Gastric Cancer – From Aetiology to Management: Differences Between the East and the West

Chan, WC; Lam, Ka-On; Lee, Victor; Davidson, Michael; So, Tsz Him; Li, J.S.; Chau, Ian; Kwong, Dora Lai-Wan

doi:10.1016/j.clon.2019.05.012

Cited by 24 publications

(17 citation statements)

References 49 publications

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“…Although initially we applied a similar criteria and a 10% cutoff for p53+, we eventually opted for a more stringent cutoff value set at 20% that reduced the number of false positives, meaning patients classified as aberrant (p53+) but having a wild type TP53 gene from 12 to 3 (see comparison in Figure S2). However, despite these methodological variations, our study confirms a number of previous reports that indicate geographical differences in GC epidemiology, and clinical and molecular features [21][22][23][24]. Importantly, to the best of our knowledge, our study is the first report on a GC molecular subtype classification with potential clinical applicability in Latin America.…”

Section: Discussionsupporting

confidence: 87%

A Molecular Stratification of Chilean Gastric Cancer Patients with Potential Clinical Applicability

Pinto

Córdova-Delgado

Retamal

et al. 2020

Cancers

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Gastric cancer (GC) is a complex and heterogeneous disease. In recent decades, The Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG) defined GC molecular subtypes. Unfortunately, these systems require high-cost and complex techniques and consequently their impact in the clinic has remained limited. Additionally, most of these studies are based on European, Asian, or North American GC cohorts. Herein, we report a molecular classification of Chilean GC patients into five subtypes, based on immunohistochemical (IHC) and in situ hybridization (ISH) methods. These were Epstein–Barr virus positive (EBV+), mismatch repair-deficient (MMR-D), epithelial to mesenchymal transition (EMT)-like, and accumulated (p53+) or undetected p53 (p53−). Given its lower costs this system has the potential for clinical applicability. Our results confirm relevant molecular alterations previously reported by TCGA and ACRG. We confirm EBV+ and MMR-D patients had the best prognosis and could be candidates for immunotherapy. Conversely, EMT-like displayed the poorest prognosis; our data suggest FGFR2 or KRAS could serve as potential actionable targets for these patients. Finally, we propose a low-cost step-by-step stratification system for GC patients. To the best of our knowledge, this is the first Latin American report on a molecular classification for GC. Pending further validation, this stratification system could be implemented into the routine clinic

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Section: Discussionsupporting

confidence: 87%

A Molecular Stratification of Chilean Gastric Cancer Patients with Potential Clinical Applicability

Pinto

Córdova-Delgado

Retamal

et al. 2020

Cancers

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“…This is shown in a higher rate of early diagnosis, with the cancer being detected at the early stages. In addition the different location, histology and risk factors explain some of the differences in Asian and Western patients with gastric cancer[ 63 ]. Distal localization with structural intestinal morphology differentiation is more frequent in Asian countries than the predominance of proximal localization with diffuse histology in the Western countries[ 64 , 65 ].…”

Section: Discussionmentioning

confidence: 99%

Is there a role for treatment-oriented surgery in liver metastases from gastric cancer?

Uggeri

Ripamonti

Pinotti

et al. 2020

WJCO

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BACKGROUND Distant metastases are found in approximately 35% of patients with gastric cancer at their first clinical observation, and of these, 4%-14% involves the liver. Unfortunately, only 0.4%-2.3% of patients with metastatic gastric cancer are eligible for radical surgery. Although surgical resection for gastric cancer metastases is still debated, there have been changes in recent years, although several clinical issues remain to be defined and that must be taken into account before surgery is proposed. AIM To analyze the clinicopathological factors related to primary gastric tumor and metastases that impact the survival of patients with liver metastatic gastric cancer. METHODS We performed a systematic review of the literature from 2000 to 2018 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The study protocol was based on identifying studies with clearly defined purpose, eligibility criteria, methodological analysis, and patient outcome. RESULTS We selected 47 studies pertaining to the purpose of the review, which involved a total of 2304 patients. Median survival was 7-52.3 mo, median disease-free survival was 4.7-18 mo. The 1-, 2-, 3-, and 5-year overall survival (OS) was 33%-90.1%, 10%-60%, 6%-70.4%, and 0%-40.1%, respectively. Only five papers reported the 10-year OS, which was 5.5%–31.5%. The general recurrence rate was between 55.5% and 96%, and that for hepatic recurrence was between 15% and 94%. CONCLUSION Serous infiltration and lymph node involvement of the primary cancer indicate an unfavorable prognosis, while the presence of single metastasis or ≤ 3 metastases associated with a size of < 5 cm may be considered data that do not contraindicate liver resection.

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“…Contrasting between the 'East' and 'West' is of particular importance to gastric cancer given the differences in incidence, pathology, treatment and outcome. It was hypothesised that these differences in approach and survival may in uence how stakeholders in these regions prioritise different health outcomes which could be examined further in this study 11,12 . Similarly, health priorities may be in uenced by resource availability as categorised by country income.…”

Section: Stakeholder Selection and Baseline Informationmentioning

confidence: 99%

Exploring the impact of regional variation on outcome prioritisation in core outcome set development: a case study in the field of gastric cancer surgery

Alkhaffaf

Metryka

Blazeby

et al. 2021

Preprint

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BackgroundInternational stakeholder participation is important in the development of core outcome sets (COS). Stakeholders, however, may value health outcomes differently when regional differences are considered. Here, we explore how region, health income and participant characteristics influence prioritisation of outcomes during development of a COS for gastric cancer surgery trials (the GASTROS study).Methods952 participants from 55 countries participating in a Delphi survey during COS development were eligible for inclusion. Recruits were grouped according to region (East or West), country income classification (high and low-to-middle income) and other characteristics (e.g. patients; age, sex, time since surgery, mode of treatment, surgical approach and healthcare professionals; clinical experience). Groups were compared with respect to how they categorised outcomes (‘consensus in’, ‘consensus out’, ‘no consensus’). Outcomes categorised as ‘consensus in’ or ‘consensus out’ by all 3 stakeholder groups would be automatically included in or excluded from the COS respectively.ResultsIn total, 13 outcomes were categorised ‘consensus in’, 13 ‘consensus out’ and 31 ‘no consensus’. There was little variation in prioritisation of outcomes by stakeholders from Eastern or Western countries and high or low-to-middle income countries. There was little variation in outcome prioritisation within either health professional or patient groups.ConclusionOur study suggests that there is little variation in opinion within stakeholder groups when participant region and other characteristics are considered. This finding may help COS developers when designing their Delphi surveys and recruitment strategies. Further work across other clinical fields is needed before broad recommendations can be made.

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Gastric Cancer – From Aetiology to Management: Differences Between the East and the West

Cited by 24 publications

References 49 publications

A Molecular Stratification of Chilean Gastric Cancer Patients with Potential Clinical Applicability

A Molecular Stratification of Chilean Gastric Cancer Patients with Potential Clinical Applicability

Is there a role for treatment-oriented surgery in liver metastases from gastric cancer?

Exploring the impact of regional variation on outcome prioritisation in core outcome set development: a case study in the field of gastric cancer surgery

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