ASO Author Reflections: Gastric Cancer Staging: More than Just TNM?

Chmelo, Jakub; Phillips, Alexander W

doi:10.1245/s10434-020-08438-1

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…Recent discoveries in the field of genetics, surgery, and targeted therapies have not yet modified the well-established treatment protocol for GC patients. 32 Although a worldwide consensus has been established on the extent of lymphadenectomy has been established, 6 , 33 , 34 a patient-tailored treatment is being pursued 35 in order to minimize unnecessary interventions and their side effects. Recently developed surgical techniques (fluorescence-guided surgery) can assist the surgeon in making decisions about extended lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

Kynurenine and Anthranilic Acid in the Peritoneum Correlate With the Stage of Gastric Cancer Disease

Gęca

Rawicz‐Pruszyński

Mlak

et al. 2022

Int J�Tryptophan�Res

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Background: This study aimed to assess the importance of selected kynurenines measured in peritoneal fluid, lavage washings, and blood serum in patients with advanced gastric cancer (GC) based on the clinical and pathological staging of TNM for a more precise evaluation of the stage of the disease. Methods: Data were collected from a prospectively maintained database of all patients operated on advanced GC between July 2018 and August 2020. In total, 98 patients were eligible for the analysis according to the REMARK guidelines. Results: Among the various kynurenines analyzed in this study, we found that the median concentration of anthranilic acid (AA) in the peritoneal lavage washings was significantly higher in patients with positive nodes (pN1-3) compared to those with negative nodes (pN0) ( P = 0.0100). Based on the ROC analysis, AA showed diagnostic utility in the differentiation of the pN staging ( P = 0.0047). Furthermore, there was a positive correlation between AA in peritoneal fluid with stage pN ( P = 0.0116) and a positive correlation between AA in peritoneal lavage washings with stage cT ( P = 0.0101). We found that the median concentration of kynurenine (Kyn) in peritoneal lavage washings was significantly higher in patients with cM1 compared to cM0 patients ( P = 0.0047). Based on the ROC analysis, Kyn showed diagnostic utility in cM staging differentiation ( P < 0.0001). There was a positive correlation between peritoneal Kyn and stage of cM ( P = 0.0079). Conclusions: AA and Kyn measured in peritoneal lavage indicate advanced GC and may be considered in the future as valuable adjunct tools in TNM staging of advanced GC.

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Section: Discussionmentioning

confidence: 99%

Kynurenine and Anthranilic Acid in the Peritoneum Correlate With the Stage of Gastric Cancer Disease

Gęca

Rawicz‐Pruszyński

Mlak

et al. 2022

Int J�Tryptophan�Res

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“…The TNM classification represents the most used staging system for upper GI tumors. Details regarding upper GI staging and classification are available as Supplementary Material as Table S1–S7 [ 26 , 27 , 28 , 29 , 30 ].…”

Section: How To Diagnose and Stage Upper Gi Cancersmentioning

confidence: 99%

From Interconnection between Genes and Microenvironment to Novel Immunotherapeutic Approaches in Upper Gastro-Intestinal Cancers—A Multidisciplinary Perspective

Accordino

Lettieri

Bortolotto

et al. 2020

Cancers

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Despite the progress during the last decade, patients with advanced gastric and esophageal cancers still have poor prognosis. Finding optimal therapeutic strategies represents an unmet need in this field. Several prognostic and predictive factors have been evaluated and may guide clinicians in choosing a tailored treatment. Data from large studies investigating the role of immunotherapy in gastrointestinal cancers are promising but further investigations are necessary to better select those patients who can mostly benefit from these novel therapies. This review will focus on the treatment of metastatic esophageal and gastric cancer. We will review the standard of care and the role of novel therapies such as immunotherapies and CAR-T. Moreover, we will focus on the analysis of potential predictive biomarkers such as Modify as: Microsatellite Instability (MSI) and PD-L1, which may lead to treatment personalization and improved treatment outcomes. A multidisciplinary point of view is mandatory to generate an integrated approach to properly exploit these novel antiproliferative agents.

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“…In the locally advanced setting, multimodal therapy based on perioperative systemic treatment and surgery has been advocated for over a decade [2]. A patient-tailored treatment should rely on an effective staging process [3]. However, conventional diagnostic imaging modalities (CT, EUS, MRI) present limited accuracy [4], particularly in nodal staging (cN) [5].…”

Section: Introductionmentioning

confidence: 99%

Staging LaParoscopy to Assess Lymph NOde InvoLvement in Advanced GAstric Cancer (POLA)—Study protocol for a single-arm prospective observational multicenter study

Rawicz-Pruszyński,

Sędłak,

Pelc

et al. 2023

PLoS ONE

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Introduction In the era of neoadjuvant chemotherapy in advanced gastric cancer (GC), the role of staging laparoscopy (SL) will become more established. However, despite guidelines recommendations, SL for optimal preoperative staging remains underutilized. Diagnostic value of near-infrared (NIR) / indocyanine green (ICG) guided sentinel node (SN) mapping in GC confirmed its technical feasibility, however no data exist regarding its potential role in pathological nodal staging. To the best of our knowledge, current study is the first to evaluate the role of ICG in nodal staging of advanced GC patients undergoing SL. Materials and methods This single-arm prospective observational multicenter study was approved by the Bioethical Committee of Medical University of Lublin (Ethic Code: KE-0254/331/2018). The protocol is registered at clinicaltrial.gov (NCT05720598), and the study results will be reported according to the Strengthening of Reporting of Observational Studies in Epidemiology (STROBE) statement. The primary endpoint of this study is the identification rate of ICG-guided SN in advanced GC patients. The secondary endpoints include pathological and molecular assessment of retrieved SNs and other pretreatment clinical variables potentially associated with SL: pattern of perigastric ICG distribution according to patients’ pathological and clinical characteristics, neoadjuvant chemotherapy compliance, 30-day morbidity, and mortality. Conclusion POLA study is the first to investigate the clinical value of ICG-enhanced sentinel node biopsy during staging laparoscopy in advanced GC patients in a Western cohort. Identifying pN status before multimodal treatment will improve GC staging process.

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ASO Author Reflections: Gastric Cancer Staging: More than Just TNM?

Cited by 4 publications

References 4 publications

Kynurenine and Anthranilic Acid in the Peritoneum Correlate With the Stage of Gastric Cancer Disease

Kynurenine and Anthranilic Acid in the Peritoneum Correlate With the Stage of Gastric Cancer Disease

From Interconnection between Genes and Microenvironment to Novel Immunotherapeutic Approaches in Upper Gastro-Intestinal Cancers—A Multidisciplinary Perspective

Staging LaParoscopy to Assess Lymph NOde InvoLvement in Advanced GAstric Cancer (POLA)—Study protocol for a single-arm prospective observational multicenter study

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