Updated evidence on adjuvant treatments for gastric cancer

Kanda, Mitsuro; Kodera, Yasuhiro; Sakamoto, Junichi

doi:10.1586/17474124.2015.1094373

Cited by 48 publications

(36 citation statements)

References 66 publications

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“…The requirement for adjuvant chemotherapy to treat patients with stage II GC with the same intensity as stage III is now under discussion worldwide, because patients with stage II GC are expected to have a favorable prognosis compared with those with stage III GC. [15,16,37,38] According to the present results, preoperative PNI may serve as an effective indicator for selecting patients with stage II GC who are eligible for intense nutritional intervention.…”

Section: Discussionmentioning

confidence: 70%

“…Since 2007, adjuvant chemotherapy with S-1 (an oral fluoropyrimidine derivative) was available as a standard option for treating patients who were eligible for the current study, unless contraindicated by a patient's condition. [15,16] The chemotherapy protocol implemented after recurrence was determined by the attending physicians according to the available evidence, the patient's physical condition, and with the patient's consent. Postoperative follow-up, which was conducted according to the Japanese Gastric Cancer Treatment Guidelines, included physical examination, laboratory tests, and enhanced computed tomography (chest and abdominal cavity) once every 6 months for 5 years or until death.…”

Section: Methodsmentioning

confidence: 99%

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Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer

et al. 2016

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Evidence indicates that impaired immunocompetence and nutritional status adversely affect short-term and long-term outcomes of patients with cancer. We aimed to evaluate the clinical significance of preoperative immunocompetence and nutritional status according to Onodera's prognostic nutrition index (PNI) among patients who underwent curative gastrectomy for gastric cancer (GC).This study included 260 patients with stage II/III GC who underwent R0 resection. The predictive values of preoperative nutritional status for postoperative outcome (morbidity and prognosis) were evaluated. Onodera's PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm3).The mean preoperative PNI was 47.8. The area under the curve for predicting complications was greater for PNI compared with the serum albumin concentration or lymphocyte count. Multivariate analysis identified preoperative PNI < 47 as an independent predictor of postoperative morbidity. Moreover, patients in the PNI < 47 group experienced significantly shorter overall and disease-free survival compared with those in the PNI ≥ 47 group, notably because of a higher prevalence of hematogenous metastasis as the initial recurrence. Subgroup analysis according to disease stage and postoperative adjuvant treatment revealed that the prognostic significance of PNI was more apparent in patients with stage II GC and in those who received adjuvant chemotherapy.Preoperative PNI is easy and inexpensive to determine, and our findings indicate that PNI served as a significant predictor of postoperative morbidity, prognosis, and recurrence patterns of patients with stage II/III GC.

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Section: Discussionmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 99%

Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer

et al. 2016

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“…The possible reason was the inclusion of patients before the standardization of S-1 adjuvant. In the early 2000s, adjuvant chemotherapy was selectively administered to worrisome patients for recurrences due to more advanced disease stages [33,34].…”

Section: Discussionmentioning

confidence: 99%

Perioperative Serum Carcinoembryonic Antigen Levels Predict Recurrence and Survival of Patients with Pathological T2-4 Gastric Cancer Treated with Curative Gastrectomy

et al. 2017

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Background/Aims: Do serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels serve as prognostic indicators in patients with gastric cancer (GC)? This is a question that has long been disputed. The aim of this study was to evaluate the significance of perioperative serum levels of CEA and CA19-9 for predicting the recurrence and long-term survival after patients with pT2-4 GC undergo curative gastrectomy. Methods: This study included 251 patients with radically resected pT2-4 GC without preoperative treatment. Associations between the preoperative and postoperative serum levels of CEA or CA19-9 and postoperative long-term outcomes and recurrence patterns were evaluated. Results: Preoperative CEA >5.0 ng/mL was an independent prognostic factor of overall survival. Elevation of both preoperative CEA and CA19-9 levels showed no synergistic adverse effects on prognosis. Preoperative levels of these markers achieved superior predictive performance compared with the postoperative values. Adverse prognosis is significantly associated with persistent elevation of CEA levels before and after gastrectomy. Elevation of CEA levels, particularly at postoperative measurement, was significantly associated with hematogenous recurrence. Conclusion: Determination of perioperative CEA levels facilitated predictions of recurrence patterns and prognosis among patients with pT2-4 GC who underwent curative gastrectomy.

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“…The specimens were classified histologically according to the 7th edition of the Union for International Cancer Control (UICC) classification system. Since 2006, adjuvant chemotherapy using S-1 (an oral fluorinated pyrimidine) is used to treat all patients with UICC stage II/III GC unless contraindicated by the patient's condition (22)(23)(24). This study conformed to the ethical guidelines of the World Medical Association Declaration of Helsinki, Ethical Principles for Medical Research Involving Human Subjects.…”

Section: Introductionmentioning

confidence: 99%

Protein arginine methyltransferase 5 is associated with malignant phenotype and peritoneal metastasis in gastric cancer

Kanda

Shimizu

Fujii

et al. 2016

International Journal of Oncology

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Abstract. Identification of novel gastric cancer (GC)-related molecules is necessary to improve management of patients with GC in both diagnostic and therapeutic aspects. The aim of the present study was to determine whether protein arginine methyltransferase 5 (PRMT5) acts as an oncogene in the progression of GC and whether it serves as a novel diagnostic marker and therapeutic target. We conducted global expression profiling of GC cell lines and RNA interference experiments to evaluate the effect of PRMT5 expression on the phenotype of GC cells. We analysed tissues of 179 patients with GC to assess the association of PRMT5 mRNA levels with clinicopathological factors. Differential expression of PRMT5 mRNA by GC cell lines correlated positively with the levels of GEMIN2, STAT3 and TGFB3. PRMT5 knockdown reduced the proliferation, invasion and migration of a GC cell line. PRMT5 mRNA levels were significantly higher in GC tissues than the corresponding adjacent normal tissues and were independent of tumour depth, differentiation and lymph node metastasis. High PRMT5 expression was an independent risk factor of positive peritoneal lavage cytology (odds ratio 3.90, P=0.003) and decreased survival. PRMT5 enhances the malignant phenotype of GC cell lines and its expression in gastric tissues may serve as a biomarker for patient stratification and a potential target of therapy.

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Updated evidence on adjuvant treatments for gastric cancer

Cited by 48 publications

References 66 publications

Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer

Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer

Perioperative Serum Carcinoembryonic Antigen Levels Predict Recurrence and Survival of Patients with Pathological T2-4 Gastric Cancer Treated with Curative Gastrectomy

Protein arginine methyltransferase 5 is associated with malignant phenotype and peritoneal metastasis in gastric cancer

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