Disease-Specific Survival of AJCC 8th Stage II Gastric Cancer Patients After D2 Gastrectomy

The association between the risk factors and long-term prognosis in patients with stage II gastric cancer after radical gastrectomy has been fully revealed. The purpose of this study was to investigate the independent risk factors for treatment failure in stage II gastric cancer. Demographic, clinical, and pathological information of 247 stage II gastric cancer patients who underwent radical D2 gastrectomy in our department between January 2011 and December 2014 were collected and retrospectively analyzed. The relationship between and long-term clinical outcomes of stage II gastric cancer was analyzed using t-tests, chi-square tests, receiver operating characteristic (ROC) analysis, time-dependent ROC analysis, K–M curves, and a Cox regression model. The median follow-up of 247 stage II gastric cancer patients was 5.49 years (range: 0.12–8.62 years). The Kaplan–Meier estimated 3-year and 5-year DSS rates of the study group were 92.7% (95% CI 89.4–95.9) and 88.7% (95% CI 84.7–92.7), respectively. Higher age (>70 vs. ≤70, log-rank p = 0.0406), nerve invasion (positive vs. negative, log-rank p = 0.0133), and non-distal gastrectomy (distal partial gastrectomy vs. other surgical methods, log-rank p = 0.00235) had worse prognoses compared to controls. Univariate and multivariate analyses of disease-specific survival showed that these three factors were independent prognostic factors for patients with stage II disease. The area under time-dependent ROC curve (AUC) is 0.748 of 5-year survival and c-index is 0.696 based on the three-marker model drawn for stage II patients. Subgroup analyses showed an interaction between tumor location and nerve invasion. The age, perineural invasion, and surgical approach are independent prognostic factors for disease-specific survival after radical gastrectomy. Tumor location may be an important confounding factor for outcomes by affecting surgical methods and the hazards of nerve invasion.

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Appraisal of Long-time Outcomes After Curative Surgery in Elderly Patients with Gastric Cancer: A Propensity Score Matching Analysis

10.21203/rs.3.rs-75500/v1 ◽

2020 ◽

Author(s):

Tomoyuki Matunaga ◽

Ryo Ishiguro ◽

Wataru Miyauchi ◽

Yuji Shishido ◽

Kozo Miyatani ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Propensity Score ◽

Elderly Patients ◽

Propensity Score Matching ◽

Cancer Patients ◽

Stage Iii ◽

Disease Specific Survival ◽

Gastric Cancer Patients ◽

Disease Specific

Abstract Background: This study was conducted to assess the long-term outcomes of elderly patients among propensity-score-matched gastric cancer patients after curative gastrectomy and to propose the proper management of elderly gastric cancer patients.Methods: We enrolled 626 patients with gastric cancer who underwent curative gastrectomy at our institution between January 2004 and December 2015. To minimize selection bias among 2 groups, propensity score matching was performed.Results: Patients were divided into an elderly group over 75 years old (EP group; n=186) and a non-elderly group (NEP group; n=440). After propensity score matching, patients were divided into EP group (n=186) and NEP group (n=186). Five-year overall survival was significantly lower in the EP group than in the NEP group, consistent with a subgroup analysis of each stage. However, the 5-year disease-specific survival among all enrolled patients and those with stage I and II disease did not differ significantly. Moreover, in the subgroup of stage III patients, 5-year disease-specific survival was significantly lower in the EP group (23.0%) than in the NEP group (59.4%; P=0.004). Because elderly patients with stage III disease had an extremely poor prognosis, we decided to compare the two groups with stage III. The EP group contained significantly fewer patients with D2 lymphadectomy (P=0.002) and adjuvant chemotherapy (P<0.001) than the NEP group. Multivariate analysis revealed that older age and lymphatic invasion were independent prognostic factors. C-reactive protein to albumin ratio was significantly higher in patients in the EP group than in the NEP group (P=0.046), and the prognostic nutritional index was significantly lower in EP group patients than NEP group patients (P=0.045). Conclusions: Elderly gastric cancer patients with stage III disease showed poorer disease-specific survival compared with non-elderly patients, which may be due to fewer D2 lymphadenectomies, a lack of adjuvant chemotherapy, and a poorer nutritional and inflammatory background. The safe induction of standard lymphadenectomy and adjuvant chemotherapy with perioperative aggressive nutritional support may improve the prognosis of elderly gastric cancer patients with stage III disease.

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Blood parameters score predicts long-term outcomes in stage II-III gastric cancer patients

World Journal of Gastroenterology ◽

10.3748/wjg.v25.i41.6258 ◽

2019 ◽

Vol 25 (41) ◽

pp. 6258-6272

Author(s):

Jian-Xian Lin ◽

Yi-Hui Tang ◽

Jia-Bin Wang ◽

Jun Lu ◽

Qi-Yue Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Blood Parameters ◽

Stage Ii ◽

Long Term Outcomes ◽

Gastric Cancer Patients

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Comparison of Long-Term Efficacy in S-1 and Capecitabine With Oxaliplatin as Adjuvant Chemotherapy for Patients With Gastric Cancer After Curative Surgery: A Retrospective, Single-Center Observational Study

Technology in Cancer Research & Treatment ◽

10.1177/15330338211039679 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110396

Author(s):

Sung E. Oh ◽

Ji Y. An ◽

Min-Gew Choi ◽

Jun H. Lee ◽

Tae S. Sohn ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Disease Free Survival ◽

Study Groups ◽

Stage Ii ◽

Curative Surgery ◽

D2 Lymph Node Dissection ◽

Gastric Cancer Patients

Purpose: Various adjuvant chemotherapies have been introduced for gastric cancer patients after gastrectomy with D2 lymph node dissection. Although the mainstream regimen of adjuvant chemotherapy in Korea includes S-1 monotherapy (TS-1) and capecitabine with oxaliplatin (XELOX), few studies have compared the long-term efficacies of these 2 regimens. Methods: Between January 2010 and June 2017, 2021 patients were diagnosed with gastric cancer and underwent curative resection with adjuvant chemotherapy at our institution. Of 1461 patients with stage IB-III gastric cancer, 825 received TS-1 and 636 received XELOX as adjuvant chemotherapy. We retrospectively reviewed their medical records and analyzed the postoperative 5-year overall survival (OS) and disease-free survival (DFS) of these 2 groups. Results: The patients in the XELOX group had more advanced stage of cancer than the TS-1 group (stages III and II: 56.6% and 43.1%, respectively, in XELOX and 35.3% and 57.0% in TS-1; P < .001). The DFS did not differ significantly between the 2 study groups at any pathologic stage. The OS differed significantly only at pathologic stages IIA ( P = .024) and IIB ( P = .015). In a multivariate analysis of stage II patients, type of regimen was an independent prognostic factor of OS (XELOX vs TS-1; hazard ratio: 0.47, 95% confidence interval: 0.25-0.89, P = .021). Conclusion: There were similar long-term efficacies between these 2 regimens in advanced gastric cancer patients who underwent curative surgery. However, the XELOX regimen might be favorable for OS of stage II patients.

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Appraisal of long-time outcomes after curative surgery in elderly patients with gastric cancer: a propensity score matching analysis

BMC Surgery ◽

10.1186/s12893-021-01046-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tomoyuki Matsunaga ◽

Ryo Ishiguro ◽

Wataru Miyauchi ◽

Yuji Shishido ◽

Kozo Miyatani ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Propensity Score ◽

Elderly Patients ◽

Propensity Score Matching ◽

Cancer Patients ◽

Stage Iii ◽

Disease Specific Survival ◽

Gastric Cancer Patients ◽

Disease Specific

Abstract Background This study was conducted to assess the long-term outcomes of elderly patients among propensity-score-matched gastric cancer patients after curative gastrectomy and to propose the proper management of elderly gastric cancer patients. Methods We enrolled 626 patients with gastric cancer who underwent curative gastrectomy at our institution between January 2004 and December 2015. To minimize selection bias among 2 groups, propensity score matching was performed. Results Patients were divided into an elderly group over 75 years old (EP group; n = 186) and a non-elderly group (NEP group; n = 440). After propensity score matching, patients were divided into EP group (n = 178) and NEP group (n = 175). Five-year overall survival was significantly lower in the EP group than in the NEP group, consistent with a subgroup analysis of each stage. However, the 5-year disease-specific survival among all enrolled patients and those with stage I and II disease did not differ significantly. Moreover, in the subgroup of stage III patients, 5 year disease-specific survival was significantly lower in the EP group (23.0%) than in the NEP group (59.4%; P = 0.004). Because elderly patients with stage III disease had an extremely poor prognosis, we decided to compare the two groups with stage III. The EP group contained significantly fewer patients with D2 lymphadectomy (P = 0.002) and adjuvant chemotherapy (P < 0.001) than the NEP group. C-reactive protein to albumin ratio was significantly higher in patients in the EP group than in the NEP group (P = 0.046), and the prognostic nutritional index was significantly lower in patients in the EP group than in the NEP group (P = 0.045).　Multivariate analysis revealed that the prognostic nutritional index and lymphatic invasion were independent prognostic factors. Conclusions Elderly gastric cancer patients with stage III disease showed poorer disease-specific survival compared with non-elderly patients, which may be due to a poorer nutritional and inflammatory background, fewer D2 lymphadenectomies, and a lack of adjuvant chemotherapy. The safe induction of standard lymphadenectomy and adjuvant chemotherapy with perioperative aggressive nutritional support may improve the prognosis of elderly gastric cancer patients with stage III disease.

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Preoperative skeletal muscle index and visceral-to-subcutaneous fat area ratio are associated with long-term outcomes of elderly gastric cancer patients after gastrectomy

Langenbeck s Archives of Surgery ◽

10.1007/s00423-021-02092-1 ◽

2021 ◽

Author(s):

Yusuke Taki ◽

Shinsuke Sato ◽

Eiji Nakatani ◽

Kazuya Higashizono ◽

Erina Nagai ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Cancer Patients ◽

Subcutaneous Fat ◽

Area Ratio ◽

Long Term Outcomes ◽

Skeletal Muscle Index ◽

Gastric Cancer Patients

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Impact of Combination Epidural and General Anesthesia on the Long-Term Survival of Gastric Cancer Patients: A Retrospective Study

Medical Science Monitor ◽

10.12659/msm.899543 ◽

2016 ◽

Vol 22 ◽

pp. 2379-2385 ◽

Cited By ~ 10

Author(s):

Jiangling Wang ◽

Wenjing Guo ◽

Qicheng Wu ◽

Runze Zhang ◽

Jun Fang

Keyword(s):

Gastric Cancer ◽

Retrospective Study ◽

General Anesthesia ◽

Cancer Patients ◽

Term Survival ◽

Long Term Survival ◽

Gastric Cancer Patients

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Does high body mass index negatively affect the surgical outcome and long-term survival of gastric cancer patients who underwent gastrectomy: A systematic review and meta-analysis

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2018.09.007 ◽

2018 ◽

Vol 44 (12) ◽

pp. 1971-1981 ◽

Cited By ~ 7

Author(s):

Bochao Zhao ◽

Jingting Zhang ◽

Di Mei ◽

Rui Luo ◽

Huiwen Lu ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Body Mass Index ◽

Cancer Patients ◽

Surgical Outcome ◽

Meta Analysis ◽

High Body Mass Index ◽

Term Survival ◽

Gastric Cancer Patients

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Clinical and Oncological Value of Preoperative BMI in Gastric Cancer Patients: A Single Center Experience

Gastroenterology Research and Practice ◽

10.1155/2015/810134 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Costantino Voglino ◽

Giulio Di Mare ◽

Francesco Ferrara ◽

Lorenzo De Franco ◽

Franco Roviello ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Blood Proteins ◽

Term Survival ◽

Long Term Survival ◽

Single Center Experience ◽

Group B ◽

Gastric Cancer Patients ◽

The Impact

Introduction. The impact of preoperative BMI on surgical outcomes and long-term survival of gastric cancer patients was investigated in various reports with contrasting results.Materials & Methods. A total of 378 patients who underwent a surgical resection for primary gastric cancer between 1994 and 2011 were retrospectively studied. Patients were stratified according to BMI into a normal group (<25, group A), an overweight group (25–30, group B), and an obesity group (≥30, group C). These 3 groups were compared according to clinical-pathological characteristics, surgical treatment, and long-term survival.Results. No significant correlations between BMI and TNM (2010), UICC stage (2010), Lauren’s histological type, surgical results, lymph node dissection, and postoperative morbidity and mortality were observed. Factors related to higher BMI were male genderP<0.05, diabetesP<0.001, and serum blood proteinsP<0.01. A trend to fewer lymph nodes retrieved during gastrectomy with lymphadenectomy in overweight patients (B and C groups) was observed, although not statistically significant. There was no difference in overall survival or disease-specific survival between the three groups.Conclusion. According to our data, BMI should not be considered a significant predictor of postoperative complications or long-term result in gastric cancer patients.

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Prognostic Indicators in Stage IV Surgically Treated Gastric Cancer Patients: A Retrospective Multi-Institutional Study

Digestive Surgery ◽

10.1159/000488775 ◽

2018 ◽

Vol 36 (4) ◽

pp. 331-339

Author(s):

Alberto Biondi ◽

Domenico D’Ugo ◽

Ferdinando Cananzi ◽

Stefano Rausei ◽

Federico Sicoli ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Residual Disease ◽

Stage Iv ◽

Long Term Results ◽

Stage Iv Gastric Cancer ◽

Short And Long Term ◽

Gastric Cancer Patients

Introduction: The role of gastric resection in treating metastatic gastric adenocarcinoma is controversial. In the present study, we reviewed the short- and long-term outcomes of stage IV patients undergoing surgery. Methods: A retrospective review was conducted that assessed patients undergoing elective surgery for incurable gastric carcinoma. Short- and long-term results were evaluated. Results: A total of 122 stage IV gastric cancer patients were assessed. Postoperative mortality was 5.7%, and the overall rate of complications was 35.2%. The overall survival rate at 1 and 3 years was 58 and 19% respectively; the median survival was 14 months. Improved survival was observed for the factors age less than 60 years (p = 0.015), site of metastases (p = 0.022), extended lymph node dissection (p = 0.044), absence of residual disease after surgery (p = 0.001), and administration of adjuvant chemotherapy (p = 0.016). Multivariate analysis showed that residual disease and adjuvant chemotherapy were independent prognostic factors. Conclusions: The results of this study suggest that surgery combined with systemic chemotherapy in selected patients with stage IV gastric cancer can improve survival.

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