Remnant gastric cancer: a neglected group with high potential for immunotherapy

Ramos, Marcus Fernando Kodama Pertille; Pereira, Marina Alessandra; Castria, Tiago Biachi De; Ribeiro, Renan Ribeiro e; Cardili, Leonardo; Mello, Evandro Sobroza de; Zilberstein, Bruno; Ribeiro-Júnior, Ulysses; Cecconello, Ivan

doi:10.1007/s00432-020-03322-7

Cited by 8 publications

(2 citation statements)

References 45 publications

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“…An increasing number of studies have shown that immunity and nutrition are closely related to the occurrence and development of cancer, which has led to the research and development of biomarkers or prognostic scoring systems based on immunity and nutrition[ 14 - 16 ]. The nutritional status of patients is often worse after partial gastrectomy and frequently combined with poor immune status, leading to the crucial evaluation of immune-nutritional indicators in patients with RGC[ 12 , 13 ]. Appropriate treatment strategies can be formulated by evaluating the relationship between immune-nutritional systems and the postoperative prognosis of patients with RGC.…”

Section: Discussionmentioning

confidence: 99%

“…However, the prognosis of RGC is often worse than that of primary GC even after radical gastrectomy[ 10 , 11 ]. Notably, patients often have malnutrition and poor immune status[ 12 , 13 ] after gastrectomy, which may be one of the factors leading to the poor prognosis of RGC patients. Therefore, systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative RGC patients are crucial.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery

Zhang¹,

Wang²,

Li³

et al. 2023

World J Gastrointest Surg

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BACKGROUND Remnant gastric cancer (GC) is defined as GC that occurs five years or more after gastrectomy. Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer (RGC) patients are crucial. A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary. AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC. METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively. Prognostic nutritional index (PNI), controlled nutritional status (CONUT), and Naples prognostic score (NPS) were calculated by preoperative blood indicators, including absolute lymphocyte count, lymphocyte to monocyte ratio, neutrophil to lymphocyte ratio, serum albumin, and serum total cholesterol. Patients with RGC were divided into groups according to the immune-nutritional risk. The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed. Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival (OS) rate between various immune-nutritional score groups. RESULTS The median age of this cohort was 70.5 years (ranging from 39 to 87 years). No significant correlation was found between most pathological features and immune-nutritional status ( P > 0.05). Patients with a PNI score < 45, CONUT score or NPS score ≥ 3 were considered to be at high immune-nutritional risk. The areas under the receiver operating characteristic curves of PNI, CONUT, and NPS systems for predicting postoperative survival were 0.611 [95% confidence interval (CI): 0.460–0.763; P = 0.161], 0.635 (95%CI: 0.485–0.784; P = 0.090), and 0.707 (95%CI: 0.566–0.848; P = 0.009), respectively. Cox regression analysis showed that the three immune-nutritional scoring systems were significantly correlated with OS (PNI: P = 0.002; CONUT: P = 0.039; NPS: P < 0.001). Survival analysis revealed a significant difference in OS between different immune-nutritional groups (PNI: 75 mo vs 42 mo, P = 0.001; CONUT: 69 mo vs 48 mo, P = 0.033; NPS: 77 mo vs 40 mo, P < 0.001). CONCLUSION These preoperative immune-nutritional scores are reliable multidimensional prognostic scoring systems for predicting the prognosis of patients with RGC, in which the NPS system has relatively effective predictive performance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery

Zhang¹,

Wang²,

Li³

et al. 2023

World J Gastrointest Surg

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Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45

Yang,

Zeng,

Liao

et al. 2024

BMC Cancer

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Purpose Proximal gastrectomy (PG) offers advantages over total gastrectomy (TG) in enhancing the postoperative nutritional status of patients with proximal gastric cancer (PGC), yet its effect on long-term quality of life is still debated. This study aims to thoroughly compare postoperative health condition outcomes between PG and TG. Methods We conducted a systematic search of English-language articles from the PubMed, Web of Science, and Cochrane Library databases, covering studies published up to February 2023. Key evaluation endpoints included surgical outcomes and postoperative health condition, assessed using the Post-Gastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Results Six retrospective cohort studies were included in the analysis. The PG group demonstrated no significant negative impact on surgical outcomes compared to the TG group. Notably, patients who underwent PG experienced a superior postoperative health condition, characterized by fewer gastroesophageal reflux symptoms (WMD = -0.106, 95% CI -0.183 to -0.029, P < 0.01), less weight loss (WMD = 4.440, 95% CI 3.900 to 4.979, P < 0.01), and reduced dietary dissatisfaction (WMD = -0.205, 95% CI -0.385 to -0.025, P = 0.03). Conclusion This study provides compelling evidence that PG is superior to TG in enhancing postoperative health condition for patients with proximal gastric cancer, without compromising surgical outcomes. However, further rigorous randomized controlled trials are necessary to inform surgical decision-making more effectively.

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The value of lymph nodes ratios in the prognosis of resectable remnant gastric cancer through the retrospective propensity score matching analysis

et al. 2023

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Purpose Currently, the characteristics and prognosis of remnant gastric cancer (RGC) are not fully understood yet. The present study aimed to describe the details of clinicopathological features of resectable RGC and investigated the factors affecting survival after the curative operation. Methods From Jan. 2006 to Dec. 2015, a total of 118 resectable RGC patients (the RGC group) and 236 age-, sex- and TNM stages-matched resectable gastric cancer (GC) patients (the control group) were recruited retrospectively. Clinicopathological characteristics and overall survival were compared between the two groups. Results The overall survival rate was 46.61% for RGC patients compared to 55.08% for control groups (P < 0.01), and the mean overall survival time of RGC patients was 40.23 ± 32.27 months, compared to 55.06 ± 34.29 months in the control group (P = 0.023 after matching). The overall survival (OS) of RGC patients with stage IIb was much worse than IIa (P < 0.001) and similar to IIIa (P = 0.463) and IIIb (P = 0.014). Multivariate Cox proportional hazards model analysis revealed that TNM stage (HR: 3.899, P < 0.001) and lymph nodes ratio (LNR) (HR: 2.405, P = 0.028) were independent prognostic significance to OS. Conclusions The OS of RGC was much worse than GC with similar TNM stages, and LNR might consider a highly reliable indicator to evaluate the prognostic in RGC.

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Remnant gastric cancer: a neglected group with high potential for immunotherapy

Cited by 8 publications

References 45 publications

Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery

Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery

Comparison of proximal gastrectomy and total gastrectomy in proximal gastric cancer: a meta-analysis of postoperative health condition using the PGSAS-45

The value of lymph nodes ratios in the prognosis of resectable remnant gastric cancer through the retrospective propensity score matching analysis

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