Borrmann’s Macroscopic Criteria and p-Smad2 Expression Are Useful Predictive Prognostic Markers for Cytology-Positive Gastric Cancer Patients Without Overt Peritoneal Metastasis

Noda, Shinichi; Yashiro, Masakazu; Toyokawa, Takahiro; Morimoto, Jyunya; Shinto, Osamu; Muguruma, Kazuya; Sawada, Tetsuji; Hirakawa, Kosei

doi:10.1245/s10434-011-1768-2

Cited by 15 publications

(3 citation statements)

References 26 publications

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“…Poor prognostic factors should also be considered in patients with CY1 gastric cancer. It has been reported that patients with a high rate of lymph node metastasis or type 4 CY1 gastric cancer have a poor outlook [9][10][11]. It may be difficult to devise an appropriate treatment strategy for these patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of initial treatment for peritoneal lavage cytology-positive gastric cancer: outcomes according to treatment strategy

et al. 2022

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Background Although patients with positive lavage cytology (CY1) are classified as having stage IV disease, long-term survival without other unresectable factors (P0CY1) has been reported. Conversion gastrectomy in patients with a change in cytology status after induction chemotherapy might improve survival, but appropriate treatment remains controversial. Here, we reviewed our experience in treating CY1 gastric cancer to evaluate the best treatment strategy. Methods Clinical and pathological findings of patients with a diagnosis of P0CY1 gastric cancer at Toranomon Hospital between February 2006 and April 2019 were retrospectively analyzed. Patients were classified into two groups according to initial treatment: a surgery-first group and a chemotherapy-first group. In addition, the patients were categorized into subgroups based on the subsequent treatment pattern. The surgery-first group was divided into two subgroups: adjuvant chemotherapy and palliative gastrectomy only. The chemotherapy-first group was divided into three subgroups with the subsequent treatment pattern depending on the response to chemotherapy: conversion gastrectomy, palliative gastrectomy after induction therapy, and palliative chemotherapy. Results In total, 38 patients were eligible for inclusion in this study. After initial assessment of cytology status, 21 patients underwent gastrectomy as initial treatment (surgery first) and 17 received induction chemotherapy (chemotherapy first). Ten patients underwent surgery first with adjuvant chemotherapy, 11 underwent palliative gastrectomy alone, 5 underwent conversion surgery, 5 with CY1 disease after induction chemotherapy underwent palliative gastrectomy, and 7 received palliative chemotherapy only. The 3-year survival rate was 23.4% (median survival, 17.7 months) in the surgery-first group and 27.3% (median survival, 19.7 months) in the chemotherapy-first group. The 3-year survival rate was 75% for conversion gastrectomy, 16.7% for palliative chemotherapy, and 0% for palliative gastrectomy after induction chemotherapy. Conclusions There was no significant difference in outcome according to whether surgery or chemotherapy was performed first. The prognosis of conversion surgery with curative resection was better than that of the other types of treatment. However, the outlook after induction chemotherapy was poor. Patients with advanced gastric cancer should be treated cautiously until more effective treatment options become available.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of initial treatment for peritoneal lavage cytology-positive gastric cancer: outcomes according to treatment strategy

et al. 2022

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“…Type 4 tumors were also reported to have an extremely poor prognosis compared to non-Type 4 tumors [20,21]. Kano et al [22] found by a multivariate analysis that Type 4 tumor, R2 resection, lymph node metastasis, and Fig.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for cytology-positive gastric cancer

et al. 2018

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“…Clinically, the risk factors for developing metachronous peritoneal carcinomatosis are advanced stage at diagnosis, right-side cancer location, infiltrative or ulcero-infiltrative carcinomas, and history of perforation and obstruction in colorectal cancer (4)(5)(6)(7), but these factors are not reliable predictors for peritoneal metastasis in individuals. Although many researchers have investigated the mechanism of peritoneal dissemination in terms of genetic variations (8)(9)(10)(11)(12)(13)(14)(15)(16)(17), common changes of gene expression in tumor progression to peritoneal metastasis have not yet been clarified.…”

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confidence: 99%

Comprehensive Analysis of Somatic Mutations in Colorectal Cancer With Peritoneal Metastasis

Ahn

Baik

Lee

2019

In Vivo

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Background: To analyze for genetic mutations which may presage peritoneal metastasis by using targeted next-generation sequencing (NGS). Materials and Methods: Formalin-fixed, paraffin-embedded primary tumor specimens were obtained from 10 patients with small obstructing colorectal cancer and peritoneal metastasis (group A) and five with large non-obstructing colorectal cancer and no recurrence (group B). DNA was extracted for the sequencing of 409 cancer genes. The distribution of genetic mutations was compared between the two groups to find genetic mutations related to peritoneal metastasis. Results: When the samples were sorted based on similarity of gene expression by hierarchical clustering analysis, the samples were well divided between the two study groups. Mutations in ATrich interactive domain-containing protein 1A (ARID1A), polycystic kidney and hepatic disease 1 (PKHD1), ubiquitin-protein ligase E3 component n-recognin 5 (UBR5), paired box 5 (PAX5), tumor protein p53 (TP53), additional sex combs like 1 (ASXL1) and androgen receptor (AR) genes were detected more frequently in group A. Conclusion: A number of somatic mutations presumed to be relevant to colorectal cancer with peritoneal metastasis were identified in our study by NGS. 447This article is freely accessible online.

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Borrmann’s Macroscopic Criteria and p-Smad2 Expression Are Useful Predictive Prognostic Markers for Cytology-Positive Gastric Cancer Patients Without Overt Peritoneal Metastasis

Abstract: Activated Smad signaling might be associated with a high potential for peritoneal recurrence in CY1P0 patients. Borrmann's macroscopic criteria and p-Smad2 expression are useful markers for surgeons selecting advanced gastric cancer patients with CY1P0 for gastrectomy.

Cited by 15 publications

References 26 publications

Clinical significance of initial treatment for peritoneal lavage cytology-positive gastric cancer: outcomes according to treatment strategy

Clinical significance of initial treatment for peritoneal lavage cytology-positive gastric cancer: outcomes according to treatment strategy

Prognostic factors for cytology-positive gastric cancer

Comprehensive Analysis of Somatic Mutations in Colorectal Cancer With Peritoneal Metastasis

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