scholarly journals Lauren Histology and Lymphatic Permeation are Critical Prognostic Factors in Borrmann Type I Gastric Cancer

2019 ◽  
Vol 103 (1-2) ◽  
pp. 95-104 ◽  
Author(s):  
Keishi Yamashita ◽  
Natsuya Katada ◽  
Kei Hosoda ◽  
Hiroaki Mieno ◽  
Hiromitsu Moriya ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Lymphatic Invasion ◽  
Stage Ii ◽  
Type I ◽  
Diffuse Type ◽  
Borrmann Type ◽  
Gastric Cancer Patients ◽  
Lymphatic Permeation

Macroscopic Borrmann type I is relatively rare in advanced gastric cancer, and its detailed prognostic traits are unknown. Among 5172 gastric cancer patients between 1971 and 2013, 114 cases with macroscopic Borrmann type I were identified (2.2%), among which 112 displayed clinicopathologic factors. Univariate prognostic factors with statistical significance were initially selected, which were further applied to the multivariate proportional hazards model. Recently, postoperative adjuvant chemotherapy was recommended for stage II/III gastric cancer patients. Results were as follows: (1) Five-year overall survival (OS) was 66% in Borrmann type I gastric cancer. Five-year relapse-free survival (RFS) was 100%, 87.1%, and 65.5% in stage IA, stage IB, and stage II/III, respectively. (2) Multivariate proportional hazard model for OS identified lymphatic permeation [hazard ratio (HR) = 4.8–7.5, P = 0.0021] and age (HR = 2.4, P = 0.026), while the multivariate analysis for RFS identified histology (HR = 3.5, P = 0.018) and lymphatic permeation (HR = 3.5–4.7, P = 0.049) as independent prognostic factors. (3) Recurrence was recognized more in liver of the intestinal type histology. Diffuse type histology with robust lymphatic invasion was all attributed to stage II/III, which occurred largely within 1 year and exhibited 49% RFS. Recurrence pattern of Borrmann Type I gastric cancer with intestinal type histology is unique, and patients with high risk for recurrences were enriched in diffuse type histology with robust lymphatic invasion.

scholarly journals Survival analysis of stage II gastric cancer patients after D2 gastrectomy: a Chinese people-based research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zi-Jian Deng ◽  
Run-Cong Nie ◽  
Jun Lu ◽  
Xi-Jie Chen ◽  
Jun Xiang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Univariate Analysis ◽  
Linitis Plastica ◽  
Stage Ii ◽  
Gastric Cancer Patients

Abstract Objective The benefit of adjuvant chemotherapy is still controversial for stage II gastric cancer patients. This study aims to identify prognostic factors to guide individualized treatment for stage II gastric cancer patients. Methods We retrospectively reviewed 1121 stage II gastric cancer patients who underwent D2 radical gastrectomy from 2007 to 2017 in the Sixth Affiliated Hospital of Sun Yat-sen University, FuJian Medical School Affiliated Union Hospital and Sun Yat-sen University Cancer Center. Propensity score matching was used to ensure that the baseline data were balanced between the adjuvant chemotherapy group and surgery-only group. Kaplan–Meier survival and multivariate Cox regression analyses were carried out to identify independent prognostic factors. Results In univariate analysis, after propensity score matching, age, tumor location, tumor size, CEA, T stage and N stage were associated with overall survival (OS). Multivariate analysis illustrated that age ≥ 60 years old, linitis plastica and T4 were independent risk factors for OS, but lower location and adjuvant chemotherapy were protective factors. Conclusion Stage II gastric cancer patients with adverse prognostic factors (age ≥ 60, linitis plastica and T4) have poor prognosis. Adjuvant chemotherapy may be more beneficial for these patients.

scholarly journals Survival Analysis of Stage II Gastric Cancer Patients after D2 Gastrectomy: A Chinese People-based Research Running Head: Survival of Stage II Gastric Cancer

2021 ◽  
Author(s):  
Zi-Jian Deng ◽  
Run-Cong Nie ◽  
Jun Lu ◽  
Xi-Jie Chen ◽  
Jun Xiang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Univariate Analysis ◽  
Individual Therapy ◽  
Stage Ii ◽  
Gastric Cancer Patients

Abstract Objective: The benefit of adjuvant chemotherapy is still controversial for stage II gastric cancer patients. This study aims to identify prognostic factors to guide individualized treatment for stage II gastric cancer patients.Methods: We retrospectively reviewed 1121 stage II gastric cancer patients who underwent D2 radical gastrectomy from 2007-2017 in the Sixth Affiliated Hospital of Sun Yat-sen University, FuJian Medical School Affiliated Union Hospital and Sun Yat-sen University Cancer Center. Propensity score matching (PSM) was used to ensure that the baseline data were balanced between the adjuvant chemotherapy (AC) group and surgery-only group. Kaplan-Meier survival and multivariate Cox regression analyses were carried out to identify independent prognostic factors. Results: In univariate analysis, after propensity score matching, age, tumor location, tumor size, CEA, T stage and N stage were associated with overall survival (OS). Multivariate analysis illustrated that age ≥60 years old, linitis plastica and T4 were independent risk factors for OS, but lower location and adjuvant chemotherapy were protective factors. Conclusion: Adjuvant chemotherapy is helpful for stage II gastric cancer patients. These prognostic factors can help guide individual therapy.

PO-1223 Prognostic factors affecting survival in gastric cancer patients in Albania: A retrospective study

2021 ◽  
Vol 161 ◽  
pp. S1011-S1012
Author(s):  
F. Kraja ◽  
J. Dervishi ◽  
A. Hoti ◽  
E. Karaulli ◽  
I. Akshija ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Retrospective Study ◽  
Cancer Patients ◽  
Factors Affecting ◽  
Gastric Cancer Patients

scholarly journals ELISA study of matrix metalloproteinases 2, 7, 9 and their type 2 tissue inhibitor in the tumors of gastric cancer patients: clinical and pathologic correlations

2018 ◽  
Vol 46 (4) ◽  
pp. 323-329
Author(s):  
E. S. Gershtein ◽  
A. A. Ivannikov ◽  
V. L. Chang ◽  
N. A. Ognerubov ◽  
М. M. Davydov ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Matrix Metalloproteinases ◽  
Tumor Progression ◽  
Cancer Patients ◽  
Univariate Analysis ◽  
Gastric Cancer Tissue ◽  
Cancer Tissue ◽  
Gastric Cancer Patients

Background: Over the last 10 years the incidence of gastric cancer has declined significantly. Nevertheless, it remains one of the most prevalent malignancies both in Russia and worldwide. Therefore, the problems of early diagnostics, prognosis and individualized treatment choice are still on the agenda. Much attention is paid to the evaluation of molecular biological characteristics of the tumor, as well as to the development of multiparametric prognostic systems for gastric cancer based on its identified characteristics. An important place among potential tumor biological markers belongs to matrix metalloproteinases (MMPs) involved into all the stages of tumor progression, first of all, into the regulation of invasion and metastasizing.Aim: Comparative quantitative evaluation of some MMP family members (MMP-2, 7, and 9) and one of the tissue MMP inhibitors (TIMP-2) levels in the tumors and adjacent histologically unchanged mucosa in gastric cancer patients, the analysis of their associations with the main clinical and pathological features of the disease and its prognosis.Materials and methods: Sixty six (66) primary gastric cancer patients (32 male and 34 female) aged 24 to 82 years (median, 61 year) were recruited into the study. Twenty two (22) patients were with stage I of the disease, 11 with stage II, 28 with stage III, and 5 with stage IV. The concentrations of the proteins studied were measured in the tumor and unchanged mucosa extracts by standard direct ELISA kits (Quantikine®, R&D Systems, USA).Results: Tumor MMP-2, 7 and 9 levels were significantly increased, compared to those in the adjacent histologically unchanged mucosa, in 80, 70 and 72% of gastric cancer patients, respectively, while the increase of TIMP-2 level found in 61% of the tumors was not statistically significant. Tumor MMP-2 and TIMP-2 content was increasing significantly with higher T index – size and advancement of the primary tumor (p < 0.01 and p < 0.05 respectively). Tumor MMP-2 level was also increasing in parallel with the N index (regional lymph node involvement; p < 0.01); it was significantly higher in the patients with distant metastases than in those without them (p < 0.05). Tumor MMP-9 and MMP-7 concentrations were not significantly associated with the indices of the tumor progression. The patients were followed up for 1 to 85 months (median, 18.3 months). According to the univariate analysis, high (> 32.6 ng/mg protein) MMP-2 and low MMP-7 (< 1.1 ng/mg protein) levels in the gastric cancer tissue represent statistically significant unfavorable prognostic factors for overall survival. Increased TIMP-2 level is associated with a non-significant decrease in the overall survival (p > 0.05), whereas the MMP-9 level was unrelated to the gastric cancer prognosis. Only T index (p = 0.0034) and tumor MMP-7 content (p = 0.026) remained independent prognostic factors in the multivariate regression analysis.Conclusion: The majority of gastric cancer patients demonstrate a significant increase in the expression of three MMP family members, i.e. gelatinases (MMP-2 and 9), and matrilysin (MMP-7), in the tumors, as compared to adjacent histologically unchanged mucosa. Only MMP-2 levels were associated with the disease progression, increasing with higher TNM system indices. High MMP-2 and low MMP-7 content in the gastric cancer tissue are significant unfavorable prognostic factors for the overall survival in the univariate analysis, but only MMP-7 has retained its independent prognostic value in the multivariate assessment.

scholarly journals Prognostic Significance of Serum Uric Acid and Gamma-Glutamyltransferase in Patients with Advanced Gastric Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Shanshan Yang ◽  
Xinjia He ◽  
Ying Liu ◽  
Xiao Ding ◽  
Haiping Jiang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Uric Acid ◽  
Prognostic Factors ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Serum Uric Acid ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Gamma Glutamyltransferase ◽  
Gastric Cancer Patients

Purpose. In this study, we aim to evaluate the prognostic role of serum uric acid and gamma-glutamyltransferase in advanced gastric cancer patients. Methods. A total of 180 patients pathologically diagnosed with advanced gastric cancer were included in this retrospective study. We used time-dependent receiver operating characteristic (ROC) curves to identify the optimal cut-off value of serum uric acid (UA) and gamma-glutamyltransferase (GGT). Survival analysis was performed using the Kaplan–Meier method and log-rank test, and multivariate Cox regression analyses were applied. A nomogram was formulated, and the calibration and discrimination of the nomogram were determined by calibration curve and concordance index (C-index). We validated the results using bootstrap resampling and a separate study on 60 patients collected from 2015 to 2017 using the same criteria in other medical center. Results. Both higher serum uric acid (>228 μmol/L) and higher gamma-glutamyltransferase (>14 U/L) had worse OS and PFS. Univariate analysis indicated that serum uric acid (UA) (p<0.001 and p<0.001) and gamma-glutamyltransferase (GGT) (p<0.001 and p=0.044) were significantly related to overall survival (OS) and progression-free survival (PFS), respectively. Multivariate analysis revealed serum uric acid (UA) and gamma-glutamyltransferase (GGT) were independent prognostic factors for OS (p=0.012, p=0.001). The optimal agreement between actual observation and nomogram prediction was shown by calibration curves. The C-indexes of the nomogram for predicting OS and PFS were 0.748 (95% CI: 0.70-0.79) and 0.728 (95% CI: 0.6741-0.7819), respectively. The results were confirmed in the validation cohort. Conclusion. We observed that both serum UA and GGT were poor prognostic factors in patients with advanced gastric cancer. And we also formulated and validated a nomogram which can predict individual survival for advanced gastric cancer patients.

scholarly journals Application value of nomogram and prognostic factors of gastric cancer patients who underwent D2 radical lymphadenectomy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guang-Chuan Mu ◽  
Yuan Huang ◽  
Zhi-Ming Liu ◽  
Xiang-Hua Wu ◽  
Xin-Gan Qin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Cox Regression ◽  
Term Survival ◽  
Long Term Survival ◽  
Cox Regression Analysis ◽  
Gastric Cancer Patients

Abstract Background The aim of this study was to explore the prognostic factors and establish a nomogram to predict the long-term survival of gastric cancer patients. Methods The clinicopathological data of 421 gastric cancer patients, who were treated with radical D2 lymphadenectomy by the same surgical team between January 2009 and March 2017, were collected. The analysis of long-term survival was performed using Cox regression analysis. Based on the multivariate analysis results, a prognostic nomogram was formulated to predict the 5-year survival rate probability. Results In the present study, the total overall 3-year and 5-year survival rates were 58.7 and 45.8%, respectively. The results of the univariate Cox regression analysis revealed that tumor staging, tumor location, Borrmann type, the number of lymph nodes dissected, the number of lymph node metastases, positive lymph nodes ratio, lymphocyte count, serum albumin, CEA, CA153, CA199, BMI, tumor size, nerve invasion, and vascular invasion were prognostic factors for gastric cancer (all, P < 0.05). However, merely tumor staging, tumor location, positive lymph node ratio, CA199, BMI, tumor size, nerve invasion, and vascular invasion were independent risk factors, based on the results of the multivariate Cox regression analysis (all, P < 0.05). The nomogram based on eight independent prognostic factors revealed a well-degree of differentiation with a concordance index of 0.76 (95% CI: 0.72–0.79, P < 0.001), which was better than the AJCC-7 staging system (concordance index = 0.68). Conclusion The present study established a nomogram based on eight independent prognostic factors to predict long-term survival in gastric cancer patients. The nomogram would be beneficial for more accurately predicting the prognosis of gastric cancer, and provide important basis for making individualized treatment plans following surgery.

The relationship between HER-2 and TOPO-2A gene expression and clinicopathologic results in gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14670-e14670
Author(s):  
Metin Ozkan ◽  
Esra Ermis Turak ◽  
Halit Karaca ◽  
Mevlude Inanc ◽  
Veli Berk ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Median Overall Survival ◽  
Intestinal Type ◽  
Negative Group ◽  
Diffuse Type ◽  
Her 2 ◽  
Gastric Cancer Patients

e14670 Background: HER-2 and Topo-2A genes are settled on a chromosome 17 and their co-amplification rates are high. In this study, early gastric cancer patients who received adjuvant chemo-radiotherapy and chemotherapy were evaluated with HER-2 and Topo-2A expression in association with clinical and histopathologic findings. Methods: A total of 103 gastric cancer patients were included the study. The HER-2 and Topo-2A levels were measured by immunohistochemistry in postoperative tumor materials. A standard evaluation method was admitted for HER-2 positivity, while Topo-2A nuclear staining 3+ and 4+ were considered as overexpression. Those with level 2+ or 3+ of HER-2, the FISH test were attempted. Results: The median follow-up was 19 months (ranges 2–70 months). Forty-six patients (44%) relapsed during follow-up whereas 60 patients (58%) had died. The median overall survival (mOS) was 23 months. Histopathologies of HER-2 positive patients were intestinal type in 7 (87.5%) and diffuse type in one (12.5%) patient. In the follow-up period 4 patients (50%) were died (mOS was 17 months in this group). Median overall survival was 23 months in HER-2 negative group (p=0.6). Histopathologies of Topo-2A positive patients were intestinal type in 9 (64.2%) and diffuse type in 5 (35.8%) patient. In the follow-up period 8 patients (57%) were died (mOS was 22 months in this group). Median overall survival was 23 months in Topo-2A negative group (p=0.8). Three patients (37.5%) who had HER-2 positive histopathologies also had Topo-2A positivity. Conclusions: Overexpression rates of HER-2 in gastric cancer were reported 6.8-34%. Racial differences and different scoring techniques thought to be impact the results. Co-amplification rate of HER-2 and Topo-2A was reported 34% in gastric cancer. In our study HER-2 and Topo-2A overexpression rates were 7.7% and 13.6% respectively and co-amplification of HER-2 with Topo-2A rate was 37.5% is also similar to the other studies. Stages of patients with HER-2 and Topo-2A overexpression were similar to the distribution of the overall patients. While intestinal subtypes showed a higher rate of HER-2 overexpression, the median survival times tend to be shorter in HER-2 positive patients.

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