Clinicopathologic characteristics in patients with upper third gastric cancer following radical surgical treatment

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Gastric cancer (GC) is the fourth most common cancer in the world and the second most common cancer in China. The aim of this study was to investigate the clinicopathologic profiles and prognosis of GC in the upper third (UT), middle third (MT) and low third (LT) of the stomach. Five hundred and forty-two patients with GC resected between January 2010 and January 2014 were retrospectively studied and divided in 3 groups according to cancer location: upper third gastric cancer (UTGC) (n = 62); MTGC (n = 131) and LTGC (n = 349). Clinical and pathological parameters including gender, age, tumor size, macroscopic types, histological types, depth of invasion, lymph node metastasis, venous infiltration and lymph embolism were compared among groups. Overall survival (OS) was calculated based on the aforementioned parameters. Univariate and multivariate survival was analyzed and Cox regression was conducted for each location. The prognostic accuracy was determined using receiver operating characteristic curve analysis. Patients with UTGC was similar to those with MTGC and both were distinct from those with LTGC based on the tumor size, macroscopic types, depth of invasion and 5-year OS. Patients with MTGC were similar to those with LTGC and distinct from UTGC patients based on gender. 5-year OS were lower for patients with UTGC than those with LTGC ( P = .001) and were comparable between MTGC and LTGC. No significant differences in 5-year OS were observed between UTGC and MTGC. Cox regression revealed that macroscopic types, depth of invasion and lymph node metastasis were the independent prognostic factors for GC patients regardless of locations. Receiver operating characteristic curve analysis revealed that macroscopic types, depth of invasion and lymph node metastasis were the significantly effective prognosis for the 5-year OS in GC patients regardless of locations. Our results showed that UTGC is distinct from LTGC whereas MTGC shares some characteristics from both UTGC and LTGC.

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Comparison of clinicopathologic profiles and prognosis of gastric cancer in the upper, middle and lower third of the stomach

Zhang

Wang

et al. 2020

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“…Qinghai Province is located in the North-Western China and one of the provinces having the highest incidence and mortality of GC in China. [ 2 ] We previously analyzed the clinicopathologic characteristics and prognosis of GC patients with different tumor locations in Qinghai Province and found that GC in upper third of the stomach is distinct from the lower third GC whereas middle third GC shares some characteristics from both upper third GC and lower third GC. [ 10 ] However, few studies reported the incidence and prognosis of young GC in the province.…”

Section: Introductionmentioning

confidence: 99%

Comparison of incidence and prognosis between young and old gastric cancer patient in North-Western China: A retrospective cohort study

Zhang

et al. 2022

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Gastric cancer (GC) is the fourth most common cancer in the world and the second most common cancer in China. In this study, we compared the clinicopathological features and prognosis of GC between young and old patients after curative resection. Six hundred and eighty-six patients with GC resected were divided two groups according to patient age: Younger GC patients ≤40 years of age (YGC, n = 52) and older GC patients >40 years of age (OGC, n = 634). The YGC group had 52 (7.6%) patients in total 686 GC patients. YGC patients was predominant in women (53.8% vs 26.5%) compared with OGC patients. 5-year overall survival exhibited differences in tumor sites, tumor sizes, macroscopic types, T staging, N staging, rate of N staging (rN), tumor node metastasis staging, scope of gastrectomy, radical degree, and lymphatic vascular invasion within each of YGC and OGC group. Univariate analysis of the clinical factors affecting overall survival in YGC group revealed the significant differences in tumor size, macroscopic types (except Borrmann), T staging (except T2), N staging (N3a and N3b), rN, tumor node metastasis staging (III), scope of gastrectomy, radical degree, and lymphatic vascular invasion. Gender, N staging, rN, radical degrees were the independent prognostic factors of younger patients with GC. Similar results were found in the OGC groups. The significant differences in radical degree and lymphatic vascular invasion were found between male and female patients in YGC group. Similar results were found in the OGC groups. Our results showed that YGC patients differ from OGC patients in predominance of women. Gender, N staging, rN, radical degrees were independent risk factors for the prognosis in YGC patients.

“…Paclitaxel is a new anti-tumor drug, which acts on G2/M phase of tumor cells, promotes tubulin polymerization, inhibits its depolymerization, and finally forms stable non-functional microtubules, thus inhibiting the mitosis of tumor cells and promoting apoptosis of tumor cells. [5] Frei et al [6] proposed and began the first neoadjuvant chemotherapy including paclitaxel for cervical cancer in 1982. Several studies have showed that neoadjuvant chemotherapy has a good therapeutic effect on high-risk cervical cancer with adverse prognostic factors, that is, locally advanced cervical cancer, stage Ib2–IIa massive cervical cancer, and early parametrial invasion of stage IIB.…”

Section: Introductionmentioning

confidence: 99%

High expression of survivin predicts poor prognosis in cervical squamous cell carcinoma treated with paclitaxel and carboplatin

Zhang¹,

Yan

Li³

et al. 2019

Lack of effective biomarkers is one of the challenges in current neoadjuvant chemotherapy to predict drug response and sensitivity of cervical squamous cell carcinoma (CSCC). The present study was designed to investigate the correlation of the expression of survivin, an inhibitor of apoptosis with the prognosis of CSCC patients undergoing neoadjuvant chemotherapy. A total of 117 CSCC patients treated with paclitaxel and carboplatin between May 2015 and April 2017 in the Second Hospital of Lanzhou University were retrospectively analyzed. The pathologic diagnosis and classification of CSCC were based on the Guidelines of the International Federation of Gynaecology and Obstetrics (FIGO). The efficacy was defined as complete remission (CR), partial remission (PR), and stability disease (SD). The expressions of survivin, vascular endothelial growth factor (VEGF), and Ki67 were determined with immunohistochemistry. Data were analyzed with SPSS software. Univariate analysis showed that survivin expression had no correlation with ages, FIGO stage, macroscopic type, lymphovascular invasion, depth of lymphovascular invasion, lymph node metastasis, and tumor size among 117 CSCC patients. However, survivin expression was positively correlated with pathological grade ( R = 0.691, P < .001). Multivariate analysis revealed that survivin expression was independently correlated with grades ( P < .001). In addition, the analysis of correlation indicated that survivin expression is positively correlated with VEGF expression ( R = 0.820, P < .001) and Ki67 expression ( R = 0.673, P < .001). The numbers (percentages) of complete remission (CR), partial remission (PR), and stability disease (SD) were 11 (9.4%), 91 (77.8%), and 15 (12.8%) respectively after the treatment of paclitaxel and carboplatin. Univariate analysis showed that efficacy of treatment was negatively correlated with pathological grade ( R = 0.513, P < .001), Ki67 expression ( R = 0.586, P < .001), VEGF expression ( R = 0.476, P < .001) and survivin expression ( R = 0.519, P < .001). Multivariate analysis revealed that efficacy of treatment was independently correlated with grades ( P = .028), Ki67 ( P < .001), and survivin expression ( P = .015). The results suggested that survivin expression is negatively correlated with the prognosis of CSCC patients treated with paclitaxel and carboplatin. Therefore, survivin expression might be a marker for prognosis in CSCC following neoadjuvant chemotherapy.