Institutional variation in short- and long-term outcomes after surgery for gastric or esophagogastric junction adenocarcinoma: correlative study of two randomized phase III trials (JCOG9501 and JCOG9502)

Kurokawa, Yukinori; Yamaguchi, Takuhiro; Sasako, Mitsuru; Sano, Takeshi; Mizusawa, Junki; Nakamura, Kenichi; Fukuda, Haruhiko

doi:10.1007/s10120-016-0636-y

Cited by 10 publications

(11 citation statements)

References 35 publications

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“…Only patients with no lymph node metastasis had a significant correlation between tumor grade and survival when TNM staging was also added to the analysis, while the number of lymph nodes was an independent prognostic factor for EGJA [37]. Institutional variation and preoperative laboratory data such as nutritional status are also associated with EGJA prognosis [38, 39]. Biomarkers are also important indicators of tumor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of CIP2A in Esophagogastric Junction Adenocarcinoma: A Study of 65 Patients and a Meta-Analysis

Wang

Zhu

et al. 2019

Disease Markers

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Background. The expression of the cancerous inhibitor protein phosphatase 2A (CIP2A) appears to be predictive of the prognosis of various solid tumors. However, the association between this protein and the risk of esophagogastric junction adenocarcinoma (EGJA) remains unclear. We investigated CIP2A expression and its clinical significance in EGJA and conducted a meta-analysis to explore the relationship between CIP2A and the prognosis of patients with solid tumors. Methods. Immunohistochemistry (IHC) was performed to detect the expression of CIP2A in EGJA. Kaplan-Meier estimation, Cox analysis, and ROC curves were performed to analyze the survival of patients and the prognostic factors. In the meta-analysis, we searched relevant publications in several widely used databases and used 15 studies (2348 patients). Results. IHC demonstrated that CIP2A was elevated in EGJA and correlated with poor survival as an independent indicator. It could forecast the survival more precisely when combined with the grade, which is another independent prognosis marker of EGJA. Meta-analysis demonstrated that the associations between the expression of CIP2A and the prognosis were detected for overall survival (HR=1.98, 95%CI=1.69‐2.32), disease-specific survival (HR=1.72, 95%CI=1.50‐1.97), and time to tumor progression (pooled HR=1.95, 95%CI=1.56‐2.43). Conclusion. High expression of CIP2A was a poor indicator of the prognosis of EGJA, and CIP2A may be a new biomarker for the diagnosis and treatment of EGJA. The meta-analysis suggested that CIP2A expression can be a predictive marker of overall survival, disease-specific survival, and time to tumor progression in patients with solid tumors.

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Section: Discussionmentioning

confidence: 99%

Prognostic Significance of CIP2A in Esophagogastric Junction Adenocarcinoma: A Study of 65 Patients and a Meta-Analysis

Wang

Zhu

et al. 2019

Disease Markers

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“…Two randomized phase III trials (JCOG9501 and JCOG9502) were conducted to compare standard and experimental surgery for gastric and esophagogastric junction adenocarcinomas. Kurokawa et al concluded that there was some degree of interinstitutional variation in outcomes after standard surgery, but there was little variation in the hazard ratio (HR) for OS for experimental surgery, indicating that the final conclusions of the two randomized phase III trials can be generalized to their respective target populations. An investigation of the relationship between hospital volume and risk‐adjusted mortality following esophagectomy for esophageal cancer in Japan using a nationwide web‐based database was reported.…”

Section: Treatmentsmentioning

confidence: 99%

Recent advancements in esophageal cancer treatment in Japan

Tanaka

Yoshida

Suetsugu

et al. 2018

Annals of Gastroent Surgery

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The 11th edition of the Japanese Classification of Esophageal Cancer (EC) was published in 2017. Some correction was made in the depth of tumor invasion to be consistent with the TNM classification by the Union for International Cancer Control (UICC). With regard to surgery, short‐term safety and long‐term effectiveness under thoracotomy/video‐assisted thoracoscopic surgery are expected to be proven by the Japan Clinical Oncology Group (JCOG)1409 study. Results of nutritional management and countermeasures for adverse events not only during the perioperative period but also during EC chemotherapy were reported. From now on, the pursuit of low invasiveness and radicality is desired. Esophageal surgery is also expected to be safe at all institutions. To determine the optimal modality of preoperative treatment and a novel chemo(radio)therapy regimen for patients with distant metastasis, the results of the ongoing JCOG1109 and 0807 studies are being released. The effect of the addition of molecular targeted drugs on chemotherapy and concurrent chemoradiation has not yet improved overall survival. Immune checkpoint inhibitor drugs could offer a potential new treatment approach for patients with treatment‐refractory advanced squamous cell carcinoma (SCC). The Cancer Genome Atlas Research Network reported the results of a comprehensive genome analysis and molecular analysis of SCC and adenocarcinoma of the esophagus. Further differentiation of SCC and adenocarcinoma by molecular characterization analysis may be useful for the development of clinical trials and targeted drug therapies as precision medicine. The era of ultimate minimally invasive surgery and personalized treatment has begun. Large, prospective studies will be required to confirm the value of these advancements.

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“…Recently, a correlative study of two randomized phase III trials evaluated the inter‐institutional heterogeneity in short‐ and long‐term outcomes after gastrectomy for resectable gastric cancer 39. This study used the data of 521 patients from 23 hospitals in the JCOG9501 trial, which evaluated the survival benefit of the addition of para‐aortic node dissection to standard gastrectomy with D2 lymphadenectomy; and 157 patients from 21 hospitals in the JCOG9502 trial, which evaluated the survival benefit of the left thoracoabdominal approach compared to the abdominal transhiatal approach.…”

Section: Resultsmentioning

confidence: 99%

Are treatment outcomes in gastric cancer associated with either hospital volume or surgeon volume?

Mukai

Kurokawa

Takiguchi

et al. 2017

Annals of Gastroent Surgery

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Surgical resection is the only curative treatment for gastric cancer. Postoperative outcomes may be affected by the average or total number of surgeries carried out at an institution (hospital volume) or by a surgeon (surgeon volume). Among seven large‐scale studies that each enrolled over 10 000 patients who underwent gastrectomy, six showed that higher hospital volume contributed to a lower mortality rate after gastrectomy. Surgeon volume was also reported by three of four studies that each included over 1000 patients to be a significant factor contributing to heterogeneity in mortality rates after gastrectomy. In contrast, most studies showed no relationship between hospital volume and postoperative morbidity. A significant long‐term relationship was demonstrated in four of nine studies that each included more than 1000 patients, but the other five studies showed negative results. A recent correlative study of randomized phase III trials for gastric cancer surgeries showed a significant relationship between hospital volume and postoperative morbidity in one trial but not in another trial. There was no correlation between overall survival and either hospital or surgeon volume. In addition, another correlative study of a phase III trial of randomized chemotherapy for unresectable or recurrent gastric cancer found that there was no correlation between hospital volume and overall survival, although there was a large degree of heterogeneity in median overall survival among participating institutions.

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Institutional variation in short- and long-term outcomes after surgery for gastric or esophagogastric junction adenocarcinoma: correlative study of two randomized phase III trials (JCOG9501 and JCOG9502)

Cited by 10 publications

References 35 publications

Prognostic Significance of CIP2A in Esophagogastric Junction Adenocarcinoma: A Study of 65 Patients and a Meta-Analysis

Prognostic Significance of CIP2A in Esophagogastric Junction Adenocarcinoma: A Study of 65 Patients and a Meta-Analysis

Recent advancements in esophageal cancer treatment in Japan

Are treatment outcomes in gastric cancer associated with either hospital volume or surgeon volume?

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