Peri-operative Inflammatory Marker as a Predictive Factor for Prolonged Post-operative Ileus After Gastrectomy for Gastric Cancer

BACKGROUND: Early gastric cancer (EGC) is defined as adenocarcinoma limited to the mucosa or submucosa regardless of lymph node involvement. Local EGC recurrence rates have been described in up to 6% of cases.OBJECTIVES: To evaluate predictive factors for incomplete resection and local recurrence of EGC treated by endoscopic mucosal resection (EMR) that was followed up for at least one year.METHODS: From June 1994 to December 2005, 46 patients with EGC underwent EMR. Possible predictive factors for incomplete endoscopic resection and local recurrence were identified by medical chart analysis. Demographic, endoscopic and histopathological data were retrospectively evaluated. EMR was considered complete or incomplete. Patients from the complete resection group were divided into subgroups (with and without local EGC recurrence).RESULTS: Complete resection was possible in 36 cases (76.6%). Predictive factors for incomplete resection were tumour location (P=0.035), histological type (P=0.021), lesion size (P=0.022) and number of resected fragments (P=0.013). On multivariate analysis, undifferentiated histological type (OR 0.8; 95% CI 0.036 to 0.897) and number of resected fragments (OR 7.34; 95% CI 1.266 to 42.629) were independent predictive factors for incomplete resection. In the complete resection group, a larger lesion size was associated with a higher the number of resected fragments (P=0.018). Local recurrence occurred in nine cases (25%). Use of the cap technique was the only predictive factor for local recurrence in five of seven cases (71.4%) (P=0.006).CONCLUSIONS: A larger lesion size was associated with a higher number of resected fragments. Undifferentiated adenocarcinoma and piecemeal resection were predictive factors for incomplete resection. Technique type was a predictive factor for local EGC recurrence.

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Perioperative inflammatory marker as a predictive factor for prolonged postoperative ileus after gastrectomy for gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.31 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 31-31

Author(s):

Hyojin Park ◽

Yoon Su Kim

Keyword(s):

Gastric Cancer ◽

Hospital Stay ◽

Operative Technique ◽

Inflammatory Markers ◽

Postoperative Ileus ◽

Inflammatory Marker ◽

Cancer Surgery ◽

Gastric Cancer Surgery ◽

Lymphocyte Ratio ◽

Prolonged Postoperative Ileus

31 Background: Inflammatory markers such as the C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently been proposed as prognostic markers for post-operative complications and poor prognosis in solid tumors especially in colon cancer. However, there are few related reports in gastric cancer patients. Therefore, the aim of this study is to assess how perioperative inflammatory markers influence the prolonged postoperative ileus (PPOI) following gastric cancer surgery. Methods: Between 2013 and 2016, 435 patients were diagnosed with gastric cancer and underwent surgery in Gangnam Severance hospital. Patients were divided into prolonged postoperative ileus (PPOI) and control groups. Uncomplicated postoperative ileus (POI) is generally identified as an inevitable process after surgery, which typically resolves within 3 days. Ileus that persists for more than 3 days following surgery is termed PPOI. Results: The total PPOI rate was 33.8%. In univariate analysis, PPOI group was significantly associated with male sex, old age, open operative technique, preoperative gastric outlet obstruction and combined colon resection. PPOI group also was significantly associated with elevated perioperative inflammatory marker (pre- and post-operative CRP, NLR, and PLR). In multivariate analysis, open operative technique and elevated perioperative inflammatory markers (CRP, NLR and PLR) were identified as significant predictors of PPOI. In addition, postoperative length of hospital stay delayed in PPOI group compared with the control group (11.58 ± 9.48 vs.7.98 ± 5.44, respectively; P < 0.001). Conclusions: In this study, PPOI group was significantly associated with elevated perioperative inflammatory marker. Patients with PPOI also are more likely to have an increased postoperative hospital stay. Therefore, the perioperative inflammatory markers may be used as clinically relevant predictive markers for PPOI following gastric cancer surgery

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Dynamin 3 Gene as a Tumor Suppressor and an Independent Predictive Factor of Poor Prognosis in Patients with Gastric Cancer

10.21203/rs.3.rs-1072813/v1 ◽

2021 ◽

Author(s):

Ru-Hong Tu ◽

Jian-Xian Lin ◽

Jian-Wei Xie ◽

Jia-Bin Wang ◽

Jun Lu ◽

...

Keyword(s):

Gastric Cancer ◽

Cell Cycle ◽

Tumor Suppressor ◽

Predictive Factor ◽

Poor Prognosis ◽

Immune Cell ◽

The Cancer Genome Atlas ◽

Independent Predictive Factor ◽

Stomach Adenocarcinoma ◽

Low Expression

Abstract Gastric cancer is a leading cause of death from malignant tumors worldwide. With the development of genome sequencing technology, an increasing number of key driver genes and tumor suppressors have been discovered. Some studies have suggested that Dynamin 3 (DNM3) is a novel tumor suppressor; however, the role of DNM3 in malignancy remains unclear. We performed a systematic analysis using The Cancer Genome Atlas Stomach Adenocarcinoma (TCGA-STAD) cohorts, and 160 patients with stomach adenocarcinoma at Fujian Medical University Union Hospital (FJMUUH) (48 quantitative PCR [qPCR] and 112 immunohistochemistry). DNM3 expression was found to be downregulated in gastric cancer compared to that in paraneoplastic tissue. Low expression of DNM3 was mainly associated with DNM3 promoter hypermethylation status. Low expression of DNM3 can upregulate the tumor cell cycle and oxidative phosphorylation process and downregulate immune regulation, and Th17 and Th2 immune cell infiltration was increased in patients with lower expression of DNM3. Patients with a lower DNM3 expression had a higher rate of lymph node metastasis and poor prognosis. In summary, DNM3 is a tumor suppressor and an independent predictive factor of poor prognosis that regulates the cell cycle and immunosuppression in the tumor microenvironment in gastric cancer via methylation.

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Xeroderma pigmentosum group D 751 polymorphism as a predictive factor in resected gastric cancer treated withchemo-radiotherapy

World Journal of Gastroenterology ◽

10.3748/wjg.v12.i37.6032 ◽

2006 ◽

Vol 12 (37) ◽

pp. 6032 ◽

Cited By ~ 17

Author(s):

RN Zárate R

Keyword(s):

Gastric Cancer ◽

Predictive Factor ◽

Xeroderma Pigmentosum ◽

Group D ◽

Xeroderma Pigmentosum Group D ◽

Resected Gastric Cancer

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White globe appearance is an endoscopic predictive factor for synchronous multiple gastric cancer

Annals of Gastroenterology ◽

10.20524/aog.2020.0565 ◽

2020 ◽

Author(s):

Teppei Masunaga

Keyword(s):

Gastric Cancer ◽

Predictive Factor ◽

Multiple Gastric Cancer

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The Glasgow Prognostic Score Before Curative Resection May Predict Postoperative Complications in Patients with Gastric Cancer

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-021-00689-9 ◽

2021 ◽

Author(s):

Yota Shimoda ◽

Hirohito Fujikawa ◽

Keisuke Komori ◽

Hayato Watanabe ◽

Kosuke Takahashi ◽

...

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Predictive Factor ◽

Proportional Hazards Model ◽

Prognostic Score ◽

Surgical Techniques ◽

Glasgow Prognostic Score ◽

Cox Proportional Hazards Model ◽

Stage Ii ◽

Independent Predictive Factor

Abstract Purpose Despite improvements in surgical techniques and devices and perioperative care of gastric cancer (GC), the rate of postoperative complications still has not decreased. If patients at high risk for postoperative complications could be identified early using biomarkers, these complications might be reduced. In this study, we investigated usefulness of the preoperative Glasgow Prognostic Score (GPS) as a predictive factor for complications after surgery in patients with stage II/III GC. Methods This study retrospectively analyzed the outcomes of 424 patients who underwent curative surgery for pathological stage II/III GC from February 2007 to July 2019 at a single center. The GPS was assessed within 4 days before surgery. To identify independent risk factors for postoperative complications, univariate and multivariate analyses were performed using a Cox proportional hazards model. Results The numbers of patients with a GPS of 0, 1, and 2 were 357, 55, and 12, respectively. The rate of complications after surgery was significantly higher among patients with a GPS of 1 or 2 than among patients with a GPS of 0 (p = 0.008). Multivariate analysis identified a GPS of 1 or 2 as an independent predictive factor for postoperative complications (p = 0.037). Conclusion The preoperative GPS may be a useful predictive factor for postoperative complications in patients with stage II/III GC. Being aware of the risk of complications after surgery as indicated by the GPS before surgery may promote safe and minimally invasive surgery that we expect will improve outcomes in patients with a GPS of 1 or 2.

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