Clinicopathological Analysis for Recurrence of Early Gastric Cancer

Lee, Hyuk‐Joon; Kim, Yoon Ho; Kim, Woo Ho; Lee, Kuhn Uk; Choe, Kuk Jin; Kim, Jin Pok; Yang, Han‐Kwang

doi:10.1093/jjco/hyg042

Cited by 85 publications

(70 citation statements)

References 11 publications

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“…Although the overall stage is determined by a combination of T and N stage, our findings may suggest that the overall stage may independently affect the prognosis beyond each of T stage and N stage. Of the six independent variables we observed, one or more were repeatedly observed as risk factors for recurrence in each of the previous studies with a smaller patient population with early-stage GC [12,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. In general, metastasis to lymph nodes has been reported to be one of the most significant risk factors for recurrence of early-stage GC [17,29].…”

Section: Discussionmentioning

confidence: 74%

“…Although the prognosis of stage I GC is known to be excellent in general after curative surgery and we also observed an RFS rate of approximately 90 % at 5 years in our series, postoperative recurrences and/or deaths still occur in a certain percentage of patients with various relapse rates [15,[17][18][19]. With more detection of stage I GC in Korea and Japan, the absolute number of patients with stage I GC who experience recurrence is also increasing, which may result in a large health problem in those countries.…”

Section: Discussionmentioning

confidence: 99%

“…In general, metastasis to lymph nodes has been reported to be one of the most significant risk factors for recurrence of early-stage GC [17,29]. The depth of invasion is generally related to metastasis to lymph nodes [18,29]; lymphatic or vascular invasion, submucosal invasion, and old age are other risk factors for metastasis to lymph nodes. In a few studies including only stage IB GC, undifferentiated adenocarcinoma, tumor size greater than 3 cm, and the presence of perineural invasion were also observed as poor prognostic factors [26,28].…”

Section: Discussionmentioning

confidence: 99%

“…However, there is recurrence in a small but definite number of patients even with stage I GC after curative resection. The recurrence rates for stage I GC after gastrectomy have been reported to range from 1.4 to 13.8 % [15,[17][18][19]. Although several previous studies attempted to evaluate the risk factors for recurrence of or death from early-stage GC, there has been no common prognostic model established based on significant factors for stage I GC because of its relatively low incidence of recurrence or death.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for selection of patients at high risk of recurrence or death after complete surgical resection in stage I gastric cancer

et al. 2015

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Background The therapeutic benefit of adjuvant chemotherapy has not been proven in stage I gastric cancer (GC). The aim of this study was to identify stage I GC patients at high risk of recurrence or death. Results With a median follow-up of 54 months (range 0-60 months), 212 patients (7.6 %) experienced recurrence or death, and the 5 -year recurrence-free survival (RFS) rate and overall survival rate were 89.9 and 93.4 %, respectively. With a multivariate analysis, six factors (age over 65 years, male gender, stage IB GC, lymphovascular invasion, perineural invasion, and elevated level of carcinoembryonic antigen) were independent poor prognostic factors for RFS (p \ 0.05). Patients with more than two of six poor risk factors had a 5-year RFS rate of 79 %, whereas patients with fewer risk factors had a 5-year RFS rate of 97 % (p \0.001). Conclusions In this study cohort, we identified six independent risk factors for RFS. The patients with more than two risk factors are expected to have significant risk of recurrence or death after curative resection and should be considered as candidates for adjuvant treatment.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for selection of patients at high risk of recurrence or death after complete surgical resection in stage I gastric cancer

et al. 2015

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“…Even in patients with early GC, blood-born metastasis occurs. 2,5,6 Recent attempts to improve staging include sensitive detection of disseminated tumor cells in the blood or lymph nodes by molecular approaches. Evidence increasingly clarifies that primary cancers begin shedding neoplastic cells into the circulation at an early stage.…”

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confidence: 99%

Development of a high‐throughput membrane‐array method for molecular diagnosis of circulating tumor cells in patients with gastric cancers

Lin

et al. 2006

Intl Journal of Cancer

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Recently several noninvasive methods have been employed to detect circulating tumor cells (CTCs) in cancer patients. In this study, we have developed a highly sensitive, high-throughput colorimetric membrane-array method that was designed to detect a panel of mRNA markers including human telomerase reverse transcriptase (hTERT), , carcinoembryonic antigen (CEA) and mucin 1 (MUC1) mRNA for the presence of CTCs in the peripheral blood of patients with gastric cancer (GC). Digoxigenin-labeled cDNA targets synthesized following total RNA isolation from peripheral blood samples of 64 GC patients and 80 healthy individuals were subjected to membrane-array hybridization. The results showed that membrane array could positively detect 5 cancer cells/ml of peripheral blood in GC cell-dilution experiments. The sensitivity, specificity and diagnostic accuracy for hTERT, CK-19, CEA and MUC1 mRNA ranged from 78.1% to 82.8%, 76.3% to 85% and 81.3% to 83.3%, respectively. Both CEA and MUC1 mRNA expression was correlated significantly with all malignant biological properties of GC, such as macroscopic type, depth of tumor invasion, lymph-node metastasis, TNM stage and coexisting distant metastasis (all p < 0.05). Using these 4 markers in combination, the sensitivity, specificity and diagnostic accuracy of membrane array were raised to 89.1%, 91.3% and 90.3%, respectively. The expression of all 4 mRNA markers was an independent predictor for postoperative recurrence/metastasis. GC patients with the expression of all the 4 mRNA markers showed a poorer survival rate than those without the expression of any 1 mRNA marker (p 5 0.0223). These findings demonstrated that our membrane-array method could detect CTCs in the circulation of GC patients with considerably high sensitivity and specificity. The identification of CTCs in the peripheral blood may be useful in the auxiliary cancer diagnostics or postoperative surveillance of GC patients for recurrence/metastasis. ' 2006 Wiley-Liss, Inc.Key words: circulating tumor cell; membrane array; gastric cancer; molecular diagnosisThe degrees of tumor penetration in the stomach wall and lymph node metastasis have been used for many decades as the 2 major prognostic determinants for gastric cancer (GC) patients. Unfortunately, despite informative staging of patients with GC, some patients with apparently localized disease at diagnosis will subsequently develop recurrent or metastatic diseases. 1-4 One of the major causes is attributed to the presence of disseminated tumor cells shed from the primary carcinoma into circulation, prior to or during surgery. Even in patients with early GC, blood-born metastasis occurs. 2,5,6 Recent attempts to improve staging include sensitive detection of disseminated tumor cells in the blood or lymph nodes by molecular approaches. Evidence increasingly clarifies that primary cancers begin shedding neoplastic cells into the circulation at an early stage. [7][8][9] It is the dissemination of cancer cells into circulation that is widely accepted as the main cause l...

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Actual 3-Year Survival After Laparoscopy-Assisted Gastrectomy for Gastric Cancer

Hwang

Park²,

Jee³

et al. 2009

Arch Surg

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Clinicopathological Analysis for Recurrence of Early Gastric Cancer

Cited by 85 publications

References 11 publications

Risk factors for selection of patients at high risk of recurrence or death after complete surgical resection in stage I gastric cancer

Risk factors for selection of patients at high risk of recurrence or death after complete surgical resection in stage I gastric cancer

Development of a high‐throughput membrane‐array method for molecular diagnosis of circulating tumor cells in patients with gastric cancers

Actual 3-Year Survival After Laparoscopy-Assisted Gastrectomy for Gastric Cancer

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