancer and the prognostic factors in these patients.Patients and methodsWe compared the results of 21 gastric patients with liver metastases and synchronous liver resection (LMR) to 21 propensity score-matched patients with gastric cancer and liver metastases in whom liver resection was not performed (LM0) and to a propensity score-matched control group of 21 patients without liver metastases and stage III and IV resectable gastric cancer (CG).ResultsThe overall 5-year survival of LMR, LM0 and CG were 14.3%, 0%, and 19%, respectively (p = 0.002). Five-year survival was 47.5% for well-differentiated tumour compared to 0% in patients with moderate or poor tumour differentiation (p = 0.006). In addition, patients with R0 resection and TNM stage N0–1 had a significantly better survival compared to patients with TNM N stage N2–3 (5-year survival: 60% for N0–1 vs. 7.7% for N2–3; p = 0.007).ConclusionsThe results presented in the study support synchronous liver resections in gastric patients and provide additional criteria for patient selection.

Multicentre propensity score‐matched study of laparoscopic versus open repeat liver resection for colorectal liver metastases

2019 ◽  
Vol 106 (6) ◽  
pp. 783-789 ◽  
Author(s):  
M. J. van der Poel ◽  
L. Barkhatov ◽  
D. Fuks ◽  
G. Berardi ◽  
F. Cipriani ◽  
...  
Keyword(s):  
Liver Resection ◽  
Propensity Score ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Repeat Liver Resection ◽  
Matched Study

What care is appropriate and necessary for metastatic gastric cancer patients? Results of a RAND/UCLA expert panel.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 70-70
Author(s):  
Alyson L. Mahar ◽  
Lucy K. Helyer ◽  
Carol Jane Swallow ◽  
Calvin Law ◽  
Lawrence Frank Paszat ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Liver Metastases ◽  
Surgical Resection ◽  
Metastatic Disease ◽  
Expert Panel ◽  
Treatment Decision ◽  
Metastatic Gastric Cancer ◽  
Treatment Decision Making ◽  
Gastric Cancer Patients ◽  
Multiple Liver Metastases

70 Background: Most gastric cancer patients present with advanced stage disease precluding curative surgical treatment. The utility of surgical and non-surgical options for non-curative, advanced disease is debated and the appropriate treatment strategy unclear. Methods: A multi-disciplinary expert panel of 16 physicians from 6 countries, scored 47 scenarios using the RAND/UCLA Appropriateness Methodology. Appropriateness was scored from 1 (highly inappropriate) to 9 (highly appropriate). Median appropriateness scores (AS) from 1-3 were considered inappropriate, 4-6 uncertain, and 7-9, appropriate. Agreement was reached when 11 of 16 panelists scored the statement similarly. If a statement was agreed to be appropriate, it was then given a necessity score (NS) in the same manner. Results: Surgical resection and bypass were agreed to be inappropriate in patients with minor symptoms and visible carcinomatosis, liver metastases or more than one site of metastatic disease for cardia and distal lesions (AS 1.0-3.5). The expert panel disagreed on the role for surgical resection in patients who were cytology positive only (AS 4-6). The role of resection for patients with major symptoms if they had visible carcinomatosis, liver metastases or more than one site of metastatic disease (AS 2-5) was indeterminate. Patients with distal tumours and major symptoms and multiple liver metastases or more than one site of metastatic disease were considered indeterminate for surgical resection (AS 2). Best supportive care was agreed to be appropriate for patients with minor symptoms and multiple liver metastases or more than one site of metastatic disease (AS 8, NS 5-6). Conclusions: The role of surgery in metastatic gastric cancer treatment decision-making is not supported by experts for the majority of scenarios. Continued uncertainty in appropriate and necessary treatment decision-making for advanced patients with a minimal burden metastatic disease exists and underscores the need for randomized controlled trials.

Conversion gastrectomy for stage IV unresectable gastric cancer: A retrospective cohort study.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 298-298
Author(s):  
Tamotsu Sagawa ◽  
Yasushi Sato ◽  
Kyoko Hamaguchi ◽  
Masahiro Hirakawa ◽  
Hiroyuki Nagashima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Study ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Distant Metastases ◽  
Metastatic Gastric Cancer ◽  
Cancer Center ◽  
R0 Resection ◽  
Stage Iv Gastric Cancer ◽  
Gastric Cancer Patients

298 Background: Stage IV Gastric cancer (GC) is a heterogeneous biological condition with a mixture of distant metastases, including hematologic, lymph nodal and/or peritoneal. In the recent classification introduced by Yoshida et al with the proposal to identify objective principles for conversion surgery, stage IV GC patients were subdivided into 4 new categories. In this study, we retrospectively investigated the efficacy of conversion gastrectomy for stage IV GC patients, with particular focus on the Yoshida’s classification. Methods: A retrospective, single center cohort study was performed in patients who had undergone conversion gastrectomy between 2005 and 2018. Data were extracted from Hokkaido Cancer Center database including all metastatic gastric cancer patients submitted to surgery. Only stage IV unresectable tumors/metastases which became resectable after chemotherapy were included in this analysis. Results: Forty-two resected stage IV GC patients were included in this analysis. Median overall survival (OS) was 40.0 months and 1-, 3- and 5-year survivals were 92.9, 70.7 and 57.7%, respectively. Univariate analysis among the patients with conversion gastrectomy identified macroscopic type, clinical response to 1st line therapy, pathological tumor depth, pathological nodal stage, R0 resection as significant prognostic factors. The MSTs of the patients with conversion gastrectomy for each category were 50.1 months for category 1, 46.6 months for category 2, 22.7 months for category 3 and 17.2 months for category 4. Conclusions: Unresectable stage IV GC patients could benefit from radical surgery after chemotherapy and achieve long survivals. Adequate selection of stage IV GC patients for conversion therapy may be an important role.

scholarly journals Laparoscopic versus open repeat liver resection for colorectal liver metastases: a multicenter propensity score matched study

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S360 ◽  
Author(s):  
M.J. van der Poel ◽  
I. Dagher ◽  
M. D'Hondt ◽  
F. Rotellar ◽  
M.G. Besselink ◽  
...  
Keyword(s):  
Liver Resection ◽  
Propensity Score ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Repeat Liver Resection ◽  
Matched Study

CLINICAL SIGNIFICANCE OF SERUM CAVEOLIN-1 LEVELS IN GASTRIC CANCER PATIENTS

2018 ◽  
Vol 40 (4) ◽  
pp. 323-327 ◽  
Author(s):  
F Tas ◽  
S Karabulut ◽  
K Erturk ◽  
D Duranyildiz
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Histological Grade ◽  
Clinical Importance ◽  
Disease Stage ◽  
Control Group ◽  
Tissue Samples ◽  
Caveolin 1 ◽  
Study Results ◽  
Gastric Cancer Patients

Aim: Caveolin-1 plays a significant role in the pathogenesis of various carcinomas and its expression affects the survival of cancer patients. However, the molecular function of caveolin-1 and its possible clinical importance has remained uncertain in gastric cancer. No clinical trial has examined serum caveolin-1 levels in gastric cancer patients so far, instead all available results were provided from studies conducted on tissue samples. In the current study, we analyzed the soluble serum caveolin-1 levels in gastric cancer patients, and specified its associations with the clinical factors and prognosis. Material and Methods: Sixty-three patients with pathologically confirmed gastric cancer were enrolled into the trial. Serum caveolin-1 concentrations were detected by ELISA method. Thirty healthy subjects were also included in the study. Results: The median age of patients was 62 years, ranging from 28 to 82 years. The serum caveolin-1 levels in gastric cancer patients were significantly higher than those in control group (p < 0.001). The common clinical parameters including patient age, sex, lesion localization, histopathology, histological grade, disease stage, and various serum tumor markers (e.g. LDH, CEA, and CA 19.9) were not found to be associated with serum caveolin-1 levels (p > 0.05). Similarly, no correlation existed between serum caveolin-1 concentration and chemotherapy responsiveness (p = 0.93). Furthermore, serum caveolin-1 level was not found to have a prognostic role (p = 0.16). Conclusion: Even though it is neither predictive nor prognostic, serum caveolin-1 level may be a valuable diagnostic indicator in patients with gastric cancer. Key

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