Integrated cancer networks improve compliance with national guidelines and outcomes for resectable gastric cancer

Thiels, Cornelius A.; Hanson, Kristine T.; Habermann, Elizabeth B.; Boughey, Judy C.; Grotz, Travis E.

doi:10.1002/cncr.32660

Cited by 32 publications

(27 citation statements)

References 33 publications

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“…In fact, only 1 patient in our study had documentation suggesting they were not referred for genetic consultation because the provider believed that the patient's personal and family history of cancer did not meet requirements for genetic counseling referral. Because genetic consultation is a component of the NCCN Guidelines for AYA Oncology and previous work has shown that higher compliance with NCCN Guidelines is associated with improved outcomes, [31][32][33][34][35] the paucity of documentation of genetics discussions in the AYA patients in our study suggests a critical care need for these patients.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Genetic Consultation in Adolescent and Young Adult Patients With Sarcoma

McKay¹,

Zakas

Osman³

et al. 2021

Journal of the National Comprehensive Cancer Network

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Background: Given a link between sarcomas and hereditary cancer predisposition syndromes, including Li-Fraumeni syndrome, the consideration for genetic counseling is recommended for all adolescent and young adult (AYA) patients diagnosed with sarcoma. The aim of this study was to evaluate factors influencing genetic consultations in AYA patients with sarcoma at the University of Wisconsin (UW). Methods: A retrospective chart review was performed on AYA patients diagnosed with sarcoma between the ages of 15 and 39 years who were seen at least once between 2015 to 2019 at UW. Our chart review identified discussions regarding genetics, referrals to genetics, genetic consultations, and results of genetic testing. Variables hypothesized to affect patient referrals for genetic consultation were identified a priori. Descriptive statistical methods and a univariate analysis were used to identify patient characteristics associated with genetic counseling referral. Results: We identified 87 AYA patients with sarcoma. Only 19 (22%) of these patients had documentation of a discussion about genetics, 15 (17%) of whom were subsequently referred for genetic consultation. Of these 15 patients, 9 (60%) were seen in consultation. All 9 patients seen by genetics underwent genetic testing, with 4 (44%) of these patients having identified heritable cancer predisposition syndromes. Likelihood for genetics referral was linked most strongly to documented genetics discussion with an oncology provider (P<.001). Conclusions: Despite the recommendation for consideration for genetic counseling in AYA patients with sarcoma, <25% of such patients in our study had a documented discussion about genetics. Supporting this need, all referred patients met criteria for genetic testing, and 44% of tested patients were found to have a heritable cancer predisposition syndrome. These data support the initial conversation by a provider as critical to genetic referral and suggest the need for more specific national recommendations for the genetic evaluation of all AYA patients with sarcoma.

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Section: Discussionmentioning

confidence: 99%

Factors Affecting Genetic Consultation in Adolescent and Young Adult Patients With Sarcoma

McKay¹,

Zakas

Osman³

et al. 2021

Journal of the National Comprehensive Cancer Network

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“…LNM is an independent risk factor for long-term outcome of gastric cancer after curative resection, and the station and number of lymph nodes removed definitely affect the tumor staging, guidance of postoperative adjuvant therapies, as well as long-term survival of patients[ 4 , 14 , 15 ]. Nowadays, the National Comprehensive Cancer Network (NCCN) Guidelines for Gastric Cancer in the United States and the Guidelines for the Treatment of Gastric Cancer in Japan and China have recommended D2 LND as the standard procedure during radical resection for advanced gastric cancer[ 16 - 18 ]. Typical D2 LND always exceeds 30 lymph nodes[ 19 , 20 ], In contrast, the national database identified that fewer than 15 lymph nodes were examined in a majority of American cases[ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Superior pancreatic lymphadenectomy with portal vein priority via posterior common hepatic artery approach in laparoscopic radical gastrectomy

Zhang¹,

Xiang²,

Li³

et al. 2022

WJCC

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BACKGROUND D2 lymph node dissection for advanced gastric cancer is advocated, and station 8p lymph node should be considered in selected patients, which is, however, technically difficult. AIM To introduce a new and easy-to-perform procedure for dissection of the lymph nodes superior to the pancreas. METHODS A series of patients who underwent laparoscopic gastrectomy for gastric cancer were retrospectively included with utilization of a new procedure for superior pancreatic lymphadenectomy (LND) with portal vein priority via the posterior common hepatic artery approach (SPLD-PPPH) based on a newly defined portal triangle. The surgical outcome of the patients, as well as the efficacy and safety of SPLD-PPPH are reported. RESULTS A total of 51 patients were included with most of them being male ( n = 34, 66.7%). According to the 8 th edition of AJCC TNM staging, there were four (7.8%) patients in stage I, 13 (25.5%) in stage II, 33 (64.7%) in stage III and one (2.0%) in stage IV. The average duration for LND was about 1 h (67.7 ± 6.9 min). After surgery, four patients developed morbidities, but all were treated successfully with no perioperative mortality. Among the 51 patients included, the percentage of patients who had lymph node metastasis at station 8p was 9.8%. Of note, with a total of 14 lymph nodes harvested at station 8p, the incidence of nodal metastasis was 14.3%. CONCLUSION About one in 10 patients with advanced gastric cancer had nodal metastasis at station 8p. The new approach of SPLD-PPPH is safe and effective for D2+ LND during laparoscopic radical gastrectomy.

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“…Accurate clinical staging is the beginning of treatment for GC. According to National Comprehensive Cancer Network (NCCN) 2020 guidelines, chest, abdominal and pelvic computed tomography (CT) is used to routinely evaluate tumor staging and monitor tumor recurrence for newly diagnosed and follow-up patients with GC [4,5] . However, based on our clinical observation, the most common distant metastases sites of GC are peritoneal, distant lymph nodes (LN, including retroperitoneal, supraclavicular, mediastinal and other unresectable lymph nodes), liver or other sites of metastases [6][7][8] , lung metastases is relatively rare [9,10] .…”

Section: Introductionmentioning

confidence: 99%

The Value of Chest CT in Staging of Gastric Cancer

Shen

et al. 2021

Preprint

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Aims: Gastric cancer (GC) is one of the most common malignant tumors in the world. However, the significance of chest computed tomography (CT) in staging of GC is uncertain and the relevant study is few. So this study aims to evaluate the value of chest CT in gastric cancer staging.Methods: This study included 1158 cases of GC patients admitted to Shaoxing People's Hospital from 2015 to 2018. Chest, abdominal and pelvic CT scans were used to systematically evaluate the site of metastasis. All images were reviewed twice by two radiologists. Clinical data was Statistically analyzed.Results: The study finally included 846 patients, 672 cases (79.4%) received surgical treatment. Only 55 cases (6.5%) had lung metastases before or after surgery, and 20 cases (2.4%) had thoracic or supraclavicular lymph nodes (LN) metastases, of which 8 cases had double lung and thoracic LN metastases. The most common site of metastases is the peritoneum (265/390, 67.9%). Almost all lung or thoracic LN metastases accompanied with metastases to other sites, only one patient had a single thoracic LN metastases (1/846, 0.12%), while no single lung metastases was found. When tumor involved gastric fundus/cardia, compared to distal GC, there was a higher probability of lung metastases, and the difference was statistically significant (P=0.028).Conclusions: This study shows that chest CT has a low application value in the routine staging of gastric cancer, but when the tumor is located in the fundus/cardia, due to the high proportion of lung metastases, chest CT has a certain existence value.

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Integrated cancer networks improve compliance with national guidelines and outcomes for resectable gastric cancer

Cited by 32 publications

References 33 publications

Factors Affecting Genetic Consultation in Adolescent and Young Adult Patients With Sarcoma

Factors Affecting Genetic Consultation in Adolescent and Young Adult Patients With Sarcoma

Superior pancreatic lymphadenectomy with portal vein priority via posterior common hepatic artery approach in laparoscopic radical gastrectomy

The Value of Chest CT in Staging of Gastric Cancer

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