The Prognostic Determinants of Gastric Cancer Treatment Outcome in Omani Arab Patients

Abstract

Background: Gastric cancer is the most common cancer in Oman and a leading cause of cancer death. The variation in survival rates between countries and ethnic groups has been attributed to early detection policies, differences in clinicopathological features, treatment approaches, and biological characteristics. There were no previous reports on gastric cancer from Oman and very few studies on Asian Arabs. Aim: To evaluate the impact of clinicopathological and treatment variables on the survival prospects of Omani Arab patients diagnosed with gastric cancer. Methods: The medical records of 339 Omani Arab patients diagnosed with invasive gastric adenocarcinoma during the period 1993–2004 were retrospectively reviewed. The relative importance of clinicopathological features and surgical and medical treatments were assessed using univariate and multivariate analyses. Results: Most patients had distal ulcerating-type gastric cancer and presented at advanced stages. The median survival time for the entire cohort was 12 months (95% CI 9.7–14.4) with a 5-year overall survival rate of 16.7%. On univariate analysis of 237 patients who underwent surgical resection, the following positive prognostic factors emerged as significant: early overall TNM stage, early T stage, negative lymph nodes, tumor size <5 cm, ulcerating macroscopic appearance, and curative surgical attempt. The independent prognostic factors on multivariate analysis were T stage and lymph node involvement. Conclusion: The overall T and N stages are the most important determining factor for survival in Omani Arab patients. More efforts need to be made for the early detection of gastric cancer in developing countries such as Oman, while continuing to employ the standard surgical and medical treatments.

Polymorphisms of Human N-Acetyltransferases and Cancer Risk

“…Ladero et al reported a weak association of the NAT2 rapid acetylation genotypes with increased risk [99], which is consistent with that reported for patients with family history of gastric cancer [100]. Three studies [98,101,102] found no association of the NAT2 genotype and risk, and two studies observed the opposite association indicating that slow NAT2 genotypes combined with the null GSTT1 [103] or GSTM1 [104] genotypes increase the risk for gastric cancer. The largest studies, summing up over 500 patients, revealed no major effect of the NAT1 or the NAT2 genotypes in gastric cancer risk [98,105].…”

Measurement of circulating levels of VEGF-A, -C, and -D and their receptors, VEGFR-1 and -2 in gastric adenocarcinoma

“…The prognosis of patients with gastric cancer has been shown to be influenced by established surgical-pathological features, such as pathological stage, location of the tumor, and histological type and grade of the tumor [2][3][4] . In comparison, the intense search for predictive molecular biomarkers has not yet translated into clinical use [5][6][7] .…”

Carcinoma de células en anillo de sello gástrico: Descripción clínico-morfológica y valor pronóstico

“…El análisis de la pieza operatoria ha permitido identifi car variables anatomo-patológicas con valor pronóstico en la supervivencia y recurrencia de la enfermedad en estos pacientes, siendo el compromiso ganglionar linfático (N) y nivel de infi ltración tumoral en la pared gástrica (T) de los factores más relevantes identifi cados. En distintos estudios se mencionan otros factores morfológicos pronósticos, como tamaño, localización y forma tumoral, grado de diferenciación histológica, tipo histológico (anillo de sello y no anillo de sello), barrera ganglionar linfática comprometida, metástasis a distancia, estadio TNM y presencia de tumor residual [6][7][8][9][10][11][12][13][14][15][16][17][18][19] . En cuanto al tipo histológico, los carcinomas gástricos se pueden agrupar de la siguiente forma: carcinoma anillo de sello (CAS) y carcinoma no anillo de sello (CNAS) incluyéndose en este último grupo los carcinomas tubular, papilar, mucinoso y otras variedades menos frecuentes tales como adenoescamoso y escamoso puro.…”