Chemoresponse after non-curative gastrectomy for M1 gastric cancer

Abstract

BackgroundM1 gastric cancer has a poor oncologic outcome with a median survival of less than 1 year despite aggressive chemotherapy. Recent trials include chemotherapy combined non-curative gastrectomy. This study evaluated the chemoresponse after non-curative gastrectomy in M1 gastric cancer and the survival benefit.MethodsBetween January 2000 and December 2010, 660 patients received chemotherapy for gastric cancer at the Department of Hemato-Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. Data was collected retrospectively from the medical records. Patients who received preoperative or adjuvant chemotherapy, who underwent other surgeries like gastrojejunal bypass or exploratory laparotomy, who died within 3 months due to seriously advanced gastric cancer, who were lost to follow-up, or whose medical records were unsuitable for data collection were excluded. The remaining 101 patients had received chemotherapy only (CTx group, n = 76) or chemotherapy after non-curative gastrectomy (NCG + CTx group, n = 25). Clinicopathologic characteristics, chemoresponse, and overall survival were compared between the two groups.ResultsThere were no significant differences between the two groups in clinicopathologic characteristics including age, sex, body mass index (BMI), comorbidity, histologic differentiation, tumor location, clinical T stage, and initial site of distant metastasis. Chemoresponse was checked on two separate occasions from the initiation of chemotherapy: first chemotherapy regimen and until the third regimen change. The NCG + CTx group showed more favorable chemoresponse than the CTx group in both checks (60% and 72% vs. 18.4% and 23.7%). The NCG + CTx group showed longer overall survival than the CTx group (26 vs. 11 months).ConclusionsNon-curative gastrectomy in M1 gastric cancer could improve chemoresponse and extend overall survival.

Age at diagnosis predicted survival outcome of female patients with breast cancer at a tertiary hospital in Yogyakarta, Indonesia

“…Likewise, centrally located tumors have the tendency to spread to internal organs through local lymph nodes and correlate with a poor prognosis [16]. Many cohorts have observed that younger age is an independent predictor of an unfavorable treatment response, more aggressive tumor behavior, and a decreased survival rate [7-10, 34]. Younger women with breast cancer have a high tumor grade, clinically are more aggressive, present in an advanced stage, and have a high risk of recurrence [7, 10, 35].…”

“…Many cohorts have observed that younger age is an independent predictor of an unfavorable treatment response, more aggressive tumor behavior, and a decreased survival rate [7-10, 34]. Younger women with breast cancer have a high tumor grade, clinically are more aggressive, present in an advanced stage, and have a high risk of recurrence [7, 10, 35]. Tumors in younger women tend to be negative for hormone receptors, and thus show a poor response to adjuvant therapy [7].…”

“…The survival of patients with breast cancer depends on many factors. Demographic variables such as age [7-10], educational level [11], financial status [12], family history [13] and marital status [14, 15] have been found to influence the survival rate. Tumor and clinicopathological parameters that have been observed to impact on survival include tumor size, nodal status, the presence of metastatic disease, the clincal stage, tumor location, histology grade, and the presence of comorbidities [9, 16-19].…”

The Impact of Intervention on Survival of Elderly Patients with Gastric Cancer at IV Stage: A SEER Population-Based Study.

“…Although Katai et al [10] reported nonideal short-term survival after surgery in elderly patients ten years ago, some recent studies have demonstrated that the postoperative morbidity and mortality in elderly patients are comparable with those in younger patients [19,22], which may be attributable to advances in nutritional support, anesthesia, surgical instruments and skills. The benefits of surgery plus CT for the survival of GC patients with stage IV disease were also clearly identified [12,26,27,32]. The postoperative complication rate was not different between elderly populations of different ages, which suggested that the benefits of surgical intervention would not decrease with age.…”

NOB1 Gene as a Potential Biomarker in Clinical Outcomes and Prognosis of Patients with Gastric Cancer

“…It is estimated that gastric cancer (GC), one of the most common cancers worldwide, has an incidence of 640,000 cases for men and 350,000 cases for women and caused death of about 464,000 men and 273,000 women in 2011 [1]. Though both diagnosis and treatment methods have been improved in recent years, the prognosis of advanced gastric cancer is still poor mainly due to metastasis, with a median overall survival less than 1 year [2,3]. Most of GC patients are diagnosed as advanced, inoperable, or metastatic stage when admitted, and the only solutions left for these patients is to maintain quality of life and prolong survival [4,5].…”