Characteristics and Clinical Outcome of Proximal-Third Gastric Cancer

Sakaguchi, Takahiro; Watanabe, Akihiko; Sawada, Hidetomo; Yamada, Yoshiaki; Tatsumi, Mitsutoshi; Fujimoto, Heisuke; Emoto, Koji; Nakano, Hirofumi

doi:10.1016/s1072-7515(98)00191-4

Cited by 58 publications

(52 citation statements)

References 10 publications

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“…In the current study, we observed that carcinomas in the antrum are smaller compared to cardia and fundus/body cases, a finding which is in agreement to previous studies [9, 10]. It is not difficult to envision that carcinomas located in the fundus/body may reach a larger size due to the volumetric redundancy of the stomach middle third.…”

Section: Discussionsupporting

confidence: 93%

“…The controversy regarding the clinic and pathologic characteristics and behavior of gastric carcinomas arising from the different gastric locations is far from clarified. Different survival curves have been reported according to tumor location with most reports agreeing that lower third gastric cancer has a better prognosis worldwide [2, 6, 8, 9, 10]. In contrast, consensus regarding proximal tumors has not been achieved and while most reports indicate that cardia carcinoma is more aggressive [2, 6, 8, 10, 11, 12], other studies claim that once the necessary adjustments in tumor staging are taken into account all gastric carcinomas have a similar prognosis which is stage dependent [13].…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

et al. 2001

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Background/Aims: The putative influence of tumor location on the biologic behavior of gastric carcinomas remains controversial. The aim of this study was to investigate if carcinomas arising in the three types of gastric mucosa (cardia, fundus/body and antrum) have different clinical and pathologic profiles and carry a different prognosis. Methods: Three hundred and two patients with cardia or gastric carcinoma resected between 1984 and 1996 were retrospectively studied. Cases were divided in three groups according to tumor location: cardia (n = 80); fundus/body (n = 60); antrum (n = 162). The three groups were crosstabulated with clinic and pathologic parameters, such as age, sex, macroscopy, histology, desmoplasia, tumor size, depth of tumor wall penetration, nodal status, venous invasion and stage. Survival rates were calculated for the three locations according to the aforementioned parameters. Univariate survival analysis and Cox regression were performed for each location. Results: Cases from the cardia and fundus/body were similar and distinct from antrum cases according to macroscopy, tumor size, depth of wall penetration, venous invasion, nodal status and stage. Cases from fundus/body were similar to antrum cases and distinct from cardia cases according to gender and Laurén’s classification. An overall difference in survival between the three locations was observed (p = 0.006). Cumulative survival was better for patients with carcinomas in the antrum than in the cardia (p = 0.04) and in the fundus/body (p = 0.003); no significant differences were observed in survival between cardia and fundus/body carcinoma cases. Cox regression identified stage and venous invasion as prognostic factors for patients with carcinomas in the three locations. In the group of cardia tumors, older patients had a worse outcome and in the group of fundus/body carcinomas, large tumors were associated with a poorer survival. Conclusions: Our results show that cardia carcinoma and antrum carcinoma are distinct gastric carcinoma entities whereas fundus/body carcinoma shares some characteristics from both entities.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

et al. 2001

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“…Because GC is considered a biologically heterogeneous disease, and genetic backgrounds can differ according to GC subtype [30][31][32][33], a subgroup analysis was conducted. Expression status of DPYSL3 was similar across tumor location (entire, upper third, middle third and lower third).…”

Section: Discussionmentioning

confidence: 99%

Dihydropyrimidinase-like 3 facilitates malignant behavior of gastric cancer

Kanda

Nomoto

Oya

et al. 2014

J Exp Clin Cancer Res

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Background: Gastric cancer (GC) remains to have a poor prognosis via diverse process of cancer progression. Dihydropyrimidinase-like 3 (DPYSL3) is a cell adhesion molecule that has been reported to be involved in the metastatic process of tumor cells. The aim of this study was to identify a novel clinically-relevant biomarker of GC. Methods: Expression analysis of DPYSL3 mRNA and protein levels was conducted using GC cell lines and 238 pairs of surgically resected gastric tissues. Correlations between expression status of DPYSL3 and clinicopathological parameters were investigated. Results: DPYSL3 mRNA expression levels positively correlated with those of potentially interacting genes (VEGF, FAK and EZR) in GC cell lines. GC tissues from tumors with distant metastases (stage IV cancer) showed elevated expression levels of DPYSL3 mRNA. The DPYSL3 staining intensity in immunochemical staining was consistent with the mRNA expression patterns in GC tissues. High DPYSL3 mRNA expression in GCs was significantly associated with more malignant phenotypes and was an independent prognostic factor. Moreover, patients with high DPYSL3 mRNA expression had a significantly shorter recurrence free survival after curative resection. In subgroup analysis based on tumor histology, similar tendency was observed between patients with differentiated and undifferentiated GCs. Conclusions: Expression status of DPYSL3 in GC tissues may represent a promising biomarker for the malignant behavior of GC.

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“…Some authors show that proximal gastric cancer is more frequently associated with advanced stage and poor prognosis than distal gastric cancer [85,86], whereas others show that survival rate after resection is not different between patients with proximal gastric cancer and those with distal gastric cancer [87]. When tumors are compared among the proximal, middle, and distal one-third of the stomach, the 5-year survival rate for proximal tumors is inferior to that for middle or distal tumors, because of esophageal invasion [88]. Siewert et al [89] investigated the surgical results of 1002 patients with adenocarcinoma of the esophagogastric junction, and showed that the 10-year survival rate was lowest in those with subcardial gastric cancer invading the esophagus.…”

Section: Prognostic Factorsmentioning

confidence: 99%

Surgery for gastric cancer: 10-year experience worldwide

2001

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extended lymph node dissection has been traditional in Japan, and critical studies from several Western countries suggest that there are improved surgical results after extended lymph node dissection. Therefore, it is important to evaluate the current information on the clinical and pathological characteristics of, and the surgical results for gastric cancer worldwide.To demonstrate recent experience of gastric cancer surgery throughout the world and to evaluate modern strategies for the treatment of gastric cancer, we investigated the English-language literature of the past 10 years, reviewed more than 100 studies concerning controversial issues in gastric cancer treatment, and assessed the current status of gastric cancer surgery worldwide. This review was generally based on promising papers published in well known medical journals, and focused on the following items: (1) surgical results worldwide, (2) lymph node metastasis, (3) lymph node dissection, (4) splenectomy, (5) prognostic factors, and (6) new therapeutic trends. Surgical results worldwideThe review of English-language publications from 1970 to 1990 showed that the operative mortality rate following surgery for gastric cancer had declined to a mean of 8% and a median of 5% [1]. In the British hospital, operative mortality decreased from 15% to 7%, and the 5-year survival rate increased from 5% to 11% [2]. In another British hospital, the proportion of patients with early gastric cancer rose from 1% to 15%, that of stage I disease rose from 4% to 26%, and that of potentially curative resection rose from 31% to 53% [3]. After curative resection, the 5-year survival rate was 60%, and the operative mortality and morbidity rates were 6% and 17%, respectively.In Sweden, the 5-year surival rate after gastrectomy for cancer increased from 19% to 25%, mainly owing to Abstract To demonstrate recent experience of gastric cancer surgery worldwide and to evaluate modern strategies for the treatment of gastric cancer, we investigated the English-language literature of the past 10 years, based on papers published in well-known medical journals. In many countries, the increased detection of early gastric cancer, advanced operative procedures, and careful postoperative management have improved the surgical results of gastric cancer over the years. Although randomized controlled trials in Europe showed no survival benefit of D2 resection over D1 resection, the results must be interpreted with caution and cannot be extrapolated to Japanese patients, because the morbidity and mortality after D2 gastrectomy in Japan are much less than those after D1 gastrectomy in Europe. Recently, less invasive treatments, including endoscopic mucosal resection and laparoscopic gastrectomy, have become feasible for patients with early gastric cancer, but their risks and benefits compared with traditional gastrectomy are unclear.

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Characteristics and Clinical Outcome of Proximal-Third Gastric Cancer

Cited by 58 publications

References 10 publications

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

Dihydropyrimidinase-like 3 facilitates malignant behavior of gastric cancer

Surgery for gastric cancer: 10-year experience worldwide

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