Lymph node metastasis as a significant prognostic factor in gastric cancer: a multiple logistic regression analysis

Yokota, Takashi; Ishiyama, Shuichi; Saito, Toshihiro; Teshima, Shin‐ichi; Narushima, Yoichi; Murata, Katsuyuki; Iwamoto, Kazutsugu; Yashima, Rei; Yamauchi, Hidemi; Kikuchi, Shu

doi:10.1080/00365520310008629

Cited by 128 publications

(94 citation statements)

References 17 publications

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“…Patients with AT1R + gastric cancer and an ACE DD genotype had all developed lymph node metastases, leading to the conjecture that this is a specific high-risk patient population. The poor prognosis for gastric cancer is often related to presentation at an advanced tumor stage, and is most strongly influenced by lymph node involvement (3). Early identification of a high-risk gastric cancer group might allow the identification of patients who should undergo extensive lymph adenectomy (D2 versus D1) in gastric cancer surgery, as well as enabling the therapeutic approach to be tailored towards a more aggressive regimen in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Its prognosis is poor, as it is usually first diagnosed in advanced stages, when curative treatment is impossible. At the time of diagnosis, most gastric cancers have already spread to the lymph nodes, which is the most significant independent prognostic factor for this disease: the 5-year survival rate for patients with lymph node metastases is 9.8 F 4% compared with 58 F 11% for patients without lymph node metastases (2,3). Identifying patients with an increased risk of developing lymph node metastasis in gastric cancer is of high importance because this would influence both the extent of surgical resection (D1 or D2 resection), and/or the indication for neoadjuvant or adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

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The Angiotensin II/Angiotensin II Receptor System Correlates with Nodal Spread in Intestinal Type Gastric Cancer

Röcken

Röhl

Diebler³

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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We aimed to substantiate the putative significance of angiotensin II receptor type 1 (AT1R) and type 2 (AT2R) for gastric cancer biology by investigating the correlation of their expression with various clinicopathologic variables and patient survival. Local expression of AT1R, AT2R, and angiotensin-converting enzyme (ACE) was investigated by immunohistochemistry in tumor and corresponding nontumor specimens obtained from 100 patients with gastric cancer, and compared with the ACE insertion/deletion gene polymorphism. AT1R and AT2R were found in the tumor epithelial cells of 26 (26%) and 95 (95%) patients, respectively. AT1R was significantly more prevalent (P < 0.001) in intestinal type gastric cancer than in diffuse type gastric cancer. In intestinal type gastric cancer, its expression correlated with the N category (P = 0.009) and the International Union Against Cancer tumor stage (P = 0.024). AT1R + intestinal type gastric cancers had a larger number of lymph node metastases (P = 0.026), a higher International Union Against Cancer tumor stage (P = 0.032), and a shorter survival time (P = 0.009) than AT1RÀ tumors. Multivariate analysis with lymph nodes as a dependent variable showed that AT1R status and ACE-I/D gene polymorphism are independent risk factors. Irrespective of the genotype, AT1R+ gastric cancers had a relative risk of lymph node metastases of 4.40 (95% confidence interval, 1.30-14.86). When the ACE genotype was included, the relative risk of having lymph node metastases increased considerably in AT1R + tumors being heterozygous or homozygous for the ACE D allele (odds ratio, 19.00; 95% confidence interval, 1.45-248.24). Our study shows that AT1R and AT2R are expressed locally in gastric cancer and that the combination of AT1R expression and ACE I/D gene polymorphism correlates with nodal spread in intestinal type gastric cancer. (Cancer Epidemiol Biomarkers Prev 2007;16(6):1206 -12)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Angiotensin II/Angiotensin II Receptor System Correlates with Nodal Spread in Intestinal Type Gastric Cancer

Röcken

Röhl

Diebler³

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Presence of lymph node metastasis was not a prognostic factor in the reviewed reports. Previous reports indicate lymph node metastasis as a strong prognostic factor in gastric cancer of any size (Yokota et al, 2004;Shiraishi et al, 2007). This difference does not seem to be explained by ethnical differences or histopathology of tumors in our region.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Factors and Gastric Cancer Prognosis in the Iranian Population: a Meta-analysis

Somi

Ghojazadeh²,

Bagheri³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Gastric cancer is the most common cancer in the Iranian population. The aim of this study was to determine the effect of clinicopathological factors on prognosis by meta-analysis. Materials and Methods: A literature search was conducted using MEDLINE, EMBASE and Cochrane library and extensive literature search using the Persian databases until February 2011. Prospective follow up studies with multivariate analysis of overall survival of the patients with gastric cancer were included in this review. The data were analyzed by CMA.2. Publication bias are checked by funnel plot and data are shown as Forest plots. Results: From a total of 63 articles, 14 retrospective studies which examined 5 prognostic factors and involving 10,500 patients were included. Tumor size (>35mm) was the main significant factor predicting an unfavorable prognosis for the patients with gastric cancer (RR=1.829 , p<0.001) followed by presence of distant metastases (RR=1.607 , p<0.001), poor differentiation (RR=1.408 , p<0.001) and male sex (RR=1.194, p<0.001). Lymph node metastases (RR=1.058, p=0.698) and moderate differentiation (RR=0.836, p=0.043) were not statistically significant as prognostic factors. Conclusions: This meta-analysis suggests that tumor size>35mm, poor differentiation, presence of distant metastasis and male gender are strongly associated with a poor prognosis in Iranian patients with gastric cancer.

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“…Risk factors of lymph node metastasis in EGC are known to be tumor size, depth of tumor invasion, differentiation and angiolymphatic invasion, which have variable criteria according to the studies (Yokoda et al, 2004). In tumor size, discrepancy may exist between surgically-resected and endoscopically-resected specimen.…”

Section: Standardization Of Risk Factors Of Lymph Node Metastasis In Egcmentioning

confidence: 99%

Endoscopic Resection of Early Gastric Cancer

Kim

2009

Korean J Gastroenterol

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Lymph node metastasis as a significant prognostic factor in gastric cancer: a multiple logistic regression analysis

Cited by 128 publications

References 17 publications

The Angiotensin II/Angiotensin II Receptor System Correlates with Nodal Spread in Intestinal Type Gastric Cancer

The Angiotensin II/Angiotensin II Receptor System Correlates with Nodal Spread in Intestinal Type Gastric Cancer

Clinicopathological Factors and Gastric Cancer Prognosis in the Iranian Population: a Meta-analysis

Endoscopic Resection of Early Gastric Cancer

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