Early Gastric Cancer: Trends in Incidence, Management, and Survival in a Well-Defined French Population

Chapelle, Nicolas; Bouvier, Anne–Marie; Manfrédi, Sylvain; Drouillard, Antoine; Lepage, Côme; Faivre, Jean; Jooste, Valérie

doi:10.1245/s10434-016-5279-z

Cited by 26 publications

(20 citation statements)

References 33 publications

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“…In EGC, which is defined as gastric cancer that invades no more deeply than the submucosa irrespective of LNM, the T stage could be T1a and T1b, with any N stage. Because distant metastasis from EGC is remarkably rare (0.14%–0.37%), LNM is a very important prognostic factor and is associated with long-term survival [25, 26]. Therefore, identifying the risk factors of LNM before determining the treatment modality is very important clinically and should be approached more individually by recognizing sex-specific differences.…”

Section: Discussionmentioning

confidence: 99%

Sex-specific differences in risk factors of lymph node metastasis in patients with early gastric cancer

Ryu

Chang

et al. 2019

PLoS ONE

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Accurate prediction of lymph node status is of crucial importance in the appropriate treatment planning for patients with early gastric cancer (EGC). Some studies have examined factors predicting lymph node metastasis (LNM) in EGC; however, these studies did not consider sex-specific differences. This study aimed to investigate sex-specific differences in predictive risk factors of LNM in EGC based on surgical specimens. Patients who underwent surgical treatment for EGC between January 2003 and February 2016 were retrospectively evaluated. Patients who underwent previous gastric surgery or treatment for gastric neoplasms were excluded. Finally, 1076 patients treated for EGC were included in the analysis. We analyzed risk factors of LNM by dividing patients into male and female groups. Of 1076 patients (mean age 59.6 years), 69% were men. The overall LNM rate was 9.4%. The LNM rate was lower in men (7.8%) than in women (12.9%). Multivariate analysis showed that elevated type (odds ratio [OR], 2.084; 95% confidence interval [CI]: 1.053–4.125; P = 0.035), submucosal invasion (OR, 2.162; 95% CI: 1.018–4.595; P = 0.045), undifferentiated type (OR, 2.044; 95% CI: 1.107–3.772; P = 0.022), and lymphovascular invasion (LVI) (OR, 7.210; 95% CI: 3.835–13.554; P<0.001) were independent predictive risk factors of LNM in EGC in men. However, only submucosal invasion (OR, 8.772; 95% CI: 2.823–27.259; P<0.001) and LVI (OR, 8.877; 95% CI: 3.861–20.410; P<0.001) were independent predictive risk factors of LNM in EGC in women. Submucosal invasion and LVI were risk factors of LNM in both men and women. However, elevated and undifferentiated types were risk factors in men but not in women. Clinicians should consider these sex-specific differences with regard to individualized management.

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Section: Discussionmentioning

confidence: 99%

Sex-specific differences in risk factors of lymph node metastasis in patients with early gastric cancer

Ryu

Chang

et al. 2019

PLoS ONE

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“…Its prognosis is closely related to the stage of the disease at diagnosis, being very good at an early stage and very poor in advanced stage. Because symptoms are rare until the disease becomes locally advanced or disseminated, GC is rarely diagnosed at an early stage [4], and the potential curability of the disease is still limited, with an overall survival rate remaining low (25-30%) [5].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Characteristics and Endoscopic Management of Gastric Premalignant Lesions in France

Chapelle

Péron

Mosnier

et al. 2019

Dig Dis

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Introduction: Surveillance of gastric precancerous lesions (GPL) is recommended, but the data on their clinical and endoscopic management in a "real-life" practice are limited. Our aim was to study the modalities of endoscopic management of patients with GPL in France. Design: All the patients diagnosed with GPL in our center between 2000 and 2015 were grouped and analyzed according to the most severe GPL found, in the following order: atrophic gastritis only (AG), intestinal metaplasia (IM), low grade dysplasia (LGD), high grade dysplasia (HGD). Results: Out of 16,764 patients having undergone upper endoscopy with gastric biopsies, 507 were identified with GPL (detection rate 3.2%). Overall, Helicobacter pylori infection was found in 41% of patients. IM was by far the most frequently found lesion (79%), followed by LGD (17%), HGD (2%), and AG only (2%). H. pylori infection rate was decreasing, while the age of the patients was increasing, together with the increasing severity of GPL (p = 0.005). Only 28% of the patients had at least one follow-up endoscopy. No correlation was found between the endoscopist's appreciation of the mucosa and histological results. Conclusion: In France, GPL can be expected in about 3% of patients undergoing upper endoscopy with gastric biopsies for any reason. The correlation between the endoscopic evaluation and histology is poor. Spreading of published guidelines should improve the management of patients with GPL in the future.

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“…This poor prognosis may be explained by diagnosis at an advanced stage, as well as resistance to conventional chemotherapies, with a high rate of recurrence as distant and peritoneal metastasis. Interestingly, GC incidence decreases by about 1.5% per year because of a better control of its risk factors, the main one being infection by the bacteria Helicobacter pylori [ 3 ]. Its eradication indeed halves the risk of GC.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of All-Trans Retinoic Acid on Gastric Cancer: A Narrative Literature Review

Bouriez

Giraud

Gronnier

et al. 2018

IJMS

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Gastric cancer (GC) is the third leading cause of cancer-related death worldwide with a five-year survival rate of around 25%, and 4% when diagnosed at a metastatic stage. Cancer stem cells (CSC) have recently been characterized as being responsible for resistance to radio/chemotherapies and metastasis formation, opening up perspectives for new targeted therapies. Those CSCs express biomarkers such as cluster of differentiation 44 (CD44) and display high aldehyde dehydrogenase activity that converts vitamin A-derived retinal into retinoic acids. All-trans retinoic acid (ATRA), which has pro-differentiating properties, has revolutionized the prognosis of acute promyelotic leukemia by increasing its remission rate from 15% to 85%. Recent studies have started to show that ATRA also has an anti-tumoral role on solid cancers such as GC. The purpose of this review is therefore to summarize the work that evaluated the effects of ATRA in GC and to evaluate whether its anti-cancerous action involves gastric CSCs targeting. It has been demonstrated that ATRA can block the cell cycle, enhance apoptosis, and decrease gastric CSCs properties in GC cell lines, tumorspheres, and patient-derived xenograft mice models. Therefore, retinoids and new synthetic retinoids seem to be a promising step forward in targeted therapy of gastric CSC in combination with existing chemotherapies. Future studies should probably focus on these points.

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Early Gastric Cancer: Trends in Incidence, Management, and Survival in a Well-Defined French Population

Abstract: EGCs are rare in France. The prognosis is favorable, except for node-positive cancers, which may benefit from the recently developed adjuvant chemotherapy for gastric cancer.

Cited by 26 publications

References 33 publications

Sex-specific differences in risk factors of lymph node metastasis in patients with early gastric cancer

Sex-specific differences in risk factors of lymph node metastasis in patients with early gastric cancer

Prevalence, Characteristics and Endoscopic Management of Gastric Premalignant Lesions in France

Efficiency of All-Trans Retinoic Acid on Gastric Cancer: A Narrative Literature Review

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