Lauren Histology and Lymphatic Permeation are Critical Prognostic Factors in Borrmann Type I Gastric Cancer

Yamashita, Keishi; Katada, Natsuya; Hosoda, Kei; Mieno, Hiroaki; Moriya, Hiromitsu; Kikuchi, Shiro; Watanabe, Masahiko

doi:10.9738/intsurg-d-15-00205.1

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…Among them, type IV gastric cancer is most common to invade the serosa and the surrounding organs. Previously, when Borrmann type IV patients were treated, more than 70% of the patients belonged to the pT4a stage, and nearly 20% of the patients belonged to the pT4b stage (35). With the recent advances in CT imaging technology, the ability of CE-CT imaging to distinguish between the 5-layer structure of the gastric wall has significantly improved (36).…”

Section: Discussionmentioning

confidence: 99%

The predictive potential of contrast-enhanced computed tomography based radiomics in the preoperative staging of cT4 gastric cancer

Liu¹,

Zhang²,

Wang³

et al. 2022

Quant Imaging Med Surg

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Background: The accuracy of preoperative staging is crucial for cT4 stage gastric cancer patients. The aim of this study was to develop the radiomics model and evaluate its predictive potential for differentiating preoperative cT4 stage gastric cancer patients into pT4b and no-pT4b patients. Methods: A multicenter retrospective analysis of 704 gastric cancer patients with preoperative contrastenhanced computed tomography (CE-CT) staging cT4 between January 2008 and December 2021. These patients were divided into the training cohort (478 patients, the Affiliated Hospital of Qingdao University) and validation cohort (226 patients, the Weihai Wendeng District People's Hospital). According to the pathological stage of the tumors, the patients were divided into pT4b or no-pT4b stage. In the training cohort, the clinical and radiomics features were analyzed to construct the clinical model, tri-phase radiomics signatures and nomogram. Two kinds of methods were employed to achieve dimensionality reduction: (I) the least absolute shrinkage and selection operator (LASSO); and (II) the minimum redundancy maximum relevance (mRMR) algorithms. We utilized Logistic regression, support vector machine (SVM), Decision tree and Adaptive boosted tree (AdaBoost) algorithms as the machine learning classifiers. The nomogram was constructed on the clinical characteristics and the Rad-score. The performance of the models was evaluated by receiver operating characteristic (ROC) area under the curve (AUC), Decision Curve Analysis (DCA) curve and calibration curve. Results: The 345 pT4b and 359 no-pT4b stage patients were included in this study. In the validation cohort, the AUC of the clinical model was 0.793 (95% CI: 0.732-0.855). The tri-phase radiomics features combined with the SVM algorithm was the best radiomics signature with an AUC of 0.862 (95% CI: 0.812-0.912). The nomogram was the best predictive model of all with an AUC of 0.893 (95% CI: 0.834-0.927). In the training and validation cohorts, the calibration curves and DCA curves of the nomogram showed satisfactory result. Conclusions: CE-CT-based radiomics nomogram offers good accuracy and stability in differentiating preoperative cT4 stage gastric cancer patients into pT4b and non-pT4b stages, which has a great clinical relevance for selecting the course of treatment for cT4 stage gastric cancer patients.

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Section: Discussionmentioning

confidence: 99%

The predictive potential of contrast-enhanced computed tomography based radiomics in the preoperative staging of cT4 gastric cancer

Liu¹,

Zhang²,

Wang³

et al. 2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…Among these macroscopic types showing better prognosis, Type I gastric cancer is reported to be relatively rare accounting for 2.2%‐8% of all resectable gastric cancer . Its detailed prognostic features remain unclear because few prognostic analyses have been carried out.…”

Section: Therapeutic Strategies According To Macroscopic Classificatimentioning

confidence: 99%

“…Its detailed prognostic features remain unclear because few prognostic analyses have been carried out. We recently investigated prognostic factors in Type I gastric cancer and reported that patients with a high risk for recurrence had diffuse‐type histology with robust lymphatic invasion . Recurrence pattern of Type I gastric cancer with intestinal‐type histology is unique as this type of gastric cancer is prone to metastasize to the liver such as colorectal cancer (CRC).…”

Section: Therapeutic Strategies According To Macroscopic Classificatimentioning

confidence: 99%

Re‐emerging role of macroscopic appearance in treatment strategy for gastric cancer

Hosoda

Watanabe

Yamashita

2018

Annals of Gastroent Surgery

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Pathological outcomes are definitely the most important prognostic factors in gastric cancer, but they can be obtained only after surgical resection. Use of preoperative adjuvant chemotherapy is becoming widespread for aggressive human cancer, so clinical factors such as macroscopic features are important as they are highly predictive for patient prognosis. In gastric cancer, the macroscopic type represents a distinct prognosis; Type 0 represents early gastric cancer with excellent prognosis, but, among advanced tumors, giant Type III and Type IV tumors have a dismal prognosis. Japan Clinical Oncology Group (JCOG) Stomach Cancer Study Group adopted macroscopic features as high‐risk entities in clinical trials. It makes sense for risk classification to use macroscopic phenotypes because The Cancer Genome Atlas (TCGA) Network has lately subcategorized different histologies associated with specific macroscopic types by the molecular features of the whole genome. Dismal prognosis of Type IV gastric cancer is notorious, but similar prognosis was seen in giant Type III gastric cancer defined as 8 cm or beyond, both of which are unique for their propensity of peritoneal dissemination. In this review, clinical relevance including prognosis of such macroscopic high‐risk features will be separately debated in the context of precision medicine and updated prognostic outcomes will be presented under the present standard therapy of curative surgery followed by postoperative S‐1 chemotherapy. Moreover, promising emerging novel therapeutic strategies including trimodal potent regimens or intraperitoneal chemotherapy will be described for such aggressive gastric cancer.

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Lauren Histology and Lymphatic Permeation are Critical Prognostic Factors in Borrmann Type I Gastric Cancer

Abstract: Lauren histology and lymphatic permeation are critical prognostic factors in Borrmann type I gastric cancer

Cited by 2 publications

References 26 publications

The predictive potential of contrast-enhanced computed tomography based radiomics in the preoperative staging of cT4 gastric cancer

The predictive potential of contrast-enhanced computed tomography based radiomics in the preoperative staging of cT4 gastric cancer

Re‐emerging role of macroscopic appearance in treatment strategy for gastric cancer

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