Prognostic value of diffuse versus intestinal histotype in patients with gastric cancer: a systematic review and meta-analysis

Petrelli, Fausto; Berenato, Rosa; Turati, Luca; Mennitto, Alessia; Steccanella, Francesca; Caporale, Marta; Dallera, P; Braud, Filippo de; Pezzica, E; Bartolomeo, Maria Di; Sgroi, Giovanni; Mazzaferro, Vincenzo; Pietrantonio, Filippo; Barni, Sandro

doi:10.21037/jgo.2017.01.10

Cited by 82 publications

(85 citation statements)

References 87 publications

(15 reference statements)

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“…Gastric cancer is one of the most frequently diagnosed malignancies and the second cause of cancer-related death in population [ 2 ]. According to Lauren's classification as well as the World Health Organization, there are two major histological entities of gastric cancer: intestinal and diffuse type [ 33 , 34 ]. Helicobacter pylori infection; Helicobacter pylori -associated chronic gastritis, atrophy, and intestinal metaplasia; lifestyle; and diet are the main risk factors for the development of intestinal type of gastric cancer [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Diverse Expression of IL-32 in Diffuse and Intestinal Types of Gastric Cancer

Pavlovic

Gajovic

Jurišević

et al. 2018

Gastroenterology Research and Practice

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Introduction Gastric cancer (GC) represents one of the most common cancers worldwide, frequently diagnosed at advanced stages with poor prognosis, indicating on need for new diagnostic and prognostic markers. The aim of the study was to determine the expression of IL-32, proinflammatory and angiogenic mediators, in patients with diffuse and intestinal gastric cancer and the relationship with clinicopathological aspects. Material and Methods The tissue samples of diffuse and intestinal types of tumor of 70 patients with gastric cancer were analyzed. Expression of IL-32, VEGF, IL-17, and CD31 was measured by immunohistochemistry. Results IL-32 expression was significantly lower in tissue samples from patients with diffuse type of gastric cancer that is also a severe and more progressive form (TNM stages III and IV, poor histological differentiation, and higher nuclear grade III). Expression of IL-17 was also decreased in patients with diffuse type of gastric cancer. Microvascular density was diminished in diffuse type of gastric cancer. Conclusions Downregulated expression of IL-32 in tumor tissue of patients with diffuse type of gastric cancer may implicate on its role in limiting ongoing proinflammatory and proangiogenic processes. This emphasizes on unrecognized role of IL-32 in biology of diffuse type of gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Diverse Expression of IL-32 in Diffuse and Intestinal Types of Gastric Cancer

Pavlovic

Gajovic

Jurišević

et al. 2018

Gastroenterology Research and Practice

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“…Increased RhoA activity in diffuse gastric cancer has been hypothesized to promote cancer stem cell-like phenotypes and chemoresistance, and RhoA inhibition might reverse chemoresistance [50]. A recent meta-analysis that included nearly 61,000 patients showed that patients with a diffuse histology had a worse prognosis than those with an intestinal-type histology (HR: 1.23; 95% CI: 1.17-1.29; p < 0.0001) in the loco-regional and advanced stages (HR:1.21; 95% IC: 1.12-1.30, p < 0.0001 and HR: 1.25; 95% IC: 1.046-1.50; p = 0.014, respectively), with or without neoadjuvant treatment [51]. While the Phase III FLOT4 study showed that a FLOT regimen was effective in patients with signet ring cells (HR: 0.74 versus 0.79 in the intestinal subgroup), thus confirming the utility of this regimen, the earlier phase II FLOT4 study reported overall pathological responses in intestinal histology of 23% and 10% in the FLOT and ECF/X arms, respectively, versus just 3% in both groups in the case of diffuse gastric cancers [9].…”

Section: Managementmentioning

confidence: 98%

Gastric Cancer with Radiographically Occult Metastatic Disease: Biology, Challenges, and Diagnostic Approaches

Sanjeevaiah

Fangman

Porembka

2020

Cancers

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Gastric adenocarcinoma is an aggressive cancer that demonstrates heterogeneous biology depending on patient ethnicity, tumor location, tumor type, and genetic profile. It remains the third leading cause of cancer deaths worldwide and was estimated to result in 782,000 deaths in 2018. Challenges exist in accurately assessing the disease burden, as available radiological staging often underestimates metastatic disease. This diagnostic handicap, along with the poor understanding of the heterogeneous biology of gastric cancer, has hindered the development of effective therapeutic solutions and thus halted improvement in patient outcomes over the last few decades. The management of occult peritoneal disease is complicated, as most patients are understaged by standard imaging studies and therefore thought to have local diseases. In this article, we systematically review recent literature on the limitations that are associated with standard radiographic staging, discuss recent molecular biology advances to better identify and diagnose occult peritoneal disease, and propose possible management strategies to approach this complicated clinical problem.

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“…However, recent data has shown that the presence of lymph node metastasis after a preoperative chemotherapy and surgery was the only independent prognostic factor for these patients, leading to reconsideration of the assumptions surrounding TRG [59]. Finally, although Lauren histotypes represent a well-known prognostic factor in GC with a worse survival in the dif-Visc Med 2020;36:364-372 DOI: 10.1159/000510489 fuse subtype [60], recent data has demonstrated that perioperative chemotherapy is effective for this subgroup of patients [3,61]. The preliminary results of the phase 2 PRODIGE-19 trial [61], which randomized 83 patients with resectable signet ring cell GC to receiving perioperative treatment or surgery followed by adjuvant chemotherapy, demonstrated that both modalities are effective (2-year OS = 53.5 and 60%, respectively).…”

Section: Radiological and Pathological Biomarkers For Response Duringmentioning

confidence: 99%

Biomarkers for Precision Treatment in Gastric Cancer

Petrillo

Smyth

2020

Visc Med

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Background: Gastric cancer (GC) is one of the most lethal cancers worldwide. Although GC was historically considered a single entity within the organ of origin, nowadays it is acknowledged that GC represents a heterogeneous disease. Nevertheless, in this field there is still a lack of biomarkers able to guide the choice of the best treatment options for each patient. This review aims to summarize the prognostic and predictive biomarkers evaluated in GC and their role as a guide for treatment for precision medicine. Summary: Human epidermal growth factor receptor 2 overexpression represents the only predictive molecular biomarker validated in GC, while its prognostic role is still controversial. Microsatellite instability and Epstein-Barr virus status are promising for prediction of the response to immunotherapy. The role of other biomarkers (ctDNA, programmed death ligand 1 [PD-L1], and TMB), as well as the practical application of molecular classifications, requires further evaluation before use in clinical practice. 18-FDG-PET scan could be useful as a predictive tool in non-metastatic GC patients receiving a perioperative approach. Finally, the tumor microenvironment may have an evolving role in the future. Key Messages: GC is a heterogeneous disease and targeted approaches are needed. The finding of prognostic and predictive factors is a hot topic in the field of GC personalized medicine.

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Prognostic value of diffuse versus intestinal histotype in patients with gastric cancer: a systematic review and meta-analysis

Abstract: Our results indicated that histology might be a useful prognostic marker for both early and advanced GC patients, with intestinal-type associated with a better outcome. This information could be used for stratification purpose in future clinical trials.

Cited by 82 publications

References 87 publications

Diverse Expression of IL-32 in Diffuse and Intestinal Types of Gastric Cancer

Diverse Expression of IL-32 in Diffuse and Intestinal Types of Gastric Cancer

Gastric Cancer with Radiographically Occult Metastatic Disease: Biology, Challenges, and Diagnostic Approaches

Biomarkers for Precision Treatment in Gastric Cancer

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