Prediction of Peritoneal Recurrence in Patients with Gastric Cancer: a Multicenter Study

Kuş, Tülay; Köse, Fatih; Aktaş, Gökmen; Arslan, Ulku Yalcintas; Sedef, Ali Murat; Çınkır, Havva Yeşil; Dirikoç, Merve; Akkus, Gulsum; Özdemir, Nuriye

doi:10.1007/s12029-020-00419-7

Cited by 11 publications

(8 citation statements)

References 21 publications

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“…In addition, through our pooled analyses, we found that patients in the SR group were more likely to occur peritoneal recurrence, which is closely associated with deeper tumor invasion (38). Consistently, our clinicopathological analysis also confirmed that the SR group had more advanced T staging.…”

Section: Discussionsupporting

confidence: 83%

Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis

et al. 2022

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BackgroundTo date, there is no evidence that intensive follow-up provides survival benefit in gastric cancer patients undergoing curative gastrectomy. The aim of this study is to investigate the efficacy of detection of asymptomatic recurrence using intensive surveillance strategy in long-term survival after curative gastric cancer surgery.MethodsA systematic review of electronic databases including PubMed, Embase, Web of Science, the Cochrane Library and China National Knowledge Infrastructure, Clinical Trials Registry and Google Scholar was performed up to April 2022. The primary outcomes were survival outcomes: overall survival, recurrence-free survival and post-recurrence survival. The secondary endpoints were clinicopathological features, recurrence patterns and treatment after recurrence. The registration number of this protocol is PROSPERO CRD42022327370.ResultsA total of 11 studies including 1898 participants were included. In the pooled analysis, the detection of asymptomatic recurrence was significantly associated with an improved overall survival compared to patients showing symptoms of recurrence (HR=0.67; 95%CI: 0.57-0.79; P<0.001), which was primarily driven by the prolongation of post-recurrence survival (HR=0.51; 95%CI: 0.42-0.61; P<0.001), since there was no significant difference observed in recurrence-free survival (HR=1.12; 95%CI: 0.81-1.55; P=0.48) between the two groups. Meanwhile, male sex and advanced T stage were more frequently observed in the symptomatic recurrence group. Furthermore, patients in the symptomatic recurrence group had a higher proportion of peritoneal relapse but lower proportion of distant lymph node metastasis. Additionally, patients in the symptomatic recurrence group were less likely to receive surgery treatment and post-recurrence chemotherapy.ConclusionThe detection of asymptomatic recurrence using intensive follow-up was associated with an appreciable improvement in overall survival. However, more robust data from high-quality studies are still required to verify this issue.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327370, identifier CRD42022327370.

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Section: Discussionsupporting

confidence: 83%

Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis

et al. 2022

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“…This study identified pT ≥ 3, pN3, Borrmann type 4, Ming infiltrative type and venous invasion as prognostic factors [8]. A 2020 Western study of 274 patients developed a prognostic score to identify patients at an increased risk of peritoneal recurrence after curative gastrectomy, identifying sex, pT stage, grading and signet ring cell histology as significant variables and detecting an 8.8-fold increased risk of peritoneal recurrence in patients with 3 or 4 of these factors [16]. This study included only patients with previously documented GC recurrence, and therefore, its clinical applicability was limited.…”

Section: Discussionmentioning

confidence: 95%

“…Quantifying the risk of peritoneal recurrence would be useful for improving decision-making in patients undergoing gastrectomy with curative intent and identifying highrisk patients who would probably benefit from prophylactic HIPEC or other intraperitoneal prophylactic treatments. The risk for carcinomatosis is influenced by specific GC subtypes that express different peritoneal tropism, as in diffuse and signet ring cell GC [9,10,13], but to date, few studies have developed prognostic models quantifying the actual risk for peritoneal recurrence in patients undergoing gastrectomy with curative intent [14], and even fewer have included indicators of the GC phenotype in these models [8,15,16].…”

Section: Introductionmentioning

confidence: 99%

Development of the PERI-Gastric (PEritoneal Recurrence Index) and PERI-Gram (Peritoneal Recurrence Index NomoGRAM) for predicting the risk of metachronous peritoneal carcinomatosis after gastrectomy with curative intent for gastric cancer

et al. 2021

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Background A model that quantifies the risk of peritoneal recurrence would be a useful tool for improving decision-making in patients undergoing curative-aim gastrectomy for gastric cancer (GC). Methods Five Italian centers participated in this study. Two risk scores were created according to the two most widely used pathologic classifications of GC (the Lauren classification and the presence of signet-ring-cell features). The risk scores (the PERI-Gastric 1 and 2) were based on the results of multivariable logistic regressions and presented as nomograms (the PERI-Gram 1 and 2). Discrimination was assessed with the area under the curve (AUC) of receiver operating curves. Calibration graphs were constructed by plotting the actual versus the predicted rate of peritoneal recurrence. Internal validation was performed with a bootstrap resampling method (1000 iterations). ResultsThe models were developed based on a population of 645 patients (selected from 1580 patients treated from 1998 to 2018). In the PERI-Gastric 1, significant variables were linitis plastica, stump GC, pT3-4, pN2-3 and the Lauren diffuse histotype, while in the PERI-Gastric 2, significant variables were linitis plastica, stump GC, pT3-4, pN2-3 and the presence of signet-ring cells. The AUC was 0,828 (0.778-0.877) for the PERI-Gastric 1 and 0,805 (0.755-0.855) for the PERI-Gastric 2. After bootstrap resampling, the PERI-Gastric 1 had a mean AUC of 0.775 (0.721-0.830) and a 95%CI estimate for the calibration slope of 0.852-1.505 and the PERI-Gastric 2 a mean AUC of 0.749 (0.693-0.805) and a 95%CI estimate for the slope of 0.777-1.351. The models are available at www. perig astric. org. Conclusions We developed the PERI-Gastric and the PERI-Gram as instruments to determine the risk of peritoneal recurrence after curative-aim gastrectomy. These models could direct the administration of prophylactic intraperitoneal treatments.

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“…Generally, female sex, invasive macroscopic type, T4 stage (positive serosal invasion), and poorly cohesive histology are associated with peritoneal recurrence. 4 However, the predictive value of these approaches is not so high, and the pathological diagnosis of serosal invasion is sometimes inferior to macroscopic diagnosis for prediction of peritoneal recurrence. 5 Additionally, several biomarkers have been reported to be associated with peritoneal recurrence, such as PECAM1.…”

Section: Predicting Peritoneal Recurrence By Artificial Intelligencementioning

confidence: 99%

Predicting peritoneal recurrence by artificial intelligence

Terashima

Irino

2022

The Lancet Digital Health

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Prediction of Peritoneal Recurrence in Patients with Gastric Cancer: a Multicenter Study

Cited by 11 publications

References 21 publications

Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis

Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis

Development of the PERI-Gastric (PEritoneal Recurrence Index) and PERI-Gram (Peritoneal Recurrence Index NomoGRAM) for predicting the risk of metachronous peritoneal carcinomatosis after gastrectomy with curative intent for gastric cancer

Predicting peritoneal recurrence by artificial intelligence

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