Clinicopathological Characteristics of Alpha-Fetoprotein-Producing Gastric Cancer

Chun, Huan; Kwon, Sung Joon

doi:10.5230/jgc.2011.11.1.23

Cited by 51 publications

(64 citation statements)

References 20 publications

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“…The prevalence of afpgc is reported to be 0.17%-8.4% in patients with gastric cancer 3,6,[11][12][13][14] . Clinical manifestations in patients with afpgc have rarely been observed because of that small incidence 15 .…”

Section: Discussionmentioning

confidence: 99%

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Clinical Manifestations in Patients with Alpha-Fetoprotein–Producing Gastric Cancer

et al. 2014

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Backgroud: Patients with alpha-fetoprotein (afp)–producing gastric cancer have a high incidence of liver metastasis and poor prognosis. There is some controversy about clinical manifestations in these patients. Methods: Our study enrolled patients who, before surgery, had gastric cancer with serum afp exceeding 20 ng/mL [afp>20 (n = 58)] and with serum afp 20 ng/mL or less [afp≤20 (n = 1236)]. Clinical manifestations were compared between the groups. Results: Early gastric cancer was more frequent (30.1% vs. 4%) and advanced gastric cancer was less frequent (69.9% vs. 96%) in the afp≤20 group than the afp>20 group (p < 0.001). Liver and lymph node metastasis occurred less frequently in the afp≤20 group (4.4% vs. 27.6%, p < 0.001, and 60.7% vs. 91.4%, p < 0.001, respectively). The 1-, 3-, 5-, and 10-year survival rates of afp≤20 patients were 75.2%, 53.4%, 45.8%, and 34.6% respectively. The 1-, 3-, 5-, and 10-year survival rates of patients with afp greater than 20 ng/mL, but 300 ng/mL or less, were 46.7%, 28.9%, 17.8%, and 13.3% respectively. The 1-, 3-, and 5-year survival rates of patients with serum afp greater than 300 ng/mL were 15.4%, 7.7%, and 0% respectively. The independent predictors for survival time were afp concentration, age, peritoneal seeding, liver metastasis, lymph node metastasis, vascular invasion, TNM stage, curative surgery, serosal invasion, and Lauren classification. Conclusions: Patients with high serum afp had a high frequency of liver and lymph node metastasis and very poor prognosis. More aggressive management with multimodal therapy (for example, chemotherapy, radiotherapy) might be needed when treating such patients.

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Section: Discussionmentioning

confidence: 99%

“…Liver metastasis (14.3%-75.6%) is one of the main features of afpgc or hepatoid adenocarcinoma of the stomach (has) [12][13][14]16 . In our series, 16 patients (27.6%) in the afpgc group were found to have liver metastasis during follow-up.…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations in Patients with Alpha-Fetoprotein–Producing Gastric Cancer

et al. 2014

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“…Other useful serum markers for gastric cancer: alphafetoprotein (AFP), CA125, and sialyl Tn antigens (STN) AFP-producing gastric cancers behave aggressively and have a high potential for metastasis to the liver [2,[52][53][54]. There was poorer differentiation, a higher incidence of lymph node metastasis, and more marked lymphatic and vascular invasion in the AFP-positive group than in the AFP-negative group [54].…”

Section: Clinical Significance Of Serum Marker Monitoring During Chemmentioning

confidence: 99%

“…Four discussion points were evaluated for CEA, CA19-9, and CA72-4 from selected articles as follows: (1) positive rates, (2) clinicopathological significance, (3) prognostic impact, and (4) clinical impact during follow-up after surgery and/or during chemotherapy. Finally, we selected 10 other publications that focused only on AFP [51][52][53][54], CA125 [3,[55][56][57], and STN [58,59] (Fig. 1).…”

Section: Manuscript Selectionmentioning

confidence: 99%

Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association

et al. 2013

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The aim of this review was to evaluate the clinical significance of serum tumor markers, particularly CEA, CA19-9, and CA72-4, in patients with gastric cancer. A systematic literature search was performed using PubMed/MEDLINE with the keywords ''gastric cancer'' and ''tumor marker,'' to select 4,925 relevant reports published before the end of November 2012. A total of 187 publications contained data for CEA and CA19-9, and 19 publications contained data related to all three tumor markers. The positive rates were 21.1 % for CEA, 27.8 % for CA19-9, and 30.0 % for CA72-4. These three markers were significantly associated with tumor stage and patient survival. Serum markers are not useful for early cancer, but they are useful for detecting recurrence and distant metastasis, predicting patient survival, and monitoring after surgery.

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“…We hypothesize that histopathological examination is important for the diagnosis of AFPGC, as other malignancies, such as hepatitis, cirrhosis, hepatocellular carcinoma and germ cell malignancies, also produce AFP and thus, must be excluded. According to the English-language literature, AFPGC accounts for 1.3-15% of GC cases worldwide (3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Successful multimodal therapy for an α-fetoprotein-producing gastric cancer patient with simultaneous liver metastases

Fang¹,

Wang²,

Yang³

et al. 2015

Oncology Letters

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Abstract. α-fetoprotein-producing gastric cancer (AFPGC) is considered to be a special type of stomach cancer, due its features of high malignancy, fast progression, easy transferral and a poor prognosis. No standard therapy is currently available for patients with AFPGC. In the present study, the case of a 59-year-old male diagnosed with AFPGC and simultaneous liver metastases is presented. The patient presented with abdominal bloating and multiple liver lesions were revealed upon imaging. During the course of treatment, the patient's serum AFP level increased to a maximum of 20,624.6 µg/l. The patient survived for 30 months and was ultimately treated with multimodal therapy, including surgery, chemotherapy, interventional therapy and molecular targeted therapy. Treatment with paclitaxel, irinotecan and TS-1, particularly sorafenib as a molecular targeted drug, are effective for such patients. The choice of chemotherapy regimen according to the Lauren classification and the use of oral sorafenib are likely to be novel and effective treatments for this type of stomach cancer. However, investigations should be performed to identify the gastric cancer patient population most receptive to sorafenib treatment. In addition, combined chemotherapy and molecular targeting treatment requires further study in order to determine if a synergistic effect is present. Further investigation in a large-sample study is required to confirm the validity of these results.

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Clinicopathological Characteristics of Alpha-Fetoprotein-Producing Gastric Cancer

Cited by 51 publications

References 20 publications

Clinical Manifestations in Patients with Alpha-Fetoprotein–Producing Gastric Cancer

Clinical Manifestations in Patients with Alpha-Fetoprotein–Producing Gastric Cancer

Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association

Successful multimodal therapy for an α-fetoprotein-producing gastric cancer patient with simultaneous liver metastases

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