Association of Adjuvant Chemotherapy With Survival in Patients With Stage II or III Gastric Cancer

Jiang, Yuming; Li, Tuanjie; Liang, Xiaoling; Hu, Yanfeng; Huang, Lei; Liao, Zhenchen; Zhao, Liying; Han, Zhen; Zhu, Shuguang; Wang, Meng-Lan; Xu, Yangwei; Qi, Xiaolong; Liu, Hao; Yang, Yang; Yu, Jiang; Liu, Wei; Cai, Shirong; Li, Guoxin

doi:10.1001/jamasurg.2017.1087

Cited by 121 publications

(136 citation statements)

References 36 publications

(67 reference statements)

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“…In addition, aging is accompanied by many physiological changes including those in the immune system and elder patients have weaker immune function in contrast with younger individuals [16][17][18]. Several studies supported that there are age-dependent variations on cancer immune surveillance, including degenerative changes of lymph nodes and reduced lymphatic flow to nodes and nodal involution [16,[19][20][21]. These data suggest that GC in younger patients may behave biologically more aggressively than in older patients and fit with our findings.…”

Section: Discussionmentioning

confidence: 99%

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Young age increases risk for lymph node positivity in gastric cancer: A Chinese multi-institutional database and US SEER database study

Jiang¹,

Huang²,

Xie³

et al. 2020

J. Cancer

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Object: The risk of lymph node positivity (LN+) in gastric cancer (GC) impacts therapeutic recommendations. The aim of this study was to quantify the effect of younger age on LN+. Methods: Data from a Chinese multi-institutional database and the US SEER database on stage I to III resected GC were analyzed for the relationship between age and LN+ status. The association of age and LN+ status was examined with logistic regression separately for each T stage, adjusting for multiple covariates. Poisson regression was used to evaluate age and number of LN+. Results: 4,905 and 14,877 patients were identified in the China and SEER datasets respectively. 479 (9.8%) patients were under age 40 years, with 768 (15.7%) between age 40 and 49 years in China dataset, and 416 (2.8%) patients were under age 40 years, with 1176 (7.9%) between age 40 and 49 years in SEER dataset. Both datasets exhibited significantly proportional decreases of N3a and N3b LN+ with age increasing. Patients younger than age 40 years were more likely to show LN+ compared with the reference age 60 to 69 years. The youngest patients had the highest ORs of N1, N2, N3a, and N3b vs N0 LN+ within T4 stage of China dataset and T3 stage of SEER dataset, the values of ORs decreased with increasing age. Young age was a predictor of an increased number of LNs positive for each T stage. Conclusion: In the two large datasets, young age at diagnosis is associated with an increased risk of LN+.

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Section: Discussionmentioning

confidence: 99%

“…Clinically, accurate prediction of lymph node involvement is essential in helping doctors make decisions more reasonably [20,[25][26][27][28][29]. Treatment recommendations for a patient with GC would vary depending on lymph node status.…”

Section: Discussionmentioning

confidence: 99%

Young age increases risk for lymph node positivity in gastric cancer: A Chinese multi-institutional database and US SEER database study

Jiang¹,

Huang²,

Xie³

et al. 2020

J. Cancer

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“…(10,17,19) Furthermore, a survival prediction model based on specific tumor and patient clinicopathologic characteristics could be used to predict survival benefit from adjuvant chemotherapy for patients with stage II or stage III GC. (20) On the basis of these findings, we hypothesize that combining multiple clinicopathologic features and immunomarkers of immune cells and angiogenesis in tumor can improve overall prediction of GC outcome.…”

Section: Introductionmentioning

confidence: 93%

Immunomarker Support Vector Machine Classifier for Prediction of Gastric Cancer Survival and Adjuvant Chemotherapeutic Benefit

Jiang

Xie

Han

et al. 2018

Clinical Cancer Research

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126

109

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TNM staging system of gastric cancer (GC) is not adequate for definition of prognosis and cannot predict the candidates who are likely to benefit from chemotherapy. In this research, we constructed a GC-SVM classifier integrating 3 clinicopathologic features and 8 IHC features in the training cohort of 251 patients. And further validation of the GC-SVM classifier was performed in two validation cohort of 535 patients.Multivariate analysis revealed that the GC-SVM classifier was an independent prognostic factor. Furthermore, the classifier had higher predictive accuracy for OS and DFS than TNM stage and can added prognostic value to the TNM staging system. Moreover, the GC-SVM classifier might be able to predict which patients will benefit from adjuvant chemotherapy. Thus, the classifier could facilitate patient counseling and individualized management. Conclusion:The newly developed GC-SVM classifier was a powerful predictor of OS and DFS. Moreover, the GC-SVM classifier could predict which patients with stage II and III GC benefit from adjuvant chemotherapy.

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“…The most extensive study in the prediction model derived from the CLASSIC study, which includes 746 patients in the discovery set and 943 in the validation set. However, it is only a survival predicting model with clinical variables (30). In the present study, we demonstrated a prediction model based on metabolic genes of chemo-reagents and clinic-pathological variables with high accuracy in the prediction of chemotherapy e cacy in two independent cohorts of LAGC patients.…”

Section: C-score Is An Ideal Predictor For Adjuvant Therapy E Cacy Inmentioning

confidence: 67%

A Predictive Signature for Oxaliplatin and 5-fluorouracil Based Chemotherapy Inlocally Advanced Gastric Cancer

Wang

Liu

Chen

et al. 2020

Preprint

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Background: Adjuvantchemotherapy(AC)plays a substantial role in the treatment of locally advanced gastric cancer (LAGC), but the response remains poor. Weaims to improve its efficacy in LAGC. Methods: We identified the expression of eight genes closely associated with platinum and fluorouracil metabolism (RRM1, RRM2, RRM2B, POLH, DUT, TYMS, TYMP, MKI67) in the discovery cohort (N=291). And we further validated the findings in TCGA (N=279) and GEO. Overall survival (OS) was used as an endpoint. Univariate and multivariate Cox models were applied. A multivariate Cox regression model was simulated to predict theOS. Results: In the discovery cohort,the univariate Coxmodelindicated that AC was beneficial to high-RRM1, high-DUT, low-RRM2, low-RRM2B, low-POLH, low-KI67, low-TYMS or low-TYMP patients, the results were validated in the TCGA cohort. The multivariate Cox model showed consistent results. Cumulative analysis indicated that patients with low C-Score respond poorly to the AC, whereas thehigh and mediumC-Score patients significantly benefit from AC. A risk model based on the above variables successfully predicted the OS in both cohorts (AUC=0.75 and 0.67, respectively). Further validation in a panel of gastric cancer cell (GC) lines (N=37) indicated that C-Score is significantly associated with IC50 value to fluorouracil. Mutation profiling showed that C-Score was associated with the number and types of mutations. Conclusion: In this study, we successfully simulated a predictive signature for the efficacy of AC in LAGC patients and further explored the potential mechanisms. Our findings could promote precision medicine and improve the prognosis of LAGC patients.

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Association of Adjuvant Chemotherapy With Survival in Patients With Stage II or III Gastric Cancer

Abstract: The survival prediction model can be used to make individualized predictions of the expected survival benefit from the addition of adjuvant chemotherapy for patients with stage II or stage III gastric cancer.

Cited by 121 publications

References 36 publications

Young age increases risk for lymph node positivity in gastric cancer: A Chinese multi-institutional database and US SEER database study

Young age increases risk for lymph node positivity in gastric cancer: A Chinese multi-institutional database and US SEER database study

Immunomarker Support Vector Machine Classifier for Prediction of Gastric Cancer Survival and Adjuvant Chemotherapeutic Benefit

A Predictive Signature for Oxaliplatin and 5-fluorouracil Based Chemotherapy Inlocally Advanced Gastric Cancer

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