Morbidity, mortality, and pathological response in patients with gastric cancer preoperatively treated with chemotherapy or chemoradiotherapy

Valentí, Víctor; Hernández-Lizoain, José Luís; Beorlegui, M. Carmen; Diaz-Gozalez, J.A.; Regueira, Fernando Martínez; Rodríguez, Javier Jacob; Viúdez, A.; Sola, Iosu; Cienfuegos, Javier A.

doi:10.1002/jso.21947

Cited by 39 publications

(28 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 30-day POM was 4.27%, and the in-hospital mortality to 90 days was 5.99%, comparing favorably with many studies, 1,7,15,16 especially because we conducted a multicenter study. The following factors on univariate analysis were related to POM: age, ASA score, tolerance of neoadjuvant chemotherapy, metastatic disease diagnosed preoperatively or perioperatively, and extended resection.…”

Section: Commentsupporting

confidence: 56%

Predictive Factors of Postoperative Mortality After Junctional and Gastric Adenocarcinoma Resection

et al. 2013

View full text Add to dashboard Cite

for the FREGAT Working Group-FRENCH IMPORTANCE Postoperative mortality after junctional and gastric adenocarcinoma resection remains a significant issue.OBJECTIVE To identify factors predictive of mortality within 30 days of junctional and gastric adenocarcinoma resection in a large national multicenter cohort.DESIGN A retrospective study collecting data from a multicenter database of patients who underwent resection for junctional and gastric adenocarcinoma from January 1, 1997, through January 31, 2010. A stepwise logistic regression model was built to identify, by multivariate analysis, variables independently predictive of 30-day postoperative mortality (POM). SETTING Nineteen university teaching hospitals in France.PARTICIPANTS Two thousand six hundred seventy patients with available data.MAIN OUTCOME MEASURES The primary end point was POM. Secondary end points included (1) late mortality (30-90 days after resection) and (2) postoperative morbidity. RESULTSOne thousand eight hundred ninety-six patients (71.01%) had gastric adenocarcinoma and 774 (28.99%) had junctional tumors. Neoadjuvant treatment was given to 655 patients (24.53%), and 114 patients (4.27%) died within 30 days of surgery. Postoperative mortality was higher in patients who experienced grades III and IV toxic effects during neoadjuvant treatment compared with those who did not (8.7% vs 2.9%, respectively; P = .007). Multivariate analysis revealed metastatic disease at diagnosis (odds ratio, 9.13 [95% CI, 3.29-25.35]; P < .001) and poor tolerance of neoadjuvant treatment (3.33 [1.25-8.85]; P = .02) as being independently predictive of POM. Centers performing at least 10 resections per year were found to be protective against POM (odds ratio, 0.29 [95% CI,; P = .008).CONCLUSIONS AND RELEVANCE This large national cohort study confirms that advanced disease heightens the risk of POM; centralization of junctional and gastric adenocarcinoma resection is warranted. The novel finding that grades III to IV toxic effects during neoadjuvant therapy increase POM has significant implications for decision making in this subgroup of patients.

show abstract

Section: Commentsupporting

confidence: 56%

Predictive Factors of Postoperative Mortality After Junctional and Gastric Adenocarcinoma Resection

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Although many phase II trials have adopted pathRR as the primary endpoint, there is no globally accepted consensus regarding the optimal cutoff percentage to determine the responder. Various definitions regarding the cutoff percentage of residual tumors such as 10 % [7][8][9][10][11][12], 40 % [13], 50 % [9,14], or 67 % [15][16][17][18][19][20][21][22][23] have been used in previous clinical trials. According to the criteria proposed by Becker et al [24,25], 10 or 50 % is typically used as the cutoff percentage in Western countries, while 33 or 67 % is commonly used in Asian countries following the definition specified in the Japanese Classification of Gastric Carcinoma [26].…”

Section: Introductionmentioning

confidence: 99%

Determination of the optimal cutoff percentage of residual tumors to define the pathological response rate for gastric cancer treated with preoperative therapy (JCOG1004-A)

Nakamura

Kuwata

Shimoda³

et al. 2014

Gastric Cancer

View full text Add to dashboard Cite

Background Pathological response rate (pathRR) is a common endpoint used to assess the efficacy of preoperative therapy for gastric cancer. PathRR is estimated based on the percentage of the residual tumor area in the primary tumorous bed. Various cutoff definitions used in previous trials (e.g., 10, 33, 40, 50, 67 %) often impair the comparability of pathRRs between trials. Methods Individual patient data were used from four JCOG trials evaluating preoperative chemotherapy (JCOG0001, JCOG0002, JCOG0210, JCOG0405). Pathological specimens were evaluated from 173 out of 188 patients (92 %) who underwent surgery. Residual tumor area and primary tumorous beds were traced on a virtual microscopic slide by one pathologist and another confirmed these areas. The hazard ratio (HR) in overall survival was calculated for each cutoff percentage by stratified Cox regression analysis, including the study as a stratification factor, and concordance probability estimates (CPE) were calculated. Results The numbers of patients with 0%, 1-10 %, 11-33 %, 34-50 %, 51-66 %, and 67-100 % residual tumors were 8, 35, 33, 27, 23, and 47, respectively. HRs in 10, 33, 50, and 67 % cutoffs were 1.91, 1.70, 1.55, and 1.71 for the overall population, and CPEs were 0.56, 0.56, 0.55, and 0.55, respectively. In patients with R0 resection, HRs in 10, 33, 50, and 67 % cutoffs were 1.87, 1.54, 1.24, and 1.38, and CPEs were 0.56, 0.55, 0.52, and 0.52. In subgroup analyses, the 10 % cutoff did not predict survival well for type 4 (linitis plastica) tumors. Conclusions The 10 % cutoff should be the global standard cutoff of %residual tumor to determine pathRR. PathRR might not be recommended for clinical trials where the main subjects are type 4 tumors.

show abstract

“…Gastric cancer (GC) is the second leading cause of cancer death worldwide after lung cancer in 2010, although mortality deaths have decreased slightly from 774,000 in 1990 to about 755,000 in 2010 [1],[2]. Epidemiological studies have showed that environmental factor, including diet, tobacco smoking, alcoholic consumptions and, especially, infection with Helicobacter pylori are associated with a higher risk for GC [3], [4].…”

Section: Introductionmentioning

confidence: 99%

The has-miR-526b Binding-Site rs8506G>A Polymorphism in the lincRNA-NR_024015 Exon Identified by GWASs Predispose to Non-Cardia Gastric Cancer Risk

Fan

Huang

et al. 2014

PLoS ONE

View full text Add to dashboard Cite

Gastric cancer including the cardia and non-cardia types is the second frequent cause of cancer-related deaths worldwide. A subset of non-cardia gastric cancer genetic susceptibility loci have been addressed among Asian through genome-wide association studies (GWASs). This study was to evaluate the effects of single nucleotide polymorphisms (SNPs) of long intergenic non-coding RNAs (lincRNAs) on non-cardia gastric cancer susceptibility in Chinese populations. We selected long intergenic noncoding RNAs (lincRNAs) located in non-cardia gastric cancer risk-related loci and identified 10 SNPs located within lincRNA exonic regions. We examined whether genetic polymorphisms in lincRNAs exons are associated with non-cardia gastric cancer risk in 438 non-cardia gastric cancer patients and 727 control subjects in Chinese populations using logistic regression. Functional relevance was further examined by biochemical assays. We found that lincRNA-NR_024015 rs8506AA carrier was significantly associated with risk of non-cardia gastric cancer (adjusted odds ratio [OR] = 1.56, 95%CI = 1.03–2.39, compared with the rs8506 AG or GG genotype. Further stratification analysis showed that the risk effect was more pronounced in subgroups of smokers (P = 0.001). Biochemical analysis demonstrated that the G to A base change at rs8506G>A disrupts the binding site for has-miR-526b, thereby influencing the transcriptional activity of lincRNA-NR_024015 and affecting cell proliferation. Our present study established a robust association between the rs8506G>A polymorphism in the lincRNA-NR_024015 exon and the risk of non-cardia gastric cancer.

show abstract

Morbidity, mortality, and pathological response in patients with gastric cancer preoperatively treated with chemotherapy or chemoradiotherapy

Cited by 39 publications

References 30 publications

Predictive Factors of Postoperative Mortality After Junctional and Gastric Adenocarcinoma Resection

Predictive Factors of Postoperative Mortality After Junctional and Gastric Adenocarcinoma Resection

Determination of the optimal cutoff percentage of residual tumors to define the pathological response rate for gastric cancer treated with preoperative therapy (JCOG1004-A)

The has-miR-526b Binding-Site rs8506G>A Polymorphism in the lincRNA-NR_024015 Exon Identified by GWASs Predispose to Non-Cardia Gastric Cancer Risk

Contact Info

Product

Resources

About