Management Strategies for Locoregional Recurrence in Early-Stage Gastric Cancer: Retrospective Analysis and Comprehensive Literature Review

Salem, Ahmed; Hashem, Sameh; Mula‐Hussain, Layth; Mohammed, I.; Nour, Alaa; Shelpai, Wael; Daoud, Faiez; Morcos, Basem; Yamin, Yasser; Jaradat, Imad; Khader, Jamal; Almousa, Abdelatif

doi:10.1007/s12029-010-9207-3

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…Many studies have shown that gene expression signatures can classify tumors into intrinsic subtypes and predict the survival of GC patients [26] . Several genomic studies also show that gene expression profiling can predict patients with a high risk for recurrence and thus can potentially improve clinical practice [42–44] . Now it is evident that gene expression techniques may significantly improve our ability to predict the risk of recurrence and to tailor the treatment for each individual gastric cancer patient.…”

Section: Molecular Prognosis Of Gcmentioning

confidence: 99%

Molecular classification and prediction in gastric cancer

Lin

Zhao

Song

et al. 2015

Computational and Structural Biotechnology Journal

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Gastric cancer, a highly heterogeneous disease, is the second leading cause of cancer death and the fourth most common cancer globally, with East Asia accounting for more than half of cases annually. Alongside TNM staging, gastric cancer clinic has two well-recognized classification systems, the Lauren classification that subdivides gastric adenocarcinoma into intestinal and diffuse types and the alternative World Health Organization system that divides gastric cancer into papillary, tubular, mucinous (colloid), and poorly cohesive carcinomas. Both classification systems enable a better understanding of the histogenesis and the biology of gastric cancer yet have a limited clinical utility in guiding patient therapy due to the molecular heterogeneity of gastric cancer. Unprecedented whole-genome-scale data have been catalyzing and advancing the molecular subtyping approach. Here we cataloged and compared those published gene expression profiling signatures in gastric cancer. We summarized recent integrated genomic characterization of gastric cancer based on additional data of somatic mutation, chromosomal instability, EBV virus infection, and DNA methylation. We identified the consensus patterns across these signatures and identified the underlying molecular pathways and biological functions. The identification of molecular subtyping of gastric adenocarcinoma and the development of integrated genomics approaches for clinical applications such as prediction of clinical intervening emerge as an essential phase toward personalized medicine in treating gastric cancer.

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Section: Molecular Prognosis Of Gcmentioning

confidence: 99%

Molecular classification and prediction in gastric cancer

Lin

Zhao

Song

et al. 2015

Computational and Structural Biotechnology Journal

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“…In early gastric cancer, the rate of recurrence after gastrectomy is reported to vary from 1.3 to 12.2%. Median time to recurrence is 16 months, and hematogenous spread is probably the most common pattern of recurrence [12]. …”

Section: Reasons For Follow-upmentioning

confidence: 99%

Follow-Up: The Evidence

D’Ugo¹,

Biondi²,

Tufo³

et al. 2013

Dig Surg

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There is currently no consensus on the best strategy for the follow-up of patients who have undergone surgical treatment with curative intent for gastric cancer. The wide variation in recommendations for surveillance among international experts and hospital schedules clearly reflects a lack of an established body of evidence on this subject. Consequently, most of the international guidelines aimed at early detection of disease recurrence gloss over details concerning the mode, duration, and intensity of surveillance since they cannot be based on an acceptable grade of recommendation. Very few report anything other than the detection of recurrences or death as the primary endpoints, and, given the poor survival of patients with recurrent gastric cancer, the prognostic effect of early detection seems doubtful. In recent years, an increasing focus on evidence-based medicine, which has coincided with a growing concern about costs and efficiency in medicine, has caused a reevaluation of most surveillance practices. In this paper, we review and discuss the current body of evidence and follow-up practices after curative resection of gastric cancer.

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“…Recurrences were classified as either locoregional, distant, or peritoneal, and as with previous reports, distant recurrences, though rare, were the predominant recurrence in our cohort of node‐negative early gastric cancer . Patients with lymph node metastasis, perhaps the most important predictor for recurrence in gastric cancer , were purposely excluded from this study.…”

Section: Discussionmentioning

confidence: 92%

“…The proportion of early gastric cancer (T1‐2) has increased in recent years , possibly due to a combination of increased screening and improved diagnostic techniques. Early gastric cancer (T1‐2N0) rarely recurs following curative resection, and the current NCCN Gastric Cancer Guidelines do not recommend adjuvant treatment for this subgroup of gastric cancer patients .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for recurrence in T1‐2N0 gastric cancer in the United States and China

Cao

Selby

et al. 2016

Journal of Surgical Oncology

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Introduction Recurrence patterns after curative intent gastrectomy for T1-2N0 gastric adenocarcinoma are poorly defined. We sought to assess timing, patterns, and risk factors for recurrence in patients treated at two high-volume gastric cancer centers in the United States and China. Methods Between 1995 and 2011, 1,058 patients underwent curative intent gastrectomy. Recurrences were classified as locoregional, distant, or peritoneal. Univariate and multivariate analyses were performed to identify risk factors for recurrence. Results Overall, 7% (76) of our 1,058 patients from the United States (n=414) and China (n=644) recurred. Liver (43%) was the most common site of recurrence in both countries (US: 24%, China: 52%), followed by peritoneum (16%), lymph nodes (10%), and anastomosis (8%). Median time to recurrence was 23 months (US: 30 months, China: 23 months), which decreased with increasing T-stage (T1a: 27 months, T1b: 24 months, T2: 22 months). Tumor size (P=0.001), depth of invasion (P=0.010), histological type (P=0.022) and lymphovascular invasion (P=0.001) were independently associated with recurrence. Conclusion Patients infrequently recur following curative intent gastrectomy for T1-2N0 gastric adenocarcinoma. Almost all recurrences occur between six months and three years post-operatively, most frequently in distant anatomic locations, selective followup during this time period is recommended.

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Management Strategies for Locoregional Recurrence in Early-Stage Gastric Cancer: Retrospective Analysis and Comprehensive Literature Review

Cited by 9 publications

References 33 publications

Molecular classification and prediction in gastric cancer

Molecular classification and prediction in gastric cancer

Follow-Up: The Evidence

Risk factors for recurrence in T1‐2N0 gastric cancer in the United States and China

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