scholarly journals Prospective Evaluation of Changes in Tumor Size and Tumor Metabolism in Patients with Advanced Gastric Cancer Undergoing Chemotherapy: Association and Clinical Implication

2016 ◽  
Vol 58 (6) ◽  
pp. 899-904 ◽  
Author(s):  
Seongyeol Park ◽  
Seunggyun Ha ◽  
Hyun Woo Kwon ◽  
Woo Hyoung Kim ◽  
Tae-Yong Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Tumor Size ◽  
Clinical Implication ◽  
Tumor Metabolism ◽  
Prospective Evaluation

Is tumor size a predictor of preoperative N staging in T2–T4a stage advanced gastric cancer?

2014 ◽  
Vol 23 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Chang-Ming Huang ◽  
Mu Xu ◽  
Jia-Bin Wang ◽  
Chao-Hui Zheng ◽  
Ping Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Tumor Size ◽  
N Staging

Prognostic value of response assessed by RECIST and WHO criteria to neoadjuvant chemotherapy in locally advanced gastric cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15647-e15647
Author(s):  
S. R. Park ◽  
J. S. Lee ◽  
Y. W. Kim ◽  
I. J. Choi ◽  
K. W. Ryu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Tumor Size ◽  
Tumor Response ◽  
Locally Advanced ◽  
R0 Resection ◽  
Who Criteria ◽  
Locally Advanced Gastric Cancer ◽  
Response To Neoadjuvant Chemotherapy

e15647 Background: In metastatic gastric cancer, the response to chemotherapy is assessed by RECIST or WHO criteria according to the change of tumor size. There are no data, however, on the usefulness of those criteria in evaluating tumor response in the setting of neoadjuvant chemotherapy. The aim of this study was to evaluate the relationship between tumor response to neoadjuvant chemotherapy-as assessed by RECIST and WHO criteria-and clinical outcome in locally advanced gastric cancer (LAGC) patients. Methods: This study recruited LAGC patients who, from January 2003 through November 2005, entered the neoadjuvant arm of prospective randomized phase II trials comparing neoadjuvant chemotherapy to adjuvant chemotherapy. LAGC was defined as stage III or IV (M0) disease based on computed tomography (CT) according to the Japanese Classification of Gastric Carcinoma. Patients with measurable lesions received 3 cycles of neoadjuvant chemotherapy consisting of docetaxel (36 mg/m2) and cisplatin (40 mg/m2) on days 1 and 8 every 3 weeks, followed by surgery. Results: After chemotherapy, 40 (95%) patients underwent surgery and the remaining 2 patients showed new distant metastasis on CT scan. Thirty-five (83%) patients had curative R0 resection. Twenty-eight (67%) patients had a clinical response to neoadjuvant chemotherapy according to RECIST/WHO criteria. Although R0 resection rate (93% vs 64%, P = 0.03), median relapse-free survival (RFS) (43.2 vs 7.5 months, P = 0.14), and overall survival (OS) (not reached vs 27.0 months, P = 0.10) were better in responders than non-responders, they did not differ significantly in the subgroup that subsequently underwent surgery. When we redefined the decrease in tumor size judged as a response by RECIST (≥60% rather than ≥30%) and WHO (≥75% rather than ≥50%) criteria, response correlated significantly with both RFS (P = 0.03) and OS (P = 0.02). Conclusions: In the neoadjuvant setting, which frequently involves smaller measurable lesions than the metastatic setting, larger changes in tumor size than those specified by RECIST and WHO criteria are needed to predict postoperative outcome. No significant financial relationships to disclose.

scholarly journals Baseline lesion number as an efficacy predictive and independent prognostic factor and its joint utility with TMB for PD-1 inhibitor treatment in advanced gastric cancer

2021 ◽  
Vol 13 ◽  
pp. 175883592198899
Author(s):  
Xiao-Li Wei ◽  
Jian-Ying Xu ◽  
De-Shen Wang ◽  
Dong-Liang Chen ◽  
Chao Ren ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Advanced Gastric Cancer ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Objective Response ◽  
Multivariable Analysis ◽  
Tumor Burden ◽  
Lesion Number ◽  
The Impact

Background: We previously reported tumor mutation burden (TMB) as a potential prognostic factor for patients with advanced gastric cancer (AGC) receiving immunotherapy. We aimed to comprehensively understand the impact of tumor burden and TMB on efficacy and prognosis in immunotherapy-treated AGC patients. Methods: A total of 58 patients with refractory AGC receiving PD-1 inhibitor monotherapy from a phase Ib/II clinical trial (ClinicalTrials.gov identifier: NCT02915432) were retrospectively included. Univariate and multivariate logistical regression analyses and the Cox proportional hazards model were performed for prognostic value of baseline factors. Factors reflecting baseline tumor burden, including baseline lesion number (BLN), the maximum tumor size (MTS) and the sum of target lesion size (SLS) were analyzed. The objective response rate (ORR) and disease control rate (DCR) were compared by Chi-square test. Results: In univariate analysis, high BLN was associated with poor median progression-free survival (mPFS) [1.7 months versus 3.4 months; hazard ratio (HR), 2.696, p < 0.05] and median overall survival (mOS) (3.2 months versus 7.6 months; HR, 1.997, p < 0.05), while high TMB was a positive prognostic factor. In multivariable analysis, both BLN and TMB were independent prognostic factors for mOS (BLN: HR, 2.782, p < 0.05; TMB: HR, 0.288, p < 0.05), while MTS or SLS had no association with survival. Better ORR and DCR were observed in the low BLN group (15.4% versus 5.3%, p > 0.05; 86.96% versus 54.29%, p < 0.05). When combining BLN and TMB, the best efficacy and survival were observed in the BLNlowTMBhigh group (ORR: 37.5%, DCR: 62.5%, mPFS and mOS: not reached). The worst efficacy and survival were shown in the BNLhighTMBlow group [ORR: 0% (0/15); DCR: 13.3%; mPFS: 1.7 months; mOS: 2.7 months (all p < 0.05)]. Conclusions: BLN, rather than factors regarding baseline tumor size, is perhaps a potential predictor for benefit from immunotherapy and its combination with TMB could further risk-stratify patients with AGC receiving immunotherapy.

Risk Factors of Survival and Surgical Treatment for Advanced Gastric Cancer with Large Tumor Size

2009 ◽  
Vol 13 (5) ◽  
pp. 881-885 ◽  
Author(s):  
Chen Li ◽  
Sung Jin Oh ◽  
Sungsoo Kim ◽  
Woo Jin Hyung ◽  
Min Yan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Surgical Treatment ◽  
Advanced Gastric Cancer ◽  
Tumor Size ◽  
Large Tumor ◽  
Large Tumor Size

Clinical implication of FDG-PET in advanced gastric cancer with signet ring cell histology

2011 ◽  
Vol 104 (6) ◽  
pp. 566-570 ◽  
Author(s):  
Kyung Ho Pak ◽  
Mijin Yun ◽  
Jae-Ho Cheong ◽  
Woo Jin Hyung ◽  
Seung Ho Choi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Fdg Pet ◽  
Clinical Implication ◽  
Signet Ring Cell ◽  
Signet Ring ◽  
Ring Cell

Association of reduction of tumor metabolism with prognosis of advanced gastric cancer patients treated with palliative chemotherapy: Prospective cohort study.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 31-31
Author(s):  
Seongyeol Park ◽  
Seunggyun Ha ◽  
Hyun Woo Kwon ◽  
Woo Hyoung Kim ◽  
Tae-Yong Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Study ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Prospective Cohort ◽  
Palliative Chemotherapy ◽  
Metabolic Response ◽  
Tumor Metabolism ◽  
Gastric Cancer Patients

31 Background: Although tumor metabolism can be measured by 18F-FDG PET, the meaning of metabolic response by chemotherapy in gastric cancer patients has not been well studied. The purpose of this study is to identify prognostic value of tumor metabolic response in gastric cancer. Methods: Advanced gastric cancer patients were enrolled in this prospective cohort study before initiation of palliative chemotherapy. At the baseline and at the first tumor response evaluation, 18F-FDG PET was taken to measure tumor metabolism. We measured maximum standardized uptake value (SUVmax), and total lesion glycolysis (TLG) calculated as multiplying mean SUV by metabolic tumor volume (MTV) using threshold SUVs of 2.5 (TLG2.5) in each patients. Correlation of clinicopathological factors and survival were analyzed. Results: A total of 87 patients were enrolled. Baseline high SUVmax and TLG2.5 were associated with HER2 positivity, histologic differentiation and tumor size. High SUVmax and TLG2.5 were also associated with worse overall survival (OS) (HR 2.14, P = 0.025; HR 2.23, P = 0.037, respectively). Comparing RECIST evaluation, 30% of the reduction of sum of target lesions was correlated with 50% reduction of SUVmax, and 50% reduction of TLG2.5. The larger reduction of SUVmax (HR 0.43, P = 0.006 for Progression-free survival (PFS); HR 0.38, P = 0.007 for OS), and TLG2.5 (HR 0.27, P < 0.001 for PFS; HR 0.27, P = 0.001 for OS) was associated with better OS. In multivariate analysis, SUVmax and TLG2.5 were independent prognostic factors along with age, histologic type, gastrectomy history and HER2 status. Conclusions: Tumor metabolic response measured by SUVmax or TLG2.5 was associated with prognosis of advanced gastric cancer patients treated with chemotherapy.

Sign in / Sign up

Export Citation Format

Share Document