Predictors and Prognostic Implications of Perioperative Chemotherapy Completion in Gastric Cancer

Karagkounis, Georgios; Squires, Malcolm H.; Melis, Marcovalerio; Poultsides, George A.; Worhunsky, David J.; Jin, Linda X.; Fields, Ryan C.; Spolverato, Gaya; Pawlik, Timothy M.; Votanopoulos, Konstantinos I.; Levine, Edward A.; Schmidt, Carl; Bloomston, Mark; Cho, Clifford S.; Weber, Sharon M.; Masi, Antonio; Berman, Russell S.; Pachter, H. Leon; Staley, Charles A.; Newman, Elliot; Maithel, Shishir K.; Hatzaras, Ioannis

doi:10.1007/s11605-017-3594-8

Cited by 11 publications

(10 citation statements)

References 16 publications

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“…Based on national guidelines, 7 this group would be recommended to receive adjuvant therapy postoperatively; however, the majority of patients included did not receive adjuvant chemotherapy in this study; only 30.8% in the OG group and 27.6% in the MIS group went on to receive chemotherapy postoperatively. A wide range of rates of utilization and completion of adjuvant therapy have been reported in patients undergoing gastrectomy, ranging from as low as 29% to 68%, and are thought to be closely related to postoperative morbidity and complication rates 12,32 . As omission of adjuvant therapy has been shown to lead to poorer outcomes, including in this study where we found a 16% reduction in adjusted mortality for those who received adjuvant therapy, there is significant interest in improving these rates 4,26,32‐34 .…”

Section: Discussionmentioning

confidence: 55%

“…A wide range of rates of utilization and completion of adjuvant therapy have been reported in patients undergoing gastrectomy, ranging from as low as 29% to 68%, and are thought to be closely related to postoperative morbidity and complication rates 12,32 . As omission of adjuvant therapy has been shown to lead to poorer outcomes, including in this study where we found a 16% reduction in adjusted mortality for those who received adjuvant therapy, there is significant interest in improving these rates 4,26,32‐34 . Guideline adherence to appropriate adjuvant therapy remains a significant challenge in gastric cancer, and comprehensive efforts should be made to improve adherence; in this study, we found that, at least currently, the use of MIS alone does not significantly impact the use of adjuvant therapy.…”

Section: Discussionmentioning

confidence: 66%

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Impact of minimally invasive gastrectomy on use of and time to adjuvant chemotherapy for gastric adenocarcinoma

Farrow

Freischlag

Adam

et al. 2020

Journal of Surgical Oncology

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Background: Chemotherapy improves outcomes in patients with resectable gastric cancer. Minimally invasive gastrectomy (MIS) rates are increasing, though the impact of MIS on postoperative chemotherapy remains uncertain. This study examines the impact of MIS vs open gastrectomy (OG) on utilization of adjuvant chemotherapy for high-risk gastric cancer. Methods: Patients in the National Cancer Database who underwent resection for high-risk gastric adenocarcinoma between 2010 and 2015 were included. Patients were stratified by surgical approach (MIS vs OG) and analyzed using multivariable regression modeling. Primary endpoints were utilization of and time to initiation of adjuvant chemotherapy. Results: Overall, 23 071 patients were included; 16 595 (71.9%) underwent OG and 6476 (28.1%) underwent MIS. After adjusting for patient and tumor characteristics, MIS was not associated with increased use of adjuvant chemotherapy (odds ratio [OR]: 1.027, 95% confidence interval [CI]: 0.95 to 1.11, P = .50), and time to initiationof chemotherapy was similar (−2% change, 95% CI: −5% to +1%, P = .27). MIS was associated with shorter hospital stays (−1 day). Thirty-day readmission rates, 90-day mortality, and overall survival were similar between groups.Conclusions: In this study, while MIS for gastric adenocarcinoma was associated with shorter hospital stays and comparable survival, it was not associated with improved utilization or time to initiation of adjuvant chemotherapy.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 66%

Impact of minimally invasive gastrectomy on use of and time to adjuvant chemotherapy for gastric adenocarcinoma

Farrow

Freischlag

Adam

et al. 2020

Journal of Surgical Oncology

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“…Gastric cancer is a malignant tumor that originated from the gastric mucosal epithelium, and its incidence ranks first among all kinds of malignant tumors in China [18, 19]. Most of the early gastric cancer can receive radical treatment under surgical therapy, and the 5-year survival rate is over 90% [20]. However, the diagnosis and treatment rate of early gastric cancer in China is less than 10%, far lower than that in other Southeast Asian countries, such as Japan (70%) and South Korea (50%) [21].…”

Section: Discussionmentioning

confidence: 99%

KIF23 Promotes Gastric Cancer by Stimulating Cell Proliferation

Song

et al. 2019

Disease Markers

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Gastric cancer (GC) is one of the most aggressive malignant tumors with low early diagnosis and high metastasis. Despite progress in treatment, to combat this disease, a better understanding of the underlying mechanisms and novel therapeutic targets is needed. KIF23, which belongs to the KIF family, plays a vital role in various cell processes, such as cytoplasm separation and axon elongation. Nowadays, KIF23 has been found to be highly expressed in multiple tumor tissues and cells, suggesting a potential link between KIF23 and tumorigenesis. Herein, we reported that KIF23 expression was correlated with poor prognosis of gastric cancer and found an association between KIF23 and pTNM stage. An in vitro assay proved that the proliferation of gastric cancer cells was significantly inhibited, which is caused by KIF23 depletion. Additionally, knockdown of KIF23 resulted in a marked inhibition of cell proliferation of gastric cancer in mice, with significant downregulation of Ki67 and PCNA expression. In conclusion, these data indicate that KIF23 is a potential therapeutic target for gastric cancer treatment.

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“…To summarize previous data and to put our data into perspective, we performed a systematic review of existing studies (Table 2) and summarized subgroup analyses of the respective studies focusing on the potential benefit of postoperative chemotherapy (Table 3). [12] good HPR (TRG 1-3) 129 70 vs. 59 improved OS in periCTx patients with preCTx responsive disease (HR 0.51, 95%CI 0.28-0.93, p = 0.028) Karagkounis et al, 2017 [13] stage II (AJCC 7th) 43 26 vs. 17 improved DFS in periCTx patients with stage II tumors (20% vs. 64.7%, p = 0.003)…”

Section: Review Of the Literaturementioning

confidence: 99%

Impact of Postoperative Chemotherapy in Patients with Gastric/Gastroesophageal Adenocarcinoma Treated with Perioperative Chemotherapy

et al. 2022

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Perioperative chemotherapy is the standard of care for patients undergoing curative resection for gastroesophageal adenocarcinoma. However, less than 50% of patients complete postoperative chemotherapy, and the added benefit to preoperative chemotherapy remains unclear. The aim of this study was to compare disease-free and overall survival (DFS and OS) in patients with perioperative chemotherapy to those who received preoperative chemotherapy only. In addition, a current literature overview is included. This multicenter, retrospective case series included 124 patients with gastroesophageal adenocarcinoma undergoing potentially curative resection and receiving pre- or perioperative chemotherapy between 2006 and 2010. Histopathological, demographic, clinical, and survival data were used to identify the impact of perioperative vs. preoperative chemotherapy on DFS and OS. Patients with perioperative chemotherapy had significantly improved DFS and OS (median DFS 28.0 months; 95%CI 0–62.4 vs. 19.0 months; 95%CI 10.5–27.5; p = 0.008 and median OS 35.7 months; 95%CI 0–73.6 vs. 19.2 months; 95%CI 7.8–30.4; p = 0.002). However, in contrast to patients with tumor-free lymph nodes at the time of resection, patients with positive lymph node status did not significantly benefit from additional postoperative chemotherapy in subgroup analysis. Further studies are encouraged to investigate optimal adjuvant treatment strategies for primary chemotherapy-resistant patients.

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Predictors and Prognostic Implications of Perioperative Chemotherapy Completion in Gastric Cancer

Abstract: Completion of perioperative chemotherapy was successful in two thirds of patients with gastric cancer and was independently associated with improved survival.

Cited by 11 publications

References 16 publications

Impact of minimally invasive gastrectomy on use of and time to adjuvant chemotherapy for gastric adenocarcinoma

Impact of minimally invasive gastrectomy on use of and time to adjuvant chemotherapy for gastric adenocarcinoma

KIF23 Promotes Gastric Cancer by Stimulating Cell Proliferation

Impact of Postoperative Chemotherapy in Patients with Gastric/Gastroesophageal Adenocarcinoma Treated with Perioperative Chemotherapy

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