Appraisal of compliance with the UICC/AJCC staging system in the staging of gastric cancer

Mullaney, P. J.; Wadley, M; Hyde, Christopher; Wyatt, John P.; Lawrence, Gill; Hallissey, M. T.; Fielding, J. W. L.

doi:10.1046/j.1365-2168.2002.02262.x

Cited by 56 publications

(39 citation statements)

References 14 publications

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“…This means that pre-operative staging should be as rigorous as possible in order to thoroughly define patients with diffuse or unresectable disease. Our rate of operability is still high (86%), similar to other important series published until the 90's (2) , though it has decreased since the second half of the second period when laparoscopy assessment was added as part of the staging, thereby coming closer to more recent series (39,53) . This is because laparoscopy can assess peritoneal implants that are difficult to detect in routine imaging exams and, in such cases, precludes palliative surgery (24,35) , leading to complementary procedures, such as neo-adjuvant chemotherapy (9,32,33,43,46) .…”

Section: Discussionsupporting

confidence: 69%

Gastric cancer patients treated by a general or gastric cancer surgical team: a comparative study

Souza¹,

Pereira

Santos

et al. 2008

Arq. Gastroenterol.

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-Background -Although gastric cancer has been decreasing in incidence in many countries, it is still the second most common cause of cancer deaths worldwide. Its prognosis is poor and depends, among other factors, on early diagnosis as well as on surgeon expertise. Aim -To compare the outcomes of gastric cancer patients treated at a university hospital by a general surgical team and later on by a gastric cancer surgical team. Methods -Gastric cancer patients were separated into two groups according to whether they were treated by a general surgical team (group 1, n = 136; 1984 to 1993) or by gastric cancer team (group 2, n = 149; 1994 to 2003). Clinical and pathologic features and survival rates were assessed. Results -During a 20-year period, a decreased number of patients underwent surgical resection in the second period (94% vs 86%), a greater number of upper gastrointestinal endoscopies were performed resulting in an increased number of tumors diagnosed as stage I (5% vs 22%). Also, D2 gastrectomies were more frequently performed instead of D0 gastrectomies and negative surgical margins were adequate. Mortality decreased from 9% to 6% in group 1 and 2, respectively and adjuvant therapy has been considered. Conclusion -Surgical specialized units for gastric cancer are necessary if better results are to be expected since this approach definitely provides better patient care.

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Section: Discussionsupporting

confidence: 69%

Gastric cancer patients treated by a general or gastric cancer surgical team: a comparative study

Souza¹,

Pereira

Santos

et al. 2008

Arq. Gastroenterol.

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“…10 Therefore, we sought to identify the proteins that may be involved in invasion and lymph node metastasis of gastric cancer by comparing The overall survival rate of all gastric cancer cases (n ϭ 93) was correlated with risk scores as shown in (A). C: The overall survival rate of the cases with a T3 gastric cancer (n ϭ 73) was determined based on their risk scores.…”

Section: Discussionmentioning

confidence: 99%

Protein Signatures for Classification and Prognosis of Gastric Cancer

Wang¹,

Ye²,

Sun³

et al. 2011

The American Journal of Pathology

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Current methods have limited accuracy in predicting survival and stratifying patients with gastric cancer for appropriate treatment. We sought to identify protein signatures of gastric cancer for classification and prognostication. The Protein Pathway Array (initial study) and Western blot (confirmation) were used to assess the protein expression in a total of 199 fresh frozen gastric samples. There were 56 paired samples divided into a training set (n ‫؍‬ 37) and a validation set (n ‫؍‬ 19) for the identification of differentially expressed proteins between tumor and normal tissues. There were 56 tumor samples used to identify proteins correlating with tumor and nodal staging. All 93 tumor samples were used to identify candidate proteins for predicting survival. We confirmed the survival prediction of the candidate proteins by using an additional cohort of gastric cancer samples (n ‫؍‬ 50). There were 22 proteins differentially expressed between normal and tumor tissues. Nine proteins were selected to build the predictor to classify normal and tumor samples. Ten proteins were differentially expressed among different T stages and four of these were associated with invasive behavior. An additional four proteins were associated with lymph node metastasis. Two proteins were identified as independent risk factors for overall survival. This study indicated that some dysregulated signaling proteins could be selected Gastric cancer is the fourth most common malignancy and ranked as the second leading cause of cancer death worldwide.1 The geographic distribution of incidence and mortality of gastric cancer varies remarkably worldwide. Areas with high incidence include Japan, Korea, China, Eastern Europe, and parts of Latin America. The mortality of gastric cancer has declined in past decades, mainly due to early detection by gastric endoscopy. 2 However, unlike that of other common cancers, the prognosis for most gastric cancer is poor and has improved little for the past several decades. Despite recent advances in chemotherapy and surgical techniques, the overall 5-year survival rate is lower than 40%.3 Perplexingly, the prognosis varies widely in patients with stage II or III disease for undetermined biological reasons.

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“…Using the Surveillance, Epidemiology, and End Results database, Coburn et al [30] found that only 29% of 10,807 resected gastric cancer patients had Ն15 lymph nodes examined. In a study from the United Kingdom analyzing 18 hospitals, only 31% of the 699 surgical resections resulted in Ն15 lymph nodes analyzed [31]. Thus, many western patients are understaged following surgical resection of their gastric cancers because of inadequate lymph node sampling.…”

Section: Potential Benefits Of More Extensive Lymphadenectomiesmentioning

confidence: 99%

Lymphadenectomy for Gastric Adenocarcinoma: Should West Meet East?

Yoon

Yang

2009

The Oncologist

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After completing this course, the reader will be able to:1. Calculate the lymph node drainage patterns of gastric adenocarcinoma based on the location of the tumor.2. Differentiate and explain the extent of lymphadenectomies performed in different countries.3. Analyze the risks and benefits of performing more extensive lymphadenectomies for gastric adenocarcinoma.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTThe extent of lymphadenectomy that should be performed for gastric adenocarcinoma has been a topic of persistent debate. In countries such as Japan and Korea, where the incidence of gastric adenocarcinoma is high, more extensive (e.g., D2) lymphadenectomies are routinely performed, usually by experienced surgeons with low morbidity and mortality. In western countries such as the U.S., where the incidence of gastric adenocarcinoma is tenfold lower, the performance of more extensive lymphadenectomies is generally limited to specialized centers, and quite possibly the majority of patients are treated at nonreferral centers with less than a D1 lymphadenectomy. There is little disagreement among gastric cancer experts that the minimum lymphadenectomy that should be performed for gastric adenocarcinoma should be at least a D1 lymphadenectomy. Two large, prospective randomized trials performed in the United Kingdom and the Netherlands failed to demonstrate a survival benefit of D2 over D1 lymphadenectomy, but these trials have been criticized for high surgical morbidity and mortality rates in the D2 group. More recent studies have demonstrated that western surgeons can be trained to perform D2 lymphadenectomies on western patients with low morbidity and mortality. Retrospective analyses and one prospective, randomized trial suggest that there may be some benefits to more extensive lymphadenectomies when performed safely, but this assertion requires further validation. This article provides an update on the current literature regarding the extent of lymphadenectomy for gastric adenocarcinoma.

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Appraisal of compliance with the UICC/AJCC staging system in the staging of gastric cancer

Abstract: These results reflect the need for improved N staging across the region to aid the appropriate multimodal treatment of patients.

Cited by 56 publications

References 14 publications

Gastric cancer patients treated by a general or gastric cancer surgical team: a comparative study

Gastric cancer patients treated by a general or gastric cancer surgical team: a comparative study

Protein Signatures for Classification and Prognosis of Gastric Cancer

Lymphadenectomy for Gastric Adenocarcinoma: Should West Meet East?

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