Clinical significance of regional lymph node enlargement in patients with EGC within the expanded criteria for ESD

Lee, Dong Seok; Park, Jong Kyu; Lee, Sang Jin; Cheon, Gab Jin

doi:10.1186/s12876-020-01197-z

Cited by 5 publications

(7 citation statements)

References 18 publications

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“…According to epidemiological statistics, the recurrence rates of patients with stage-I and -II GC are about 10% and 30%, respectively [24]. At present, radical surgery, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD) are alternative treatments for patients with GC invading the mucosa and submucosa [25][26][27]. However, developed countries such as South Korea and Japan are more inclined to ESD and EMR, while for developing countries in Southeast Asia and China, radical surgery is a more common choice.…”

Section: Discussionmentioning

confidence: 99%

Proposed Models for Prediction of Mortality in Stage-I and Stage-II Gastric Cancer and 5 Years after Radical Gastrectomy

Fang

Yin

Wang

et al. 2022

Journal of Oncology

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The current American Joint Committee on Cancer (AJCC) staging system provides limited information for patients with early death from stage-I and stage-II gastric cancer (GC) and death at >5 years after radical gastrectomy. The aim of this study was to construct nomogram models to predict the mortality risk of these patients. In this study, clinical and pathological data on patients who underwent curative gastrectomy at Harbin Medical University Cancer Hospital between 2000 and 2014 were retrospectively collected. Receiver operating characteristic analysis was used to screen for sensitive serum immune biomarkers to predict the risk of mortality death >5 years after radical gastrectomy (Group A) and risk of early death in stage-I and stage-II GC (Group B). The prediction model was constructed by combining serum immune markers with clinicopathological features by R Studio. We found that serum fibrinogen (F), systemic immune inflammation (SII), and pTNM stage were independent risk factors for prognosis in Group A ( P < 0.05 ). F, SII, age, Borrmann type, and scope of gastrectomy were independent risk factors for prognosis in Group B ( P < 0.05 ). The area under the curve of the predictive model in Groups A and B was 0.726 and 0.848, respectively. In conclusion, the predictive models of F and SII combined with clinicopathological features can predict high mortality risk in patients with stage-I and stage-II GC and >5 years after radical gastrectomy, which will contribute to the supplement of the traditional AJCC system and to individual survival prediction.

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Section: Discussionmentioning

confidence: 99%

Proposed Models for Prediction of Mortality in Stage-I and Stage-II Gastric Cancer and 5 Years after Radical Gastrectomy

Fang

Yin

Wang

et al. 2022

Journal of Oncology

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“…The scoring system was then validated on 905 patients with non-curative ESD who declined surgery. 5-year cancer-specific survival was 99.6% in the low-risk group (60.4% of patients), 96% in the intermediate risk group (27.6% of patients) and 90% in the high-risk group (11.9% of patients), suggesting that ESD without additional surgical management may be sufficient in low-risk patients according to the eCura system[ 138 ].…”

Section: Endoscopic Treatment Of Gastric Neoplasiamentioning

confidence: 99%

“…These risk stratification tools are of particular importance when considering patients with radiologically enlarged lymph nodes that may or may not signify the presence of LNM. Lee et al [ 138 ] reported 47 cases of ESD for expanded criteria lesions, where patients had at least one enlarged lymph node on CT[ 138 ]. 12 of 47 patients had surgical resection, with no evidence of metastatic disease, while the remaining 35 patients had serial CT monitoring over a median 56 mo.…”

Section: Endoscopic Treatment Of Gastric Neoplasiamentioning

confidence: 99%

“…Chae et al [ 188 ] reported a successful case of FTR for an EGC with a positive horizontal margin after initial ESD which had resulted in severe fibrosis[ 188 ]. Cho et al [ 138 ] reported a series of 9 patients treated with FTR and laparoscopic lymph node resection who had lesions outside of expanded criteria, in whom lymph nodes were positive in only 1 case[ 138 ].…”

Section: Future Directions For the Endoscopic Treatment Of Gastric Neoplasiamentioning

confidence: 99%

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Endoscopic diagnosis and treatment of gastric dysplasia and early cancer: Current evidence and what the future may hold

Young¹,

Philpott²,

Singh³

2021

WJG

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Gastric cancer accounts for a significant proportion of worldwide cancer-related morbidity and mortality. The well documented precancerous cascade provides an opportunity for clinicians to detect and treat gastric cancers at an endoscopically curable stage. In high prevalence regions such as Japan and Korea, this has led to the implementation of population screening programs. However, guidelines remain ambiguous in lower prevalence regions. In recent years, there have been many advances in the endoscopic diagnosis and treatment of early gastric cancer and precancerous lesions. More advanced endoscopic imaging has led to improved detection and characterization of gastric lesions as well as superior accuracy for delineation of margins prior to resection. In addition, promising early data on artificial intelligence in gastroscopy suggests a future role for this technology in maximizing the yield of advanced endoscopic imaging. Data on endoscopic resection (ER) are particularly robust in Japan and Korea, with high rates of curative ER and markedly reduced procedural morbidity. However, there is a shortage of data in other regions to support the applicability of protocols from these high prevalence countries. Future advances in endoscopic therapeutics will likely lead to further expansion of the current indications for ER, as both technology and proceduralist expertise continue to grow.

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“…Some patients' tumors only invade the muscle layer but have multiple lymph node metastases. Even if radical surgery, postoperative chemotherapy or preoperative neoadjuvant treatment is performed, their 5-year and 10-year survival rates are significantly reduced [ 12 , 13 ]. However, studies have shown that about 60% of GC has obvious tissue heterogeneity in transcriptomics sequencing, which makes it difficult to find molecules targeted at lymph node metastasis.…”

Section: Introductionmentioning

confidence: 99%

Lymph Node Metastasis-Related Gene ITGA4 Promotes the Proliferation, Migration, and Invasion of Gastric Cancer Cells by Regulating Tumor Immune Microenvironment

Fang

Yin

Wang

et al. 2022

Journal of Oncology

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The Integrin Subunit Alpha 4 (ITGA4) plays important roles in cancers pathogenesis. However, the expression and association with clinicopathological and survival probability have not been previously assessed in gastric cancer (GC). Protein expression of ITGA4 was assessed in TMA using immunohistochemistry and correlated with clinicopathological factors and survival. The mRNA expression of ITGA4 was also assessed in the HMU-GC cohort. Bioinformatics function analysis was conducted through GSEA. The “CIBERSORT” package was used for immune infiltration analysis. “SvyNom” package is used to construct prognosis model. ITGA4 knock down using shRNA. The evaluation of cell function was performed by CCK-8 and Transwell invasion and migration experiments. ITGA4 was significantly associated with N classification ( P = 0.031 ), tumor location ( P = 0.033 ), WHO classification ( P = 0.007 ), and poor prognosis in mRNA level. GSEA analysis of the validation cohort suggested that ITGA4 was associated with macrophage infiltration. Immunohistochemistry showed that ITGA4 was associated with poor prognosis. Multivariate Cox regression analysis found that ITGA4 ( P = 0.045 ) and lymph node metastasis rate ( P = 0.026 ) were independent prognostic factors and could construct a prognosis model. ITGA4 knockdown cell line significantly reduced the ability of proliferation, invasion, and metastasis. ITGA4 is associated with patient survival in GC and may be an important prognostic biomarker.

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Clinical significance of regional lymph node enlargement in patients with EGC within the expanded criteria for ESD

Cited by 5 publications

References 18 publications

Proposed Models for Prediction of Mortality in Stage-I and Stage-II Gastric Cancer and 5 Years after Radical Gastrectomy

Proposed Models for Prediction of Mortality in Stage-I and Stage-II Gastric Cancer and 5 Years after Radical Gastrectomy

Endoscopic diagnosis and treatment of gastric dysplasia and early cancer: Current evidence and what the future may hold

Lymph Node Metastasis-Related Gene ITGA4 Promotes the Proliferation, Migration, and Invasion of Gastric Cancer Cells by Regulating Tumor Immune Microenvironment

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