Prognostic factors for cytology-positive gastric cancer

Endo, Shunji; Ikenaga, Masakazu; Ohta, Katsuya; Ueda, Masami; Tsuda, Yujiro; Kato, Ryo; Itakura, Hiroaki; Matsuyama, Jin; Nishikawa, Kazuhiro; Yamada, Terumasa

doi:10.1007/s00595-018-1704-1

Cited by 16 publications

(9 citation statements)

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“…On the other hand, only 14% and 13% of patients developed their first recurrence in the lymph nodes after standard and <D2 lymphadenectomy, respectively. Although nodal status is reported to be a risk factor for CY1 gastric cancer (7,8,(19)(20)(21)(22)(23), the extent of lymph node dissection did not affect the lymph node recurrence rate in this population. D1+ or even D1 lymphadenectomy may be sufficient for patients with CY1 gastric cancer.…”

Section: Discussionmentioning

confidence: 63%

“…Multivariate analysis showed that postoperative chemotherapy may play a more important role than lymphadenectomy for CY1 cases. Previous studies have also reported that the absence of postoperative chemotherapy, as well as poorer PS (17), poorer PNI (19), and massive lymph node metastases (7,8,(19)(20)(21)(22)(23), were independent unfavorable predictors of survival among patients with CY1 gastric cancer (7). Our univariate analyses also showed that PS 1-3, PNI of <40, cN2-3, <D2 lymphadenectomy, undifferentiated histological classification, pN3, and absence of postoperative chemotherapy were prognostic factors, but the multivariate analysis showed that only undifferentiated histological classification and lack of postoperative chemotherapy were independent predictors.…”

Section: Discussionmentioning

confidence: 90%

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Is D2 Lymphadenectomy Essential for Cytology-positive Gastric Cancer? A Retrospective Analysis

et al. 2019

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Background: The appropriate extent of lymphadenectomy on gastric cancer patients with positive peritoneal cytology (CY1) is uncertain. This study retrospectively compared overall survival (OS) after standard and limited lymphadenectomy. Patients and Methods: The medical records from four institutions from 2004 to 2018 were reviewed and data for 91 patients with CY1, but no other distant metastases, who underwent gastrectomy were analyzed. D2 or greater lymphadenectomy and less than D2 lymphadenectomy were performed in 51 and 40 patients, respectively. Results: Full cohort analyses showed that patients who underwent D2 or greater lymphadenectomy had better prognostic nutritional indices and more such patients received postoperative chemotherapy. The OS in the group treated with D2 or greater lymphadenectomy was also significantly better (p=0.045). Twenty-seven pairs of patients were generated via propensity score matching, and analysis of their OS showed no significant difference between the groups according to lymphadenectomy (p=0.61). Conclusion: The extent of lymphadenectomy may not affect the prognoses for patients with CY1 gastric cancer.Gastric cancer was estimated to be the fourth most common cause of cancer death worldwide, behind lung, liver, and colorectal cancer, in 2016 (1). Although early gastric cancer can be cured by endoscopic resection or surgery, the prognosis of advanced gastric cancer with distant metastases is still poor. The presence of free cancer cells in the abdominal cavity, which can be determined by peritoneal lavage cytology from the pouch of Douglas during surgery, is classified as CY1 in the Japanese classification of gastric carcinoma (2), is included in distant metastasis, and is categorized as stage IV in both the Japanese classification and the International Union Against Cancer TNM classification (3). In the Japanese gastric cancer registry in 2010 (4), the 5-year overall survival (OS) rates for patients with CY0 and CY1 gastric cancer were 66.2% and 13.1%, respectively.The CCOG0301 study, a phase II study of radical surgery followed by postoperative chemotherapy with S-1 for CY1 gastric cancer, showed excellent outcomes with a median survival time (MST) of 23.1 months and a 5-year survival rate of 26% (5). In that study, gastrectomy was performed with D2 lymphadenectomy. Since that study, radical gastrectomy with D2 lymphadenectomy has been recognized as a standard therapy for CY1 gastric cancer without other distant metastases. However, in clinical practice, limited lymphadenectomy of D1+, D1, or D0 has often been performed for CY1 gastric cancer (6, 7). Because recurrences after radical gastrectomy in patients with CY1 disease were most frequently found in the peritoneum (8), radical lymphadenectomy did not seem to be associated with survival benefit. D1+ or lesser lymphadenectomy may be appropriate for CY1 gastric cancer (6). However, the optimal lymphadenectomy for CY1 gastric cancer has not yet been clarified.In this study, we hypothesized that limited lymphadenectomy was ...

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 90%

Is D2 Lymphadenectomy Essential for Cytology-positive Gastric Cancer? A Retrospective Analysis

et al. 2019

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“…There are numerous factors that affect the prognosis of patients with GC ( 64 , 65 ). Recent studies have found that positive abdominal cytology is an important factor affecting the prognosis of patients with GC ( 66 , 67 ). A recent study found postoperative chemotherapy can improve the survival rate of GC patients with positive peritoneal cytology ( 68 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, due to the limited number of samples, the value and mechanism of hsa_circ_0060975 in GC needs to be further studied. In addition, the present was a retrospective study, which only used GC tissues and blood samples and did not obtain detailed data about peritoneal cytology, which may have an impact on the prognosis of patients with GC ( 66 , 67 ). Future research should collect detailed patient data, including abdominal cytology data of patients with GC and conduct large-scale and multicenter studies to investigate the value and possible mechanism of hsa_circ_0060975 in patients with GC.…”

Section: Discussionmentioning

confidence: 99%

hsa_circ_0060975 is highly expressed and predicts a poor prognosis in gastric cancer

Zhang

et al. 2021

Oncol Lett

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Gastric cancer (GC) is the fifth most common cancer and GC has a high mortality rate worldwide. Circular (circ) RNAs serve an important role in cancer. The present study aimed to investigate the expression level of hsa_circ_0060975 in gastric cancer (GC) and to determine the clinical pathological significance of hsa_circ_0060975 in patients with GC. Reverse transcription-quantitative PCR was used to detect expression level of hsa_circ_0060975 in 192 GC and adjacent non-cancerous gastric tissues, in GC cell lines (MKN-45, HGC27 and AGS) and a human gastric epithelium cell line (GES-1), as well as in plasma samples from 126 patients with GC and 92 healthy volunteers. All plasma and tissue samples of were obtained from The First Affiliated Hospital of Anhui Medical University (Hefei, China). The relationship between hsa_circ_0060975 expression and clinical pathological factors was analyzed using the χ 2 test. The diagnostic value of hsa_circ_0060975 was analyzed using the receiver operating characteristic curve (ROC curve), while the Kaplan-Meier method was used to analyze the relationship of hsa_circ_0060975 expression with the survival of patients with GC as determined by log-rank tests. Univariate and multivariate Cox regression analyses were used to identify the prognostic factors, including hsa_circ_0060975 expression and clinical pathological factors. In addition, the potential function of hsa_circ_0060975 was evaluated via bioinformatics analysis. The expression level of hsa_circ_0060975 was higher in GC tissues compared with adjacent non-cancerous gastric tissues, GC cell lines compared with GES-1 and plasma samples from patients with GC compared with plasma samples from healthy volunteers. In addition, higher hsa_circ_0060975 expression was associated with histological grade, pathological stage and tumor (T) classification in GC tissues and plasma samples (P<0.05). The area under the ROC curves of hsa_circ_0060975, the combination with hsa_circ_0060975 and carcinoembryonic antigen (CEA) or CEA alone were 0.804 (sensitivity, 0.746; specificity, 0.783; P<0.001); 0.931 (sensitivity, 0.937; specificity, 0.870; P<0.001) and 0.924 (sensitivity, 0.937; sspecificity, 0.804; P<0.001) respectively. The Kaplan-Meier survival analysis revealed that the overall survival (OS) and disease-free survival (DFS) time of patients with higher hsa_circ_0060975 expression were shorter compared with those in patients with lower hsa_circ_0060975 expression. Univariate and multivariate Cox regression analyses in OS and DFS time determined that the expression level of hsa_circ_0060975, histological grade and pathological stage were independent prognostic factors for patients with GC. In addition, the bioinformatics analysis results suggested that the abnormal expression of hsa_circ_0060975 may serve an important role in tumorigenesis. Hence, hsa_circ_0060975 expression may be an independent prognostic factor for patients with GC and may be a potential marker for biological malignancy.

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“…Multidisciplinary approaches for the treatment of GC with advanced peritoneal metastasis are currently chemo-Visc Med 2022;38:81-89 DOI: 10.1159/000522604 therapy based with regimens containing a platinum/fluorouracil backbone in the 1st line due to the encouraging results of the AIO-FLOT 3 trial. Cytologic findings of free cancer cells in peritoneal washings in the absence of macroscopic peritoneal involvement are thereby considered as an early metastatic stage [51,52], associated with significantly worse survival than non-metastatic GC [53,54].…”

Section: Treatment Options For Locally Advanced Gc With Peritoneal Me...mentioning

confidence: 99%

Indication of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer (Gastripec, Gastrichip)

et al. 2022

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Background: Gastric cancer (GC) is associated with a poor prognosis mostly due to peritoneal metastasis, which will develop in time during the patient’s disease history. To prevent and treat peritoneal metastasis, different kinds of treatment regimens have been described. Summary: In this review, we addressed two main topics – prophylaxis and treatment of peritoneal metastasis in GC. Prevention should be directed towards diminishing cancer cell spillage and reducing adherence of cancer cells to the abdominal cavity. Postoperative washing of the abdomen with or without chemotherapy and additional heat are herein discussed. Key Messages: Treatment of existing peritoneal metastasis is effective in patients with limited disease and tumour spread. Cytoreductive surgery including resection of peritoneal metastasis followed directly with hyperthermic intraperitoneal chemotherapy can increase overall survival and progression-free survival in selected patients. Drugs, duration and time schedules of intraperitoneal chemotherapy are reviewed and presented. Intraperitoneal chemotherapy seems to improve the prognosis of patients with GC and peritoneal metastasis after complete resection of both primary and metastatic tumours.

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Prognostic factors for cytology-positive gastric cancer

Abstract: The prognoses of CY1 gastric cancer patients with cN2-3 or PNI < 40 were poor, even after gastrectomy.

Cited by 16 publications

References 15 publications

Is D2 Lymphadenectomy Essential for Cytology-positive Gastric Cancer? A Retrospective Analysis

Is D2 Lymphadenectomy Essential for Cytology-positive Gastric Cancer? A Retrospective Analysis

hsa_circ_0060975 is highly expressed and predicts a poor prognosis in gastric cancer

Indication of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer (Gastripec, Gastrichip)

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