OBJECTIVES:Surgery remains the cornerstone treatment modality for gastric cancer, the fifth most common type of tumor in Brazil. The aim of this study was to analyze the surgical treatment outcomes of patients with gastric cancer who were referred to a high-volume university hospital.METHODS:We reviewed all consecutive patients who underwent any surgical procedure due to gastric cancer from a prospectively collected database. Clinicopathological characteristics, surgical and survival outcomes were evaluated, with emphasis on patients treated with curative intent.RESULTS:From 2008 to 2017, 934 patients with gastric tumors underwent surgical procedures in our center. Gastric adenocarcinoma accounted for the majority of cases. Of the 875 patients with gastric adenocarcinoma, resection with curative intent was performed in 63.5%, and palliative treatment was performed in 22.4%. The postoperative surgical mortality rate for resected cases was 5.3% and was related to D1 lymphadenectomy and the presence of comorbidities. Analysis of patients treated with curative intent showed that resection extent, pT category, pN category and final pTNM stage were related to disease-free survival (DFS) and overall survival (OS). The DFS rates for D1 and D2 lymphadenectomy were similar, but D2 lymphadenectomy significantly improved the OS rate. Additionally, clinical factors and the presence of comorbidities had influence on the OS.CONCLUSIONS:TNM stage and the type of lymphadenectomy were independent factors related to prognosis. Early diagnosis should be sought to offer the optimal surgical approach in patients with less-advanced disease.

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Background: Brazilian population displays very high levels of genomic diversity due to the multi-ethnicity, which have important clinical/genomic implications. The vascular endothelial growth factor-A (VEGF-A) and Cyclooxygenase-2 (Cox-2) polymorphisms have been implicated in colorectal cancer (CRC) risk, however, the results on the association between polymorphisms and cancer risk are conflicting. VEGF and Cox-2 polymorphisms might modify the levels of mRNA and protein expression and may have a considerable influence on disease phenotype. Aim: We carried out a case-control study to evaluate whether polymorphisms of VEGF-A and Cox-2 genes modulate the risk of developing CRC. We also aimed to investigate possible interactions between these genetic variations and environmental factors in CRC. Methods: We evaluated VEGF-A and Cox-2 genotypes obtained from a series of 230 CRC patients and 194 controls from the Hospital-based Brazilian population. DNA was isolated from leukocyte using extraction and purification kit PureLink, followed by amplification by polymerase chain reaction (PCR). Real-time analysis was used for genotyping of polymorphisms of VEGF-A and Cox-2, through the TaqMan ® SNP Genotyping Assay. There was no difference between the cases and controls regarding gender, age, ethnicity, and no individual or familial history of cancer was found in control cases. Results: We determined frequencies of four VEGF-A biallelic polymorphisms (-2578C>A, -460T>C, -634G>C, +936C>T), with twelve genotypes; and three Cox-2 polymorphisms (-1195A>G, -765G>C, 8437T>C,) with nine genotypes. The genotypes frequencies were similar in both case and control groups, and there was, therefore, no association between these genotypes and CRC risk. A high frequency of the wild genotype Cox-2 -765GG and 8437TT and polymorphic genotype Cox-2 -1195GG and VEGF-A -634CC was found in an Asiatic (mostly Japanese) population. Moreover, VEGF-A -2578C>A, and -460T>C were associated to familial history of cancer in the cases series. Tobacco consumption was marginally associated to Cox-2 -1195A>G genotype. Conclusion: VEGF-A and Cox-2 gene polymorphisms are not associated with an increased risk of CRC in a Brazilian population. We could demonstrate the genotype differences among ethnicity, and the association of these polymorphisms with some risk-factors for CRC. Citation Format: Michele T. P. Tomitão, Márcia S. Kubrusly, Guilherme C. Cotti, Evelise P. Zaidan, Adriana V. Safatle-Ribeiro, Suely K. N. Marie, Ivan Cecconello, Sergio C. Nahas, Ulysses Ribeiro. VEGF-A and Cox-2 gene polymorphisms and susceptibility to colorectal cancer in Brazilian population. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4845. doi:10.1158/1538-7445.AM2013-4845

BACKGROUND: The enzyme methylenetetrahydrofolate reductase is engaged in DNA synthesis through folate metabolism. Inhibiting the activity of this enzyme increases the susceptibility to mutations, and damage and aberrant DNA methylation, which alters the gene expression of tumor suppressors and proto-oncogenes, potential risk factors for esophageal cancer. AIMS: This study aimed to investigate the association between methylenetetrahydrofolate reductase 677C>T and methylenetetrahydrofolate reductase 1298A>C polymorphisms and susceptibility to esophageal cancer, by assessing the distribution of genotypes and haplotypes between cases and controls, as well as to investigate the association of polymorphisms with clinical and epidemiological characteristics and survival. METHODS: A total of 109 esophageal cancer patients who underwent esophagectomy were evaluated, while 102 subjects constitute the control group. Genomic DNA was isolated from the peripheral blood buffy coat followed by amplification by polymerase chain reaction and real-time analysis. Logistic regression was used to assess associations between polymorphisms and the risk of developing esophageal cancer. RESULTS: There was no association for methylenetetrahydrofolate reductase 677C>T and methylenetetrahydrofolate reductase 1298A>C polymorphisms and haplotypes, with esophageal cancer susceptibility. Esophageal cancer patients carrying methylenetetrahydrofolate reductase 677TT polymorphism had higher risk of death from the disease. For polymorphic homozygote TT genotype, the risk of death significantly increased compared to wild-type genotype methylenetetrahydrofolate reductase 677CC (reference) cases (p=0.045; RR=2.22, 95%CI 1.02–4.83). CONCLUSIONS: There was no association between methylenetetrahydrofolate reductase 677C>T and methylenetetrahydrofolate reductase 1298A>C polymorphisms and esophageal cancer susceptibility risk. Polymorphic homozygote genotype methylenetetrahydrofolate reductase 677TT was associated with higher risk of death after surgical treatment for esophageal cancer.