Clinical impact of underutilization of adjuvant therapy in node positive gastric adenocarcinoma

Zhu, Rebecca; Liu, Fangfang; Grisotti, Gabriella; Pérez-Irizarry, Javier; Salem, Ronald R.; Cha, Charles; Johung, Kimberly L.; Boffa, Daniel J.; Zhang, Yawei; Khan, Sajid

doi:10.21037/jgo.2018.03.05

Cited by 2 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study was unable to assess the impact of adjuvant therapy on OS in node positive EGC due to limited population (46%, 12/26, 95% CI 29%–65%). Past trials have recommended adjuvant therapy in advanced GC 38,39 ; however, we suspect its role is likely underrecognized 40 in Western patients where node positive EGC can present more aggressively, highlighting a need for future investigation. Ultimately, regardless of staging, Western patients who have LNM have worse OS compared to their Eastern counterparts; therefore, LNM should be heavily weighted when prognosticating disease with a lower threshold for surgical resection.…”

Section: Discussionmentioning

confidence: 97%

“…Our study was unable to assess the impact of adjuvant therapy on OS in node positive EGC due to limited population (46%, 12/26, 95% CI 29%-65%). Past trials have recommended adjuvant therapy in advanced GC 38,39 ; however, we suspect its role is likely underrecognized 40 therefore, LNM should be heavily weighted when prognosticating disease with a lower threshold for surgical resection.…”

Section: Predictors Of Os and Disease Recurrencementioning

confidence: 99%

See 1 more Smart Citation

Risk of lymph node metastasis in early gastric cancer for a Western population

Watanabe

McKendry

Yip

et al. 2022

Journal of Surgical Oncology

View full text Add to dashboard Cite

Introduction: Endoscopic resection (ER) of early gastric cancer (EGC) is increasingly used in Eastern countries due to their low rates of lymph node metastasis (LNM); however, there is a paucity of evidence in Western countries. We investigated LNM and its effect on overall survival (OS) in Western patients with EGC.Methods: Patients diagnosed with T1 gastric cancer between 2000 and 2017 were retrospectively evaluated. Univariate Kaplan-Meier, multivariate logistic and Coxregression models were used to assess the associations between clinical characteristics, LNM, and OS.Results: Among 86 patients, median age was 68 years and 72% were male. Node positivity was 30%. Two percent of patients met the classical guidelines for ER and all were node-negative, while 16% met expanded criteria of which 14% were nodepositive. T1b disease (odds ratio [OR] 41.2 [95% confidence interval [CI] 1.62-1048], p = 0.02) and lymphovascular/perineural invasion (OR 18.0 [95% CI 2.41 -134], p = 0.01) were predictive of node positivity. The 5-year OS for nodenegative and node-positive patients was 84% and 53% (p = 0.004), respectively. Conclusions:The risk of LNM in Western patients with EGC is higher; therefore, generalizability of the expanded criteria for ER should be interpreted with caution.

show abstract

Section: Discussionmentioning

confidence: 97%