Epidemiological, clinical and pathological characteristics of gastric neoplasms in the province of Cremona: the experience of the first population-based specialized gastric cancer registry in Italy

Abstract

Background The gastric cancer incidence rate differs widely across geographical areas. In Italy, in the province of Cremona the incidence is high, compared to the national situation. For this reason a specialized population-based registry was set up. Methods The collection encompasses all gastric cancers diagnosed in the three districts of the province since January 1, 2010. The main data sources were the pathological and Hospital Discharge Records and patient clinical charts. Only diagnoses of primary gastric cancer were considered. For each case the following variables were registered: personal data, medical history and symptoms at diagnosis; imaging assessments performed, details on surgery and other treatments received; genetic background and biomolecular characteristics; social and environmental factors. Results As of November 2017, 1087 cases were collected; of which 876, diagnosed up to December 2015, were analyzed. Male/female ratio was 1.4. The European Age-standardized Incidence Rate was 41.4 for males and 28.3 for females as compared to a national average of 33.3 and 17.0 respectively. Median age at diagnosis was 73 for male and 78 for female. Helicobacter Pylori infection was present in fewer than 20% of cases. HER-2 gene was amplified in about 25% of cases. Primary tumour location was the gastro-esophageal junction or cardia in 17.5% in males and 8.3% in females. The majority of cases (58.3%) were diagnosed at an advanced stage and overall only 41.2% underwent surgery. Median overall survival was 14.8 months for men and 18.5 for women. Age standardized 5-year relative survival was 31.4% for men and 40.5% for females. Neoadjuvant treatment was performed in fewer than 10% of patients who underwent surgery, and the rate of postoperative therapy adherence was low. Discussion This study shows a high gastric cancer incidence in the province of Cremona, with a geographical spread across different districts. Moreover, a high percentage of gastric cancers were detected at an advanced stage of disease and a low rate of 5-year relative survival was registered. Based on these findings, effective preventive interventional health strategies and screening procedures need to be implemented to reduce the impact of this pathology in this geographical area.

Retrospective analysis of gastric cancer management in a real-world setting: a single-institution experience

“…In our experience, the percentage of patients treated with first-line chemotherapy was slightly higher than the 33.8% reported for Europe by Bang et al 10 in the first REGATE study but much lower than that reported by Donida et al 24 (77% of cases received first-line chemotherapy, 48% second-line). Our 5-year OS rates by stage are reported in Table 4 and reflect those of Rosa et al 15 for stage I and II GC and those of Marelli et al 14 for stage I disease.…”

Long Noncoding RNA AFAP1-AS1 Promotes Cell Proliferation and Metastasis via the miR-155-5p/FGF7 Axis and Predicts Poor Prognosis in Gastric Cancer

“…Gastric cancer (GC) is one of the most common malignancies worldwide [1,2]. Although diagnosis and treatment strategies have been improved, a large number of newly diagnosed GC cases have occurred over the past decades [3,4]. At present, surgery is still the main way to treat GC, but the overall five-year survival rate of GC patients is about 35% [5][6][7][8].…”

Evolutionarily-Related Helicobacter pylori Genotypes and Gastric Intraepithelial Neoplasia in a High-Risk Area of Northern Italy

“…Archived formalin-fixed, paraffin-embedded endoscopic or surgical biopsy specimens from a total of 70 patients with GIN or non-neoplastic gastro-duodenal lesions (NNGDL) were selected after a pathological review from the 1998-1999 files of the Pathology Unit, Cremona Hospital, Cremona, Lombardy (a well-known high-GC-risk region in Italy [16,28]). These included 33 biopsy samples representative of non-cardia GIN, of which 12 were from patients also diagnosed with invasive GC (mean age of patients 66 years, range 50-82 years, 11 females, 22 males) and 37 biopsy samples representative of the NNDGL (mean age of patients 52 years, range 29-75 years, 16 females, 21 males).…”

“…It is still debated whether the higher geographic risk of GC in Northern and Central Italy is due to host, environmental, or bacterial factors or to combinations among such factors [20][21][22][23][24][25][26][27]. Here, to assess the relationships between Hp virulence factors and non-cardia gastric intraepithelial neoplasia (GIN), we analyze the Hp genotypes found in an archived paraffin-embedded series of GINs and non-neoplastic gastro-duodenal lesions (NNGDLs) from Cremona (Lombardy), a high GC risk area in Northern Italy [16,28].…”