Adenocarcinoma with Mixed Subtypes in the Early and Advanced Gastric Cancer

Zhao, Xixian; Li, Yizhang; Yang, Zhenwei; Zhang, Hailin; Wang, Hongling; Lin, Jun; Liu, Jing; Zhao, Qiu

doi:10.1155/2021/8497305

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…In histological type, we found that the prognosis of undifferentiated carcinoma was the worst in both OS and CSS, while the prognosis of signet ring cell carcinoma (SRCC) and adenocarcinoma did not differ significantly. This is consistent with the study of Zhao et al, who found little difference in the prognosis of the three types of adenocarcinomas (mixed, classic, and mucinous) and SRCC in advanced gastric cancer (40).…”

Section: Discussionsupporting

confidence: 93%

Developing and validating nomograms for predicting the survival in patients with clinical local-advanced gastric cancer

2022

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BackgroundMany patients with gastric cancer are at a locally advanced stage during initial diagnosis. TNM staging is inaccurate in predicting survival. This study aims to develop two more accurate survival prediction models for patients with locally advanced gastric cancer (LAGC) and guide clinical decision-making.MethodsWe recruited 2794 patients diagnosed with LAGC (2010–2015) from the Surveillance, Epidemiology, and End Results (SEER) database and performed external validation using data from 115 patients with LAGC at Yantai Affiliated Hospital of Binzhou Medical University. Univariate and multifactorial survival analyses were screened for meaningful independent prognostic factors and were used to build survival prediction models. Concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were evaluated for nomograms. Finally, the differences and relationships of survival and prognosis between the three different risk groups were described using the Kaplan–Meier method.ResultsCox proportional risk regression model analysis identified independent prognostic factors for patients with LAGC, and variables associated with overall survival (OS) included age, race, marital status, T-stage, N-stage, grade, histologic type, surgery, and chemotherapy. Variables associated with cancer-specific survival (CSS) included age, race, T-stage, N-stage, grade, histological type, surgery, and chemotherapy. In the training cohort, C-index of nomogram for predicting OS was 0.722 (95% confidence interval [95% CI]: 0.708–0.736] and CSS was 0.728 (95% CI: 0.713–0.743). In the external validation cohort, C-index of nomogram for predicted OS was 0.728 (95% CI:0.672–0.784) and CSS was 0.727 (95% CI:0.668–0.786). The calibration curves showed good concordance between the predicted and actual results. C-index, ROC, and DCA results indicated that our nomograms could more accurately predict OS and CSS than TNM staging and had a higher clinical benefit. Finally, to facilitate clinical use, we set up two web servers based on nomograms.ConclusionThe nomograms established in this study have better risk assessment ability than the clinical staging system, which can help clinicians predict the individual survival of LAGC patients more accurately and thus develop appropriate treatment strategies.

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Section: Discussionsupporting

confidence: 93%

Developing and validating nomograms for predicting the survival in patients with clinical local-advanced gastric cancer

2022

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“…In our study, LNM rate of mixed type EGC was higher than rate of pure histology type EGC (16.6% vs. 6.1%, p < 0.01), which supports some of the previous reports ( 24 – 26 ). However, we revealed a pattern that clinicopathological features including LNM rate differ according to PUC level.…”

Section: Discussionsupporting

confidence: 91%

“…Several parameters such as LVI, tumor size, invasion depth, presence of ulcer had been confirmed to be related to LNM in EGC. Several previous studies showed that EGC with mixed histological type was more aggressive ( 24 – 26 ), but none of the studies focused on the PUC levels, which might be different on clinicopathological features and related to LNM in EGC. Since proportion of each histologic type varies widely in different EGC lesions, we investigated clinicopathological features of EGC according to different PUC levels.…”

Section: Discussionmentioning

confidence: 98%

Clinicopathological characteristics of early gastric cancer with different level of undifferentiated component and nomogram to predict lymph node metastasis

Xie²,

Chen³

et al. 2023

Front. Surg.

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BackgroundFew studies showed that mixed type early gastric cancer (EGC) relates to higher risk of lymph node metastasis. We aimed to explore the clinicopathological feature of GC according to different proportions of undifferentiated components (PUC) and develop a nomogram to predict status of lymph node metastasis (LNM) in EGC lesions.MethodsClinicopathological data of the 4,375 patients who underwent surgically resection for gastric cancer in our center were retrospectively evaluated and finally 626 cases were included. We classified mixed type lesions into five groups (M1:0% < PUC ≤ 20%, M2:20%<PUC ≤ 40%, M3:40%<PUC ≤ 60%, M4:60%<PUC ≤ 80%, M5:80%<PUC < 100%). Lesions with 0% PUC were classified as pure differentiated group (PD) and lesions with 100% PUC were classified as pure undifferentiated group (PUD).ResultsCompared with PD, LNM rate was higher in group M4 and group M5 (p < 0.05 after Bonferroni correction). Differences of tumor size, presence of lymphovascular invasion (LVI), perineural invasion and invasion depth also exist between groups. No statistical difference of LNM rate was found in cases who met the absolute endoscopic submucosal dissection (ESD) indications for EGC patients. Multivariate analysis revealed that tumor size over 2 cm, submucosa invasion to SM2, presence of LVI and PUC level M4 significantly predicted LNM in EGC. With the AUC of 0.899(P < 0.05), the nomogram exhibited a good discrimination. Internal validation by Hosmer–Lemeshow test showed a good fitting effect in model (P > 0.05).ConclusionPUC level should be considered as one of the predicting risk factors of LNM in EGC. A nomogram that predicts the risk of LNM in EGC was developed.

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“…Heger U (2014) [8]; Hsu JT (2016) [60]; Imamura T (2016) [34]; Jiang CG (2011) [53]; Kao YC (2019) [68]; Khan N (2020) [82]; Lemoine N (2016) [77]; Liu X (2015) [59]; Lu M (2016) [62]; Luu C (2017) [88]; Men HT (2016) [49]; Piessen G (2012) [79]; Postlewait LM (2015) [85]; Riihimäki M (2016) [78]; Schmidt T (2014) [80]; Shim JH (2014) [58]; Shridhar R (2013) [83]; Taghavi S (2012) [84]; Tang CT (2020) [90]; Voron T (2016) [81]; Wang Z (2015) [32]; Zhao X (2021) [92]; Zu H (2014) [46].…”

Section: Lymphovascular Invasionmentioning

confidence: 99%

Clinical Features of Gastric Signet Ring Cell Cancer: Results from a Systematic Review and Meta-Analysis

Dal Cero,

Bencivenga,

Liu

et al. 2023

Cancers

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Background: Conflicting results about the prognostic relevance of signet ring cell histology in gastric cancer have been reported. We aimed to perform a meta-analysis focusing on the clinicopathological features and prognosis of this subgroup of cancer compared with other histologies. Methods: A systematic literature search in the PubMed database was conducted, including all publications up to 1 October 2021. A meta-analysis comparing the results of the studies was performed. Results: A total of 2062 studies referring to gastric cancer with signet ring cell histology were identified, of which 262 studies reported on its relationship with clinical information. Of these, 74 were suitable to be included in the meta-analysis. A slightly lower risk of developing nodal metastases in signet ring cell tumours compared to other histotypes was found (especially to undifferentiated/poorly differentiated/mucinous and mixed histotypes); the lower risk was more evident in early and slightly increased in advanced gastric cancer. Survival tended to be better in early stage signet ring cell cancer compared to other histotypes; no differences were shown in advanced stages, and survival was poorer in metastatic patients. In the subgroup analysis, survival in signet ring cell cancer was slightly worse compared to non-signet ring cell cancer and differentiated/well-to-moderately differentiated adenocarcinoma. Conclusions: Most of the conflicting results in signet ring cell gastric cancer literature could be derived from the lack of standardisation in their classification and the comparison with the different subtypes of gastric cancer. There is a critical need to strive for a standardised classification system for gastric cancer, fostering clarity and coherence in the forthcoming research and clinical applications.

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Adenocarcinoma with Mixed Subtypes in the Early and Advanced Gastric Cancer

Cited by 6 publications

References 24 publications

Developing and validating nomograms for predicting the survival in patients with clinical local-advanced gastric cancer

Developing and validating nomograms for predicting the survival in patients with clinical local-advanced gastric cancer

Clinicopathological characteristics of early gastric cancer with different level of undifferentiated component and nomogram to predict lymph node metastasis

Clinical Features of Gastric Signet Ring Cell Cancer: Results from a Systematic Review and Meta-Analysis

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