Different Risk Profiles for the Postsurgical Prognosis of Gastric Cancer Patients with Different Blood Types: The FIESTA Study

Fan, Guohui; Hu, Dan; Peng, Feng; Xu, Guodong; Lin, Xiaoxiao; Liang, Binying; Zhang, Hejun; Xia, Yan; Lin, Jinxiu; Zheng, Xiongwei; Niu, Wenquan

doi:10.7150/jca.25408

Cited by 5 publications

(4 citation statements)

References 29 publications

(27 reference statements)

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“…No previous studies have reported the relationship between serum HDL-C levels and LNM in ESCC. However, in a study on LNM in gastric cancer, we found that a low HDL-C level was a risk factor for LNM (28), which was contrary to our findings that a high HDL-C level was a risk factor in ESCC. We suspected that in ESCC and gastric cancer, the mechanism may be somewhat different.…”

Section: Discussioncontrasting

confidence: 99%

Clinical nomogram for lymph node metastasis in pathological T1 esophageal squamous cell carcinoma: a multicenter retrospective study

Tian¹,

Jiang²,

Huang³

et al. 2020

Ann Transl Med

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Background: Endoscopic resection is increasingly used to treat pathological T1 (pT1) esophageal cancer (EC) patients. However, the procedures are limited by lymph node metastasis (LNM) and remain controversial. We aimed to construct a nomogram to predict the risk of LNM in patients with pT1 esophageal squamous cell carcinoma (ESCC). Methods: A total of 243 patients with pT1 ESCC who underwent esophagectomy and lymph node dissection at two different institutes between February 2013 and June 2019 were analyzed retrospectively. Patients were categorized into the negative group and the positive group according to whether there was LNM. Risk factors for LNM were evaluated by univariate and multivariate analyses. The nomogram was used to estimate the individual risk of LNM.Results: Forty-six (18.9%) of the 243 patients with pT1 ESCC exhibited LNM. The LNM rate in patients with stage T1a disease was 5.7% (5/88), and the rate in patients with stage T1b disease was 26.5% (41/155).Multivariable logistic regression analysis showed that tumor differentiation [odds ratio (OR) =1.942, 95% confidence interval (CI): 1.067-3.536, P=0.030], the T1 sub-stage (OR =4.750, 95% CI: 1.658-13.611, P=0.004), the preoperative alanine aminotransferase/aspartate aminotransferase ratio (LSR) (OR =5.371, 95% CI: 1.676-17.210, P=0.005), and the high-density lipoprotein cholesterol (HDL-C) level (OR =5.894, 95% CI: 1.917-18.124, P=0.002) were independent risk factors for LNM. The nomogram had relatively high accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.803 (95% CI: 0.732-0.873). The calibration curve showed that the predicted probability of LNM was in good agreement with the actual probability.Conclusions: Clinicopathological and hematological parameters of tumor differentiation, the T1 substage, the preoperative LSR, and the HDL-C level may predict the risk of LNM in T1 ESCC. The risk of LNM can be predicted by the nomogram.

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Section: Discussioncontrasting

confidence: 99%

Clinical nomogram for lymph node metastasis in pathological T1 esophageal squamous cell carcinoma: a multicenter retrospective study

Tian¹,

Jiang²,

Huang³

et al. 2020

Ann Transl Med

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“…Using data from the FIESTA cohort 7-9,12-20, a total of 6865 eligible patients who underwent radical surgery for esophageal cancer (n=2535), gastric cancer (n=3012) and colorectal cancer (n=1318) at Fujian Provincial Cancer Hospital (the current Fujian Cancer Hospital & Fujian Medical University Cancer Hospital) and survived hospitalization between January 2000 and December 2010 were analyzed in the current study, and they were followed up as of December 2015. The FIESTA study got approval from the Ethical Committee of the Fujian Provincial Cancer Hospital, and all patients gave written informed consent.…”

Section: Methodsmentioning

confidence: 99%

The risk trajectory between preoperative fasting glucose and common digestive tract cancer-specific mortality in the FIESTA cohort involving 6865 Chinese patients

Peng

Lin

et al. 2019

J. Cancer

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Backgrounds: High blood glucose or hyperglycemia is an established risk factor for the development and progression of cancer at many sites, whereas data on the relevance between low blood glucose or hypoglycemia and cancer survival are lacking.Aims: We aimed to assess the shape of risk trajectory between preoperative fasting glucose and postoperative digestive cancer-specific mortality in Chinese.Methods: In total, 6865 patients who underwent radical surgery for esophageal cancer (n=2535), gastric cancer (n=3012) and colorectal cancer (n=1318) during 2000-2010 were followed up as of December 2015. All patients received neither chemotherapy nor radiotherapy before and after the surgery. Optimal cutoff points were determined using survival tree analysis.Results: The median follow-up time was 44.9 months (range: 0.5-188.9 months), with 1065 deaths from esophageal cancer, 1331 from gastric cancer and 412 from colorectal cancer. Using fasting glucose (4.36, 6.09] mmol/L as the reference group, hazard ratios for fasting glucose ≤4.36, (6.09, 8.95], (8.95, 11.5] and >11.5 mmol/L were 1.35 (95% confidence interval: 1.19, 1.54), 2.82 (2.57, 3.11), 3.56 (3.10, 4.08) and 4.27 (3.67, 4.97), respectively (p<0.001).Conclusions: Our findings indicate a U-shaped risk trajectory between preoperative fasting glucose and digestive tract cancer-specific mortality in Chinese. Further external validation is warranted.

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“…The FIESTA study was initiated by Fujian Provincial Cancer Hospital in January 2000, with the aims to optimize presurgical risk factors and predict cancer‐specific mortality of common digestive system malignancies, including esophageal cancer, gastric cancer, and colorectal cancer. 11 , 14 , 15 , 18 , 19 , 20 , 21 The Ethics Committee of Fujian Provincial Cancer Hospital approved the implementation of the FIESTA study (Approval Number: SQ2015‐070‐01).…”

Section: Methodsmentioning

confidence: 99%

“…Total 3012 patients with gastric cancer who received radical resection of primary gastric cancer for the first time, underwent no presurgical and postsurgical chemotherapy/radiotherapy, and were consecutively recruited from January 2000 to December 2010, with the latest follow‐up ended on December 31, 2015, were eligible for inclusion, as previously described. 11 , 13 , 14 , 15 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 The reason for us to exclude patients with presurgical and postsurgical chemotherapy/radiotherapy is due to its significant impact on survival outcomes.…”

Section: Methodsmentioning

confidence: 99%

Prediction of presurgical metabolic syndrome for gastric cancer‐specific mortality is more evident in smokers: The FIESTA study

Zhang

Deng

et al. 2022

Cancer Medicine

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Backgrounds We aimed to test whether the prediction of presurgical metabolic syndrome for postsurgical survival outcomes of gastric cancer hinges upon cigarette smoking status. Methods This study is a part of the ongoing Fujian prospective investigation of cancer (FIESTA) study. Patients with gastric cancer received radical resection of primary gastric cancer between January 2000 and December 2010, with the latest follow‐up ended in December 2015. The 1:1 propensity score matching analysis was adopted to balance confounders between smokers and never‐smokers. Effect‐size estimates are expressed as hazard ratio (HR) with 95% confidence interval (CI). Model performance was evaluated using the Hosmer and Lemeshow test and 10‐fold cross‐validated area under the receiver operating characteristic curve (AUROC). Statistical analyses were completed with SAS software (v9.4). Results Total 2779 patients with gastric cancer were analyzed, including 2223 smokers and 556 never‐smokers. Median follow‐up time was 45.6 months. Cigarette smoking was not associated with postsurgical survival differences. Presurgical metabolic syndrome complication was significantly associated with increased gastric cancer‐specific mortality in smokers (HR [95% CI]: 2.73 [1.53–4.89], p < 0.001), but not in never‐smokers. Relative excess risk due to interaction was estimated to be 2.43 (95% CI: 0.40–4.45). After constructing a risk assessment score, one unit increment was associated with 10% reduced risk of gastric cancer‐specific mortality (HR [95% CI]: 0.90 [0.88–0.91], p < 0.001), with 10‐fold cross‐validated AUROC being 0.82 (95% CI: 0.74–0.92). Conclusions Our findings showed that the prediction of presurgical metabolic syndrome for gastric cancer‐specific mortality was more evident in smokers. Practically, this study provides evidence base for future personalized prediction and helped risk‐stratify gastric cancer patients who might experience serious postsurgical consequences.

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Different Risk Profiles for the Postsurgical Prognosis of Gastric Cancer Patients with Different Blood Types: The FIESTA Study

Cited by 5 publications

References 29 publications

Clinical nomogram for lymph node metastasis in pathological T1 esophageal squamous cell carcinoma: a multicenter retrospective study

Clinical nomogram for lymph node metastasis in pathological T1 esophageal squamous cell carcinoma: a multicenter retrospective study

The risk trajectory between preoperative fasting glucose and common digestive tract cancer-specific mortality in the FIESTA cohort involving 6865 Chinese patients

Prediction of presurgical metabolic syndrome for gastric cancer‐specific mortality is more evident in smokers: The FIESTA study

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