Timing of Adjuvant Chemotherapy and Survival in Colorectal, Gastric, and Pancreatic Cancer. A Systematic Review and Meta-Analysis

Petrelli, Fausto; Zaniboni, Alberto; Ghidini, Antonio; Ghidini, Michele; Turati, Luca; Pizzo, Claudio; Ratti, Margherita; Libertini, Michela; Tomasello, Gianluca

doi:10.3390/cancers11040550

Cited by 58 publications

(52 citation statements)

References 47 publications

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“…Despite major progress in the diagnosis and treatment of early gastric cancer (EGC), gastric cancer remains the second most frequent cause of cancer death globally [1,2]. To date, endoscopic mucosal resection and endoscopic submucosal dissection are the 2 ideal curative treatments for EGC, and no significant difference in mortality and survival rate between endoscopic surgery and open surgery was observed [3,4].…”

Section: Introductionmentioning

confidence: 99%

Abundance of CD163-Positive Tumor-Associated Macrophages in the Early Gastric Cancer Predicts the Recurrence after Curative Resection

Zhou¹,

Zhang

He³

et al. 2020

Dig Dis

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Background: We aimed to investigate the prognostic value of M2 macrophages to predict the recurrence of early gastric cancer (EGC). Methods: A retrospective analysis was carried out among EGC patients (95 non-recurrence and 78 recurrence) who underwent surgery at Luhe People’s Hospital of Nanjing. A 5-year recurrence status was utilized to classify the patients into the recurrence group and non-recurrence group. CD163 and proliferating cell nuclear antigen were utilized as markers to detect M2 macrophages and proliferation. Cumulative tumor recurrence curve was adopted to analyze the association between the number of tumor-associated macrophages (TAMs) and the recurrence of EGC. Colony formation and invasion abilities of MKN45 (JCRB0254, human gastric epithelial cell line) with or without M2 macrophage coculture were detected in vitro, and the xenograft model was utilized to detect in vivo effect of M2 macrophages on tumor growth. Results: The number of CD163+ macrophages and expression of transforming growth factor-β1, matrix metallopeptidase 9, and vascular endothelial growth factor A were significantly different between the EGC recurrence and non-recurrence group. The cumulative tumor recurrence rate was found to be dependent on the infiltration number of TAMs. M2 macrophages promoted the proliferation and invasion of human MKN45 cells in vitro, as well as tumor growth in the xenograft model. Conclusion: The abundance of CD163+-positive TAMs in EGC predicts the recurrence after curative resection.

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Section: Introductionmentioning

confidence: 99%

Abundance of CD163-Positive Tumor-Associated Macrophages in the Early Gastric Cancer Predicts the Recurrence after Curative Resection

Zhou¹,

Zhang

He³

et al. 2020

Dig Dis

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“…A recent meta-analysis showed a survival benefit when AC was started within 6 to 8 weeks of surgery. However, when AC was started after 8 weeks, a 20% increased risk of death was observed (27). Notwithstanding, this meta-analysis did not evaluate solely gastric cancer, but also included other types of cancer such as colorectal or pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

Optimal time interval from surgery to adjuvant chemotherapy in gastric cancer

et al. 2020

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The effect of adjuvant chemotherapy (AC) for resected gastric cancer is well established; however, delays in treatment and its impact on clinical outcomes have not yet been determined. The current study analyzed the survival rates based on time interval (TI) between surgery and AC administration to evaluate a potential association between the two variables. Patients diagnosed with stage II-III gastric adenocarcinoma between 2009 and 2016 at the Kyung Hee University Hospital were included. Patients' data including demographics, TNM stage, types of AC, and TI retrospectively collected from surgery to the start of AC. Patients were dichotomized based on the TI, which was predetermined at 3, 4, 5, 6, 7 or 8 weeks. Median disease-free survival (DFS) and overall survival (OS) were analyzed according to TI. In total, 172 patients were identified. The median follow-up duration was 40.8 (3-109) months. The median TI was 4.1 (2.1-9.8) weeks. DFS in patients with TI ≥4 weeks (n=106, 61.6%) was significantly lower compared with patients with TI <4 weeks (n=66, 38.4%), with a median DFS of TI < vs. ≥4 weeks of 8.1 vs. 6.0 years [hazard ratio (HR)=1.80, 95% confidence interval (CI): 1.067-3.045, P=0.0277]. OS was also significantly reduced in patients with TI ≥4 weeks, favoring TI <4 weeks [median OS of TI < vs. ≥4 weeks: Not reached (NR) vs. 7.0 years, HR=2.15, 95% CI: 1.173-3.939, P=0.0133]. Other predetermined TIs were not associated with survival outcomes. The current study demonstrated that AC within 4 weeks of surgery should be recommended for gastric cancer, and delays of >4 weeks may be detrimental to patients' survival.

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“…Adjuvant therapy should be initiated as soon as patient has recovered from surgery with complete healing of surgical wounds which usually takes about 2-4 weeks. A meta-analysis in 2019 which included 34 comparative studies of resected colon cancer reported that delay in treatment beyond 6-8 weeks was associated with inferior survival (HR 1.27,95% CI 1.21-1.33; p < 0.001) [50]. Another review which included more than 15,000 patients concluded that a 4-week increase in time to initiate adjuvant chemotherapy was associated with a 14% relative decrease in disease free survival and overall survival [51].…”

Section: Timing Of Chemotherapymentioning

confidence: 99%

Adjuvant Therapies in Colon Cancer

Prasanna¹,

Yip²

2021

Colorectal Cancer

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Most of the patients with localized colon cancer undergo curative resection. However, significant number of patients will recur with metastatic disease, especially those with node positive cancer. Adjuvant chemotherapy has shown to improve cure rate and survival by eradicating micrometastases. The benefit of adjuvant therapy is well established in node-positive cancers, while their role in stage II cancer is not well defined. A number of molecular markers have been identified that are prognostic and/or predictive in colon cancer. Such molecular markers, and other clinicopathological features play an important role in selection of appropriate therapy and duration of treatment. Emerging evidence for the utility of genomic profiling or detection of circulating tumor DNA (ctDNA) are promising which may further facilitate decision making in the future. This chapter reviews the evolution of adjuvant therapy for resected colon cancer, the current evidence and the factors influence the choice of therapy.

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Timing of Adjuvant Chemotherapy and Survival in Colorectal, Gastric, and Pancreatic Cancer. A Systematic Review and Meta-Analysis

Cited by 58 publications

References 47 publications

Abundance of CD163-Positive Tumor-Associated Macrophages in the Early Gastric Cancer Predicts the Recurrence after Curative Resection

Abundance of CD163-Positive Tumor-Associated Macrophages in the Early Gastric Cancer Predicts the Recurrence after Curative Resection

Optimal time interval from surgery to adjuvant chemotherapy in gastric cancer

Adjuvant Therapies in Colon Cancer

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