Comparison of Survival Curves of Gastric Cancer Patients After Surgery According to the UICC Stage Classification and the General Rules for Gastric Cancer Study by the Japanese Research Society for Gastric Cancer

Nio, Yoshinori; Tsubono, Michihiko; Kawabata, Kazuya; Masai, Yoshikazu; Hayashi, H.; Meyer, C.; Inoue, Kazutomo; Tobe, Takayoshi

doi:10.1097/00000658-199307000-00008

Cited by 43 publications

(26 citation statements)

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“…With a mature follow-up, the 2-year OS rate of this treatment was 43% (95% CI 29.4-56.1). This appeared to be better than the 2-year OS of 20-25% that was estimated from previous studies of stage IV GC patients treated with chemotherapy alone or with surgery and postoperative chemotherapy [2,3,6,22]. However, our study failed to show a survival benefit, because our threshold 2-year survival probability was estimated to be 35%.…”

Section: Discussioncontrasting

confidence: 77%

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Phase II trial of combined treatment consisting of preoperative S-1 plus cisplatin followed by gastrectomy and postoperative S-1 for stage IV gastric cancer

et al. 2011

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Background To improve the poor prognosis in patients with stage IV (StIV) gastric cancer (GC), we conducted a multicenter phase II study of preoperative S-1 plus cisplatin followed by gastrectomy and postoperative S-1 for StIV GC (the protocol is registered at the clinical trial site of the National Cancer Institute; KYUH-UHA-GC03-01, NCT00088816). Methods Eligibility criteria included histologically proven StIVGC. Patients received S-1 (80 mg/m 2 /day, days 1-21) plus cisplatin (60 mg/m 2 on day 8) for 2 courses. After preoperative chemotherapy (CTx), radical gastrectomy was performed. Postoperative S-1 (80 mg/m 2 /day, days 1-14) was administered every 3 weeks for 1 year. Results Fifty-one patients were enrolled and all patients were followed for more than 2 years. The 2-year overall survival and progression-free survival rates were 43.1% (95% confidence interval [CI] 29.4-56.1%) and 33.3% (95% CI 20.9-46.2%), respectively. Preoperative chemotherapy was accomplished in 44 patients (86.3%). These 44 patients underwent surgery and R0 resection was achieved in 26. The rate of R0 resection for GC with a single StIV factor (n = 24) was 79.2% and that for GC with multiple StIV factors (n = 27) was 25.9%. All patients with cancer cells in peritoneal washings (cytology [Cy] 1) alone (n = 12) became Cy0 after preoperative chemotherapy. Postoperative chemotherapy was completed in 11 patients, including 8 with Cy1 alone. No treatment-related death was recorded. Recurrences were observed in 14 patients after R0 resection. The most frequent recurrence site was the peritoneum. Patients who underwent R0 resection and those with Cy1 alone had a better survival. Conclusions This perioperative treatment was safe and feasible for StIVGC but failed to show a survival benefit. In patients with StIVGC with Cy1 alone this treatment resulted in a better prognosis.

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Section: Discussioncontrasting

confidence: 77%

“…It is often diagnosed at an advanced stage. The prognosis of stage IV GC is poor (e.g., the 1-, 2-, and 5-year survival rates of stage IV GC are approximately 40, 20, and \10%, respectively [2,3]), even if patients are treated surgically.…”

Section: Introductionmentioning

confidence: 99%

Phase II trial of combined treatment consisting of preoperative S-1 plus cisplatin followed by gastrectomy and postoperative S-1 for stage IV gastric cancer

et al. 2011

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“…The clinicopathologic staging was performed according to the TNM criteria 24 and were categorized into early (stage I-II) and advanced (stage III-IV) because these criteria are known to affect the 5-year survival significantly. 25,26 The histologic type of a gastric carcinoma was defined as being intestinal (glandular, cohesive, or solid), diffuse and mixed according to the Lauren classification, 27,28 and the degree of differentiation was graded according to the WHO classification. The location of the tumor was divided into the proximal (cardia and body) and distal (antrum) stomach.…”

Section: Imaging and Pathologic Diagnosismentioning

confidence: 99%

Preoperative genetic diagnosis of gastric carcinoma based on chromosomal loss and microsatellite instability

Hong

Choi

Lee

et al. 2004

Intl Journal of Cancer

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The degree of chromosomal losses and the presence of microsatellite instability (MSI) in gastric carcinomas have been categorized into low-risk (low-level loss and MSI) and high-risk (baseline-and high-level losses) genotypes. With the aim of making a preoperative diagnosis, this study confirmed the stem line genotype that is common over an entire tumor as well as in a single biopsy specimen. Biopsy specimens were obtained from 91 gastric carcinoma patients and examined for their microsatellite genotypes using a panel of 41 microsatellite markers on 8 cancer-associated chromosomes. The genotype of the biopsy specimens was compared with that of a surgical specimen, which had been multifocally examined for its intratumoral heterogeneity. Of the 91 pairs of biopsy and surgical specimens, 87 (96%) containing either the same (60 cases) or a similar (17 cases) number of chromosomal losses were categorized into the same microsatellite genotype, and the remaining 4 pairs (4%) were classified into a different genotype. The surgical specimens showed that an extraserosal invasion and lymph node metastasis are frequently associated with either a high-level (4 or more) of chromosomal losses irrespective of the tumor size (73% and 85%) or the large carcinomas > 5 cm in diameter irrespective of the tumor genotype (76% and 83%). The status of the extraserosal invasion and lymph node metastasis (0.691 and 0.802 receiver operating characteristic areas, respectively) predicted by the biopsy genotype and the tumor size corresponded closely to the surgical pathology results. Therefore, the extent of chromosomal losses and the presence of an MSI determined on a biopsy specimen will provide valuable information for making a preoperative genetic diagnosis of a gastric carcinoma.Key words: preoperative genetic diagnosis; gastric carcinoma; chromosomal loss A gastric carcinoma is one of the most common malignancies and leading causes of death. 1 The complete removal (R0) of the residual tumor cells is the only cure, which can be achieved only by a surgical resection of the stomach and locoregional lymph nodes. [2][3][4][5] Clinicians frequently experience several variants of the tumor such as the early nodal involvement of small-sized tumors and the recurrence of early-stage disease. 6,7 This suggests that the metastatic potential varies between cases. In addition, the presence of microscopic tumor cells spreading to the surrounding tissues and distant organs in common cases of gastric carcinoma cannot be predicted from a conventional image and a naked-eye diagnosis. 8 -10 It is believed that genetic instability in a malignancy causes the complex genetic alterations. 11,12 In gastrointestinal carcinomas, a microsatellite instability (MSI) and a loss of heterozygosity (LOH) are frequently observed as a result of the hypermutability of simple repeated nucleotide sequences and unilateral chromosomal losses, respectively. 13,14 The presence of an MSI and the extent (baseline, low, and high levels) of chromosomal losses have been reported t...

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“…Noh et al (2005) reported that the 5-year survival rate of early gastric cancer without lymph node metastasis is 94.2% and that of early gastric cancer with lymph node metastasis is 87.3%. Nio et al (1993) reported a 5-year survival rate of 95% for N1 patients and 68.4% for N2 patients for early gastric cancers, and Miwa et al (1984) observed similar rates of 90% and 79%, respectively. Seto et al (1997) reported a 5-year survival rate of 74% for patients with >4 positive lymph nodes.…”

Section: Discussionmentioning

confidence: 95%

Long-Term Outcomes after D2 Gastrectomy for Early Gastric Cancer: Survival Analysis of a Single-Center Experience in China

Wang¹,

Ma²,

Zhang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Early gastric cancer (EGC) is well accepted as having a favorable prognosis, but some patients experience an ominous outcome after curative resection. This study was aimed at evaluating predictive factors associated with prognosis of D2 gastrectomies in patients with early gastric cancer. Materials and Methods: A total of 518 patients with early gastric cancer who underwent D2 gastrectomies were reviewed in this study. The clinicopathological features and surgical outcomes were analyzed. The survival rate was estimated using the Kaplan-Meier method and compared by log rank test. Prognostic factors were analyzed using a multivariate Cox proportional hazards model. Results: The 5-year survival rate was 90.3%. Tumor infiltration, lymph node metastasis and lymphovascular invasion were significant prognostic factors for survival. Gender, age, tumor size, tumor location, macroscopic type and histological type were not significant prognostic factors. Multivariate analysis indicated that lymph node metastasis was an independent poor prognosis factor. Conclusions: Early gastric cancers with lymph node metastasis have a relatively poor prognosis after standard surgery. Even after curative resection, patients with EGC with positive lymph nodes should be closely followed and be considered as candidates for comprehensive therapies.

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Comparison of Survival Curves of Gastric Cancer Patients After Surgery According to the UICC Stage Classification and the General Rules for Gastric Cancer Study by the Japanese Research Society for Gastric Cancer

Cited by 43 publications

References 1 publication

Phase II trial of combined treatment consisting of preoperative S-1 plus cisplatin followed by gastrectomy and postoperative S-1 for stage IV gastric cancer

Phase II trial of combined treatment consisting of preoperative S-1 plus cisplatin followed by gastrectomy and postoperative S-1 for stage IV gastric cancer

Preoperative genetic diagnosis of gastric carcinoma based on chromosomal loss and microsatellite instability

Long-Term Outcomes after D2 Gastrectomy for Early Gastric Cancer: Survival Analysis of a Single-Center Experience in China

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