A Distinct Clinicopathological Feature and Prognosis of Young Gastric Cancer Patients Aged ≤ 45 Years Old

Huang, Qian; Zheng, Xiufeng; Jiao, Yang; Lei, Yanna; Li, Xiaoying; Feng, Bo; Guo, Fukun; Wang, Gang; Liu, Ming

doi:10.3389/fonc.2021.674224

Cited by 14 publications

(20 citation statements)

References 36 publications

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“…In several cancer types, younger patients have been shown to have faster disease progression. [13][14][15][16] This may explain why younger age was found to increase the risk of switching to high-dose methadone. Moreover, outpatient status may have increased the risk of highdose switching for different reasons.…”

Section: Discussionmentioning

confidence: 99%

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A Survey of the Status of Methadone Switching in Japan Using a Hospital‐Based Administrative Claims Database

Imai,

Aoki,

Ikegami

et al. 2023

The Journal of Clinical Pharma

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Methadone is generally used for the management of cancer pain in patients who cannot obtain adequate analgesia from other strong opioids; however, it has a complicated and inconsistent conversion ratio from pre‐switching opioid dosage to methadone. This issue may be pronounced in Japan because only oral tablets are commercially available. We aimed to elucidate the status of methadone switching in Japan, focusing on its dosage. Using a Japanese hospital‐based administrative claims database, we included patients who switched to methadone between April 2008 and January 2021. The proportion of methadone switching completion that required more than the defined conversion ratio in the Japanese package insert (called “high‐dose methadone switching”) was evaluated as a primary endpoint. Other endpoints included “the duration from initiation to completion of methadone switching” and “factors affecting high‐dose methadone switching by using multivariate logistic regression analysis.” Of 1,585 patients who received methadone, 370 were enrolled. Among those, 130 (35.1%) received high‐dose methadone switching. The median duration of methadone switching completion (12 days) was longer in the high‐dose methadone switching group than in other patients. Four variables were identified as factors affecting high‐dose methadone switching. Younger age and outpatient status increased the risk of requiring high‐dose methadone switching, whereas the concomitant use of nonsteroidal anti‐inflammatory drugs and fentanyl as a pre‐switching opioid decreased the risk. In conclusion, more than 30% of the patients underwent high‐dose methadone switching and required long completion periods, suggesting that methadone switching remains challenging in Japan.This article is protected by copyright. All rights reserved

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Section: Discussionmentioning

confidence: 99%

“…Conversely, factors that decreased the risk included the concomitant use of NSAIDs and fentanyl as the pre‐switching opioid. In several cancer types, younger patients have been shown to have faster disease progression 13‐16 . This may explain why younger age was found to increase the risk of switching to high‐dose methadone.…”

Section: Discussionmentioning

confidence: 99%

A Survey of the Status of Methadone Switching in Japan Using a Hospital‐Based Administrative Claims Database

Imai,

Aoki,

Ikegami

et al. 2023

The Journal of Clinical Pharma

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“…Others have shown that EOGC displays unique genomic features. For example, tumors of patients with EOGC are more likely to have a diffuse histologic subtype and include signet ring cells, more likely to contain mutated CDH1 , BANP , MUC5B , and TGFBR1 genes, and less likely to contain microsatellite instability [ 9 , 17 , 18 , 19 ]. While smoking and alcohol use are known modifiable risk factors for the development of gastric cancer, particularly in the US, where the prevalence of Helicobacter pylori infection is relatively low, modifiable risk factors such as smoking and alcohol use were not found to be associated with the development of EOGC in an analysis of the Behavioral Risk Factor Surveillance System [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Variation in Treatment Patterns of Patients with Early-Onset Gastric Cancer

LaPelusa

Shen

Gillaspie

et al. 2022

Cancers

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Background: Early-onset gastric cancer (EOGC), or gastric cancer in patients younger than 45 years old, is poorly understood and relatively uncommon. Similar to other gastrointestinal malignancies, the incidence of EOGC is rising in Western countries. It is unclear which populations experience a disproportionate burden of EOGC and what factors influence how patients with EOGC are treated. Methods: We conducted a retrospective, population-based study of patients diagnosed with gastric cancer from 2004 to 2018 using the National Cancer Database (NCDB). In addition to identifying unique demographic characteristics of patients with EOGC, we evaluated (using multivariable logistic regression controlling for year of diagnoses, primary site, and stage) how gender/sex, race/ethnicity, treatment facility type, payor status, and location of residence influenced the receipt of surgery, chemotherapy, and radiation. Results: Compared to patients 45–70 and >70 years of age with gastric cancer, patients with EOGC were more likely to be female, Asian/Pacific Islander (PI), African American (AA), Hispanic, uninsured, and present with stage IV disease. On multivariable analysis, several differences among subsets of patients with EOGC were identified. Female patients with EOGC were less likely to receive surgery and chemotherapy than male patients with EOGC. Asian/Pacific Islander patients with EOGC were more likely to receive chemotherapy and less likely to receive radiation than Caucasian patients with EOGC. African American patients were more likely to receive chemotherapy than Caucasian patients with EOGC. Hispanic patients were more likely to receive surgery and chemotherapy and less likely to receive radiation than Caucasian patients with EOGC. Patients with EOGC treated at community cancer centers were more likely to receive surgery and less likely to receive chemotherapy than patients with EOGC treated at academic centers. Uninsured patients with EOGC were more likely to receive surgery and less likely to receive chemotherapy than privately insured patients with EOGC. Patients with EOGC living in locations not adjacent to metropolitan areas were less likely to receive surgery compared to patients with EOGC who resided in metropolitan areas, Conclusions: Patients with EOGC are a demographically distinct population. Treatment of these patients varies significantly based on several demographic factors. Additional analysis is needed to elucidate why particular groups are more affected by EOGC and how treatment decisions are made for, and by, these patients.

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“…Therefore, these patients require special attention. According to Qian Huang et al, early-onset GC is associated with diffuse Lauren type and poorly differentiated tumors (19). Surprisingly, after adjusting for other variables, the degree of tumor differentiation was eventually excluded from our prediction nomogram.…”

Section: Radiationmentioning

confidence: 91%

Retrospective analysis of risk factors for distant metastasis of early-onset gastric cancer during the perioperative period

Deng

Duan

et al. 2023

Front. Oncol.

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BackgroundAlthough the overall global incidence of gastric cancer has been declining, the number of new cases in people under the age of 50 is increasing, which is related to metastasis, late pathological stages, and poor prognosis. There is a scarcity of large-scale studies to evaluate and predict distant metastasis in patients with early-onset gastric cancer.MethodsFrom January 2010 to December 2019, data on early-onset GC patients undergoing surgery were gathered from the Surveillance, Epidemiology, and End Results (SEER) database. We investigated the independent risk factors for distant metastasis in patients with early-onset gastric cancer. Based on these risk factors, we developed a nomogram to predict distant metastasis. The model underwent internal validation on the test set and external validation on 205 patients from the First Affiliated Hospital of Sun Yat-sen University and the seventh Affiliated Hospital of Sun Yat-sen University. The novel nomogram model was then evaluated using the receiver operating characteristic (ROC) curve, calibration, the area under the curve (AUC), and decision curve analysis (DCA). The training set nomogram score was used to classify the different risk clusters of distant metastasis.ResultsOur study enrolled 2217 patients after establishing the inclusion and exclusion criteria, with 1873 having no distant metastasis and 344 having distant metastasis. The tumor size, total lymph nodes, whether or not receiving radiotherapy and chemotherapy, T stage, and N stage were significant predictors of advanced distant metastasis (p < 0.05). The AUC of the ROC analysis demonstrated our model’s high accuracy. Simultaneously, the prediction model shows high stability and clinical practicability in the calibration curve and DCA analysis.ConclusionsWe developed an innovative nomogram containing clinical and pathological characteristics to predict distant metastasis in patients younger than 50 years old with gastric cancer. The tool can alert clinicians about distant metastasis and help them develop more effective clinical treatment plans.

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A Distinct Clinicopathological Feature and Prognosis of Young Gastric Cancer Patients Aged ≤ 45 Years Old

Cited by 14 publications

References 36 publications

A Survey of the Status of Methadone Switching in Japan Using a Hospital‐Based Administrative Claims Database

A Survey of the Status of Methadone Switching in Japan Using a Hospital‐Based Administrative Claims Database

Variation in Treatment Patterns of Patients with Early-Onset Gastric Cancer

Retrospective analysis of risk factors for distant metastasis of early-onset gastric cancer during the perioperative period

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