Prognostic Factors for Stage IV Gastric Cancer

Baba, H.; Kuwabara, Kouki; Ishiguro, Toru; Kumamoto, Kensuke; Kumagai, Yoshito; Ishibashi, Keiichiro; Haga, Norihiro; Ishida, Hideyuki

doi:10.9738/intsurg-d-12-00027.1

Cited by 13 publications

(11 citation statements)

References 25 publications

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“…The incidence and pathology of gastric cancer vary significantly by geography, especially between the East and the West. Globally, half of the cases occur in Eastern Asia, and the stages at initial consultation, as well as location of tumor and therapeutic outcomes, are different [2]. For example, due to the higher incidence of gastric cancer in Japan, systematic screening programs are common and result in the detection of gastric cancer in its early stages [3].…”

Section: Introductionmentioning

confidence: 99%

Recent Strategies for Treating Stage IV Gastric Cancer: Roles of Palliative Gastrectomy, Chemotherapy, and Radiotherapy

Izuishi

Mori

2016

JGLD

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Recently, many strategies have been reported for the effective treatment of gastric cancer. However, the strategy for treating stage IV gastric cancer remains controversial. Conducting a prospective phase III study in stage IV cancer patients is difficult because of heterogeneous performance status, age, and degree of cancer metastasis or extension. Due to poor prognosis, the variance in physical status, and severe symptoms, it is important to determine the optimal strategy for treating each individual stage IV patient. In the past decade, many reports have addressed topics related to stage IV gastric cancer: the 7th Union for International Cancer Control (UICC) TNM staging system has altered its stage IV classification; new chemotherapy regimens have been developed through the randomized ECF for advanced and locally advanced esophagogastric cancer (REAL)-II, S-1 plus cisplatin versus S-1 in RCT in the treatment for stomach cancer (SPIRITS), trastuzumab for gastric cancer (ToGA), ramucirumab monotherapy for previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD), and ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW) trials; and the survival efficacy of palliative gastrectomy has been denied by the reductive gastrectomy for advanced tumor in three Asian countries (REGATTA) trial. Current strategies for treating stage IV patients can be roughly divided into the following five categories: palliative gastrectomy, chemotherapy, radiotherapy, gastric stent, or bypass. In this article, we review recent publications and guidelines along with above categories in the light of individual symptoms and prognosis.

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Section: Introductionmentioning

confidence: 99%

Recent Strategies for Treating Stage IV Gastric Cancer: Roles of Palliative Gastrectomy, Chemotherapy, and Radiotherapy

Izuishi

Mori

2016

JGLD

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“…Gastric cancer (GC) is the second most common cause of death from cancer in the world, and little improvement in long-term survival has been achieved over decades [1]. Though chemotherapy is the most common treatment for GC, multidrug resistance (MDR) limited the effect of chemotherapy, which is caused by the development of resistance to multiple chemo-therapeutic agents [2].…”

Section: Introductionmentioning

confidence: 99%

MicroRNA‐106a induces multidrug resistance in gastric cancer by targeting RUNX3

Zhang

Cai

2013

FEBS Letters

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a b s t r a c tMultidrug resistance (MDR) is the main barrier to the success of chemotherapy for gastric cancer (GC). miR-106a, which is highly expressed in GC, influences a variety of aspects of GC. However, the function of miR-106a in MDR of GC still remains unclear. In the present study, we found that miR-106a is elevated in MDR cell lines. miR-106a promotes chemo-resistance of GC cells, accelerates ADR efflux, and suppresses drug-induced apoptosis. Finally, we show that runt-related trans factor 3 (RUNX3) is the functional target of miR-106a. Collectively, these findings demonstrate that miR106a may promote MDR in GC cells by targeting RUNX3.

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“…Moreover, gastrectomy itself may contribute to the continuation of modern chemotherapy by preventing tumor stenosis or bleeding if the surgery is reductive. 15 In this study, 91% (29 of 32) of patients who had undergone gastrectomy received first-line chemotherapy, mainly with S-1-based regimens. However, because chemotherapy with these regimens was not treated equally with all patients, its efficacy cannot be sufficiently evaluated.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Role of Gastrectomy in Patients With Gastric Cancer With Positive Peritoneal Cytology

Suzuki

Fukuchi

Mochiki

et al. 2014

International Surgery

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This retrospective study identified the optimal treatment strategy for patients with gastric cancer with positive peritoneal cytology. We analyzed clinicopathologic and survival data for 54 patients who had undergone gastrectomy and/or chemotherapy for treatment of gastric cancer with positive peritoneal cytology with (n ¼ 40) or without (n ¼ 14) metastatic disease. The median overall survival did not differ significantly between patients with gastric cancer with positive peritoneal cytology with and without metastatic disease (19 versus 13 months, respectively). Among 14 clinicopathologic variables, the lack of gastrectomy was the only significant independent unfavorable factor for survival (odds ratio, 1.64; 95% confidence interval, 1.04-2.57; P ¼ 0.03). The median overall survival significantly differed among patients who had undergone gastrectomy plus chemotherapy, chemotherapy alone, and gastrectomy alone (25, 10, and 17 months, respectively; P , 0.01). Gastrectomy may be optimal for patients with (gastric cancer with positive peritoneal cytology), considering its favorable prognostic effect with respect to perioperative chemotherapy.

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Prognostic Factors for Stage IV Gastric Cancer

Cited by 13 publications

References 25 publications

Recent Strategies for Treating Stage IV Gastric Cancer: Roles of Palliative Gastrectomy, Chemotherapy, and Radiotherapy

Recent Strategies for Treating Stage IV Gastric Cancer: Roles of Palliative Gastrectomy, Chemotherapy, and Radiotherapy

MicroRNA‐106a induces multidrug resistance in gastric cancer by targeting RUNX3

Prognostic Role of Gastrectomy in Patients With Gastric Cancer With Positive Peritoneal Cytology

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