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Panda SS, Mohanty SS, Sanyal A, Ganesan P, Kayal S, Rathnam K, Saju SV, Cyriac S, Unnikrishnan P, Sehrawat A, Sundriyal D, Philips AO, Jain D, Mohanty SS, Agrawal SK, Moharana L, Choudhury SR, Dubashi B. Adolescent and Young Adults with Gastric Cancer (AYA-GC)-The Dilemma of an Under-Represented Group: A Multi-Institutional Analysis from the Indian Subcontinent. South Asian J Cancer 2024; 13:142-145. [PMID: 38919666 PMCID: PMC11196132 DOI: 10.1055/s-0043-1771275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Abstract
Soumya Surath PandaGastric cancer (GC) is often ignored at a young age, which frequently leads to tragic consequences. The worldwide incidence of GC is increasing at a young age. In view of the limited Indian publication, we sought to characterize clinicopathological parameters and risk factors in the adolescents and young adults (AYA) population. Retrospective data from six centers (which are part of the Network of Oncology Clinical Trials in India) from 2015 to 2020 were collected from patient (18-39 years of age) records. This study was approved by the institutional ethical committee of individual centers. All statistical analyses were performed using Microsoft Excel and SPSS (Version 20). Data interpretation along with the analysis of obtained results was carried out using the following tests: Qualitative data was expressed in terms of frequency/percentage. One-hundred fifty-two AYA GC patients were enrolled. The 31 to 39 years age group was most affected in which 76.3% were females. The majority of patients were nonalcoholic (93.4%), nonsmokers (98.0%), and without a family history (98.0%). The most common (MC) presenting symptom was abdominal pain (67.1%). MC site was antrum (48%). Among esophagogastric junction cancers, the majority were type I and II Siewert classifications (77% [20/26] patients in cardia), MC histology-signet ring cell (67.1%) followed by diffuse-type (65.1%). Most were poorly differentiated (65.1%) and were diagnosed at an advanced stage (III & IV= 54.6%). This is one of our country's first large multicenter studies on GC in the AYA population. There was a higher female prevalence, aggressive tumor behavior and the majority of patients were diagnosed at a more advanced stage. The majority were nonsmokers with a negative family history. Awareness among general people, researchers, clinicians, and policymakers must be improved to better the loss of life years in the younger population.
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Affiliation(s)
- Soumya Surath Panda
- Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Swati Sucharita Mohanty
- Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Antara Sanyal
- Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Prasanth Ganesan
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Smita Kayal
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Krishnakumar Rathnam
- Department of Medical Oncology, Meenakshi Mission Medical College and Research Center, Madurai, Tamil Nadu, India
| | - S. V. Saju
- Department of Medical Oncology, Meenakshi Mission Medical College and Research Center, Madurai, Tamil Nadu, India
| | - Sunu Cyriac
- Department of Medical Oncology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
| | - P. Unnikrishnan
- Department of Medical Oncology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
| | - Amit Sehrawat
- Department of Medical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Sundriyal
- Department of Medical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashwin Oommen Philips
- Department of Medical Oncology, Christian Medical College & Hospital, Ludhiana, Punjab, India
| | - Deepak Jain
- Department of Surgery, Christian Medical College & Hospital, Ludhiana, Punjab, India
| | - Sumit Subhadarshi Mohanty
- Department of Gastrosurgery, Institute of Medical Sciences and Sum Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Sunil Kumar Agrawal
- Department of Surgical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India
| | - Lalatendu Moharana
- Department of Medical Oncology, Institute of Medical Sciences and Sum Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Satyaprakash Ray Choudhury
- Department of Gastrosurgery, Institute of Medical Sciences and Sum Hospital, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Biswajit Dubashi
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Specifics of Young Gastric Cancer Patients: A Population-Based Analysis of 46,110 Patients with Gastric Cancer from the German Clinical Cancer Registry Group. Cancers (Basel) 2022; 14:cancers14235927. [PMID: 36497406 PMCID: PMC9739447 DOI: 10.3390/cancers14235927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction: 2−8% of all gastric cancer occurs at a younger age, also known as early-onset gastric cancer (EOGC). The aim of the present work was to use clinical registry data to classify and characterize the young cohort of patients with gastric cancer more precisely. Methods: German Cancer Registry Group of the Society of German Tumor Centers—Network for Care, Quality and Research in Oncology (ADT)was queried for patients with gastric cancer from 2000−2016. An approach that stratified relative distributions of histological subtypes of gastric adenocarcinoma according to age percentiles was used to define and characterize EOGC. Demographics, tumor characteristics, treatment and survival were analyzed. Results: A total of 46,110 patients were included. Comparison of different groups of age with incidences of histological subtypes showed that incidence of signet ring cell carcinoma (SRCC) increased with decreasing age and exceeded pooled incidences of diffuse and intestinal type tumors in the youngest 20% of patients. We selected this group with median age of 53 as EOGC. The proportion of female patients was lower in EOGC than that of elderly patients (43% versus 45%; p < 0.001). EOGC presented more advanced and undifferentiated tumors with G3/4 stages in 77% versus 62%, T3/4 stages in 51% versus 48%, nodal positive tumors in 57% versus 53% and metastasis in 35% versus 30% (p < 0.001) and received less curative treatment (42% versus 52%; p < 0.001). Survival of EOGC was significantly better (five-years survival: 44% versus 31% (p < 0.0001), with age as independent predictor of better survival (HR 0.61; p < 0.0001). Conclusion: With this population-based registry study we were able to objectively define a cohort of patients referred to as EOGC. Despite more aggressive/advanced tumors and less curative treatment, survival was significantly better compared to elderly patients, and age was identified as an independent predictor for better survival.
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Guo Y, Wang Q, Tian Q, Bo C, Li N, Zhang S, Li P. Clinicopathological Features and Prognostic-Related Risk Factors of Gastric Signet Ring Cell Carcinoma: A Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3473445. [PMID: 36035278 PMCID: PMC9410921 DOI: 10.1155/2022/3473445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/06/2022] [Accepted: 07/17/2022] [Indexed: 11/23/2022]
Abstract
Background Gastric signet ring cell carcinoma (SRCC) has shown a growth growing trend worldwide, but its clinicopathological features and prognostic-related risk factors have not been systematically studied. This systematic review was devoted to this. Method PubMed, Embase, Cochrane Library, and Web of Science databases were retrieved, and retrospective cohort studies comparing clinicopathological features and related risk factors in SRCC patients were included. Results In SRCC patient population, males were more than females (male, OR = 1.38, 95% CI: 1.20-1.60); N3 patients were more than N0-2 patients (N0-2, OR = 3.19, 95% CI: 1.98-5.15); M1 patients were more than M0 patients (M0, OR = 3.30, 95% CI: 1.88-5.80); patients with tumor > 5 cm were more than those with tumor (≤5 cm, OR = 7.36, 95% CI: 1.33-40.60). Patients with age < 60 years (age ≥ 60 years, OR = 1.03, 95% CI: 1.01-1.05), lymphatic vessel invasion (no, OR = 1.74, 95% CI: 1.03-2.45), T2 (T1, OR = 1.17, 95% CI: 1.07-1.28) and T4 (T1, OR = 2.55, 95% CI: 2.30-2.81) stages, and N1 (N0, OR = 1.73, 95% CI: 1.08-2.38), N2 (N0, OR = 2.24, 95% CI: 1.12-3.36), and N3 (N0, OR = 3.45, 95% CI: 1.58-5.32) stages had higher hazard ratio (HR). Conclusion SRCC may occur frequently in male. Age, lymphatic vessel invasion, TN, and M stage may be risk factors for poor prognoses of SRCC patients.
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Affiliation(s)
- Ying Guo
- Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Qian Wang
- Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Qing Tian
- Thoracic Surgery Department, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Changwen Bo
- Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Na Li
- Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Sujing Zhang
- Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China
| | - Peishun Li
- Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, Shandong 277500, China
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Alhalabi MM, Alsayd SA, Albattah ME. Advanced diffuse gastric adenocarcinoma in young Syrian woman. A case report. Ann Med Surg (Lond) 2022; 78:103728. [PMID: 35600190 PMCID: PMC9114456 DOI: 10.1016/j.amsu.2022.103728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 01/03/2023] Open
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Zhang T, Chen H, Zhang Y, Yin X, Man J, Yang X, Lu M. Global changing trends in incidence and mortality of gastric cancer by age and sex, 1990-2019: Findings from Global Burden of Disease Study. J Cancer 2021; 12:6695-6705. [PMID: 34659559 PMCID: PMC8517992 DOI: 10.7150/jca.62734] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/07/2021] [Indexed: 02/06/2023] Open
Abstract
Background: The global disease burden of gastric cancer (GC) is still heavy. Understanding the patterns and trends of the global GC burden is important for developing precise prevention strategies. Materials and Methods: The data of GC burden were retrieved from the Global Burden of Disease Study (2019). The estimated annual percentage change (EAPC) was calculated to estimate the temporal trends of the age-standardized incidence and mortality rates (ASIR and ASMR) of global GC by age-specific groups (15-49, 50-69, and ≥70 years), sexes, socio-demographic indexes (SDIs), regions, and countries. Results: In 2019, the ASIR and ASMR of global GC increased with age in both sexes, and reached a peak in the older 70 age group. The ASIR and ASMR in males were higher than those in females. From 1990 to 2019, the global number of GC incident cases increased in both sexes in all age-specific groups; while the ASIR of GC decreased, and the most significant decrease was observed in the 50-69 age group [males: EAPC=-1.34, 95% CI: (-1.49, -1.18); females: EAPC= -2.09, 95% CI: (-2.22, -1.96)]. During the study period, downward trends in ASIR of GC were observed in both sexes in most SDI regions, GBD regions, and countries. Similar trends in ASMR of GC were also observed. Conclusion: The global GC incidence and mortality rates decreased from 1990 to 2019 in both sexes, most GBD regions, and most countries. However, the GC burden was still heavy in some GBD regions and countries in special age-specific groups. It is important to formulate and implement tertiary prevention strategies based on the GC burden of age-specific groups in different regions and countries.
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Affiliation(s)
- Tongchao Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuan Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaolin Yin
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jinyu Man
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Gastroenterology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ming Lu
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Chen GL, Huang Y, Zhang W, Pan X, Feng WJ, Zhao XY, Zhu XD, Li WH, Huang M, Chen ZY, Guo WJ. Three-Tier Prognostic Index in Young Adults With Advanced Gastric Cancer. Front Oncol 2021; 11:667655. [PMID: 34568007 PMCID: PMC8462089 DOI: 10.3389/fonc.2021.667655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 08/17/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To characterize clinical features and identify baseline prognostic factors for survival in young adults with advanced gastric cancer (YAAGC). MATERIALS AND METHODS A total of 220 young inpatients (age less than or equal to 40 years) with an initial diagnosis of advanced gastric cancer were retrospectively enrolled in this study. RESULTS Of a consecutive cohort of 220 patients with YAAGC, the median overall survival (OS) time was 16.3 months. One-year survival rate was 43.6% (95% CI: 36.5 to 50.7). In this cohort, a female (71.4%, n = 157) predominance and a number of patients with poorly differentiated tumors (95.9%, n = 211) were observed. In the univariate analysis, OS was significantly associated with neutrophil-lymphocyte ratio (NLR) (≥3.12), hypoproteinemia (<40 g/L), presence of peritoneal or bone metastases, and previous gastrectomy of primary tumor or radical gastrectomy. In multivariate Cox regression analysis, hypoproteinemia [hazard ratio (HR) 1.522, 95% CI 1.085 to 2.137, p = 0.015] and high NLR level (HR 1.446, 95% CI 1.022 to 2.047, p = 0.021) were two independent poor prognostic factors, while previous radical gastrectomy was associated with a favorable OS (HR 0.345, 95% CI 0.205 to 0.583, p = 0.000). A three-tier prognostic index was constructed dividing patients into good-, intermediate-, or poor-risk groups. Median OS for good-, intermediate-, and poor-risk groups was 36.43, 17.87, and 11.27 months, respectively. CONCLUSIONS Three prognostic factors were identified, and a three-tier prognostic index was devised. The reported prognostic index may aid clinical decision-making, patient risk stratification, and planning of future clinical studies on YAAGC.
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Affiliation(s)
- Guang-Liang Chen
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Yan Huang
- Department of Oncology and Chemotherapy, Red Cross Hospital of Yulin City, Yulin, China
| | - Wen Zhang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Xu Pan
- Department of Medical Oncology, Yixing Traditional Chinese Medicine Hospital, Wuxi, China
| | - Wan-Jing Feng
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Xiao-Ying Zhao
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Xiao-Dong Zhu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Wen-Hua Li
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Mingzhu Huang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Zhi-Yu Chen
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Wei-Jian Guo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
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Wang W, Wang L, She J, Zhu J. Examining heterogeneity of stromal cells in tumor microenvironment based on pan-cancer single-cell RNA sequencing data. Cancer Biol Med 2021; 19:j.issn.2095-3941.2020.0762. [PMID: 34398535 PMCID: PMC8763007 DOI: 10.20892/j.issn.2095-3941.2020.0762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/05/2021] [Indexed: 11/28/2022] Open
Abstract
Tumor tissues contain both tumor and non-tumor cells, which include infiltrated immune cells and stromal cells, collectively called the tumor microenvironment (TME). Single-cell RNA sequencing (scRNAseq) enables the examination of heterogeneity of tumor cells and TME. In this review, we examined scRNAseq datasets for multiple cancer types and evaluated the heterogeneity of major cell type composition in different cancer types. We further showed that endothelial cells and fibroblasts/myofibroblasts in different cancer types can be classified into common subtypes, and the subtype composition is clearly associated with cancer characteristic and therapy response.
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Affiliation(s)
- Wenhui Wang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Li Wang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Sema4, a Mount Sinai venture, Stamford, CT 06902, USA
| | - Junjun She
- First Affiliate Hospital of Xi’an Jiaotong University, Xi’an 710061, China
| | - Jun Zhu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Sema4, a Mount Sinai venture, Stamford, CT 06902, USA
- First Affiliate Hospital of Xi’an Jiaotong University, Xi’an 710061, China
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Zhou QP, Ge YH, Liu CY. Comparison of metastasis between early-onset and late-onset gastric signet ring cell carcinoma. BMC Gastroenterol 2020; 20:380. [PMID: 33189128 PMCID: PMC7666509 DOI: 10.1186/s12876-020-01529-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
Background There is little knowledge to date about the distant metastasis of early-onset gastric signet ring cell carcinoma (SRCC) or the difference in metastasis based on age. Therefore, we conducted a comprehensive retrospective study using the Surveillance, Epidemiology, and End Results (SEER) database and data from our hospital. Methods Patients were collected from the SEER database and our hospital. Univariate and multivariate logistic regression analyses and propensity score matching (PSM) were used to identify risk factors for metastasis. K-M survival curves were generated to analyse patient survival. Results In total, we retrieved 2052 EOGC patients diagnosed with SRCC from the SEER database and included 403 patients from our hospital. K-M survival curves showed that late-onset SRCC patients had worse survival than early-onset patients but that late-onset SRCC patients were less likely to have distant metastasis, as validated by SEER data (OR = 0.462, 95%CI, 0.272–0.787; P = 0.004) and our data (OR = 0.301, 95%CI, 0.135–0.672; P = 0.003). Multivariate logistic regression and PSM analysis revealed that age of 45 or younger was an independent risk factor for distant metastasis. Conclusion Our study showed that distant metastasis was more common in early-onset SRCC than in late-onset SRCC. However, further studies are needed to explore the potential aetiologic basis for this disparity.
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Affiliation(s)
- Qiang-Ping Zhou
- Department of Emergency Surgery, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
| | - Yong-Hua Ge
- Department of Prevention and Health Care, Jiangxi Cancer Hospital, Nanchang, China
| | - Cheng-Yuan Liu
- Department of Emergency Surgery, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China.
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Zou J, Qin W, Yang L, Wang L, Wang Y, Shen J, Xiong W, Yu S, Song S, Ajani JA, Lin SY, Mills GB, Yuan X, Chen J, Peng G. Genetic alterations and expression characteristics of ARID1A impact tumor immune contexture and survival in early-onset gastric cancer. Am J Cancer Res 2020; 10:3947-3972. [PMID: 33294279 PMCID: PMC7716160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/21/2020] [Indexed: 06/12/2023] Open
Abstract
The AT-rich Interactive Domain 1A (ARID1A) is one of the most frequently mutated genes in gastric cancer. Here, we found that genetic variants in noncoding regions of ARID1A associated with altered protein levels by target sequencing. Notably, tumors with ARID1A variants in the 3'untranslated region (3'UTR) exhibited remarkably increased heterogeneity of ARID1A protein. In general, genetic variants and protein deficiency of ARID1A in tumors were associated with a better survival. Strikingly, altered patterns and heterogeneity of ARID1A protein expression were observed in peritumor tissues and carried significant implications in defining tumor immune contexture by multiplex immunohistochemistry. By analyzing the spatial distribution of TILs, we showed that reduced ARID1A protein levels in both tumor and peritumor tissues were significantly correlated with increased density and proximity of TILs to tumor cells. In contrast, high heterogeneity of ARID1A expression was associated with increased TIL density, but reduced proximity of TILs to tumor cells. Collectively, our study characterized ARID1A genetic alterations and its protein expression patterns in EOGC, demonstrating new strategies for clinically assessing its molecular impact on tumor onset and progression, tumor immune response, and patient survival.
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Affiliation(s)
- Jun Zou
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, China
| | - Wan Qin
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, China
| | - Lin Yang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, China
| | - Lulu Wang
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer CenterHouston, TX 77030, USA
| | - Yu Wang
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, China
| | - Jianfeng Shen
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiaotong University School of MedicineShanghai 200025, China
| | - Wei Xiong
- Department of Oncology, Second Hospital of Wuhan Iron and Steel (Group) Corp.Wuhan 430080, China
| | - Shiying Yu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, China
| | - Shumei Song
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer CenterHouston, TX 77030, USA
| | - Jaffer A Ajani
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer CenterHouston, TX 77030, USA
| | - Shiaw-Yih Lin
- Department of Systems Biology, The University of Texas MD Anderson Cancer CenterHouston, TX 77030, USA
| | - Gordon B Mills
- Department of Cell, Development & Cancer Biology, Oregon Health and Science University Knight Cancer InstitutePortland, Oregon, USA
| | - Xianglin Yuan
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, China
| | - Jianying Chen
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan 430030, China
| | - Guang Peng
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer CenterHouston, TX 77030, USA
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Puhr HC, Karner A, Taghizadeh H, Jomrich G, Schoppmann SF, Preusser M, Ilhan-Mutlu A. Clinical characteristics and comparison of the outcome in young versus older patients with upper gastrointestinal carcinoma. J Cancer Res Clin Oncol 2020; 146:3313-3322. [PMID: 32617700 PMCID: PMC7679328 DOI: 10.1007/s00432-020-03302-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/24/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The clinical behaviour and outcome of young patients with gastroesophageal tumours (GET) is surmised to differ from older patients, yet data on the comparison of these two patient subgroups is scarce. This study focuses on the investigation of the clinical characteristics and survival outcome of younger-age people with GET, when compared to older patients. METHODS Patients diagnosed with GET at the Medical University of Vienna between 2004 and 2016 were included in this study. Clinical parameters and the overall survival (OS) were compared between young (≤ 45 years) and elderly (≥ 65 years) patients. RESULTS Among 796 patients, who were eligible for this analysis, fifty-eight patients (7%) were ≤ 45 years at the initial onset of the disease. These 58 young patients were then matched to elderly patients based on the gender, tumour stage, histology and tumour location. The number of metastatic lesions was significantly higher among young patients (p < 0.05). In a non-metastatic setting younger patients showed a significant longer OS than older patients (median 1226 versus 801 days, p = 0.028). Furthermore, young patients with extensive metastatic disease (2 or more metastatic site) had a significantly poorer OS than elderly patients (median 450 versus 646 days, p = 0.033). CONCLUSION These results indicate that young patients might be diagnosed very late, which might lead to the development of a more aggressive disease compared to older patients, but a relatively long OS when diagnosed and treated in a non-metastatic setting. Thus, screening methods for younger patients might be considerable to enhance the outcome of young patients with GET.
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Affiliation(s)
- Hannah Christina Puhr
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Alexander Karner
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Hossein Taghizadeh
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Gerd Jomrich
- Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Sebastian Friedrich Schoppmann
- Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Aysegül Ilhan-Mutlu
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. .,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria.
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11
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Li J. Gastric Cancer in Young Adults: A Different Clinical Entity from Carcinogenesis to Prognosis. Gastroenterol Res Pract 2020; 2020:9512707. [PMID: 32190044 PMCID: PMC7071806 DOI: 10.1155/2020/9512707] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/13/2020] [Indexed: 02/07/2023] Open
Abstract
Approximately 5.0% of gastric cancer (GC) patients are diagnosed before the age of 40 and are not candidates for screening programs in most countries and regions. The incidence of gastric cancer in young adults (GCYA) has declined over time in most countries except in the United States. Genetic alterations, environmental factors, and lifestyle may predispose some young adults to GC. According to molecular classifications, the cancer of most GCYA patients belongs to the genomically stable or microsatellite stable/epithelial-mesenchymal transition subtype, with the common genetic aberrations being mutations in CDH1. What characterizes GCYA are a higher prevalence in females, more aggressive tumor behaviors, diagnosis at advanced stages, fewer comorbidities and being better treatment candidates, and a similar or better survival outcome when compared with older patients. Considering the greater loss of life-years in younger patients, lowering the incidence of GC and diagnosing at a relatively early stage are the two most effective ways to decrease GC mortality. To achieve these goals, the low awareness of GCYA among general people, policy-makers, clinicians, and researchers should be changed.
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Affiliation(s)
- Jian Li
- Department of General Surgery, The Third Hospital of Mianyang Sichuan Mental Health Center, Mianyang, Sichuan 621000, China
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12
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Cruz DF, Rojas A, Bastidas BE, Orozco Chamorro CM. Cáncer del tubo digestivo en pacientes jóvenes del departamento del Cauca, tipificación clínica. REVISTA COLOMBIANA DE CIRUGÍA 2019. [DOI: 10.30944/20117582.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Liu S, Zhou Y, Zhao L, Wang J, Ji R, Wang Y, Wu J, Yan X. IL-6 and miR-1271 expression levels in elderly and young gastric cancer patients and correlation analysis with prognosis. Oncol Lett 2019; 17:5419-5424. [PMID: 31186760 PMCID: PMC6507464 DOI: 10.3892/ol.2019.10230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 03/18/2019] [Indexed: 12/26/2022] Open
Abstract
Differences in inflammatory factors IL-6 and miR-1271 expression levels between elderly and young gastric cancer patients were investigated. A retrospective analysis of 146 cases of gastric cancer tissue and normal fresh tissue specimens diagnosed in The First Hospital of Lanzhou University from January 2013 to January 2015, was performed. Patients aged ≥60 years were the elderly group (76 cases), and patients ≤40 years were the youth group (70 cases). RT-qPCR was used to detect the relative expression levels of IL-6 and miR-1271, and Kaplan-Meier for a postoperative 3-year survival analysis of young and elderly gastric cancer patients. The expression level of IL-6 and miR-1271 was significantly higher in young gastric cancer tissues than that in elderly gastric cancer tissues (P<0.001). The expression levels of IL-6 and miR-1271 were correlated with age, tumor size, lymph node metastasis, distant metastasis, clinical stage and differentiation degree of gastric cancer patients (P<0.05). The 3-year overall survival rate of patients with a low expression of IL-6 and miR-1271 was better than that of patients with a high expression in young and elderly gastric cancer (P<0.05). IL-6 was highly expressed but miR-1271 expression was low in gastric cancer tissues. The 3-year overall survival rate of patients with the low expression of IL-6 was better than that of patients with the high expression in young and elderly gastric cancer. The high expression of miR-1271 was better than that of patients with the low expression in young and elderly gastric cancer. Findings of the present study provide data support for the clinical evaluation of differences between young and elderly gastric cancer and their prognosis.
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Affiliation(s)
- Shixiong Liu
- Department of Geriatrics (II), The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Yun Zhou
- Department of Geriatrics (II), The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Li Zhao
- Department of Ultrasound, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu 730020, P.R. China
| | - Jing Wang
- Department of Geriatrics (II), The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Rui Ji
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Yiqing Wang
- Department of Geriatrics (II), The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Jiyin Wu
- Department of Geriatrics (II), The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Xiang Yan
- Department of Geriatrics (II), The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
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Guan WL, Yuan LP, Yan XL, Yang DJ, Qiu MZ. More attention should be paid to adult gastric cancer patients younger than 35 years old: extremely poor prognosis was found. J Cancer 2019; 10:472-478. [PMID: 30719142 PMCID: PMC6360302 DOI: 10.7150/jca.27517] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 12/05/2018] [Indexed: 02/06/2023] Open
Abstract
Purpose: Several studies have reported controversial results about prognosis of gastric cancer in young age patients. The difference may partially result from variable definitions of young age. The aim of this study was to find out the relation between age and prognosis of gastric cancer patients, and to analyze the clinicopathological features and prognostic factors in young gastric cancer patients. Methods: Data queried for this analysis included GC patients from the Surveillance, Epidemiology, and End Results Program database from 1973 to 2014. Gastric cancer patients (N=79,505) diagnosed with an age≥18 were included. By combining patients with similar prognosis, we figured out 3 cutoff values of age, 35 years old, 65 years old and 75 years old. We divided patients into 4 groups: young age patients: 18-34 years; middle-age patients: 35-64 years; elderly patients: 65-74 years; extremely elderly patients: >74 years. GC patients from Sun Yat-sen University Cancer Center (SYSUCC) were used as external validation data. Results: The clinicopathological features of young age gastric cancer patients included: poor-differentiated, diffuse type of cancer, and advanced stage at diagnosis. The median survival of patients <35 years old was significantly lower than middle-age patients (35-64 years) and elderly patients (65-74 years) (12 months vs. 15 and 16 months, respectively, both p <0.001). Location of tumor, ethnicity, tumor size, surgery and TNM stage were independent prognostic factors by multivariate analysis in young patients. The poor prognosis for young patients remained valid in the SYSUCC database. Conclusions: Our results demonstrated that gastric cancer patients <35 years old had an extremely poor prognosis. Early detection of gastric cancer is of paramount importance in young age people.
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Affiliation(s)
- Wen-Long Guan
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lu-Ping Yuan
- Department of Experimental Research, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xiang-Lei Yan
- Department of Experimental Research, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Da-Jun Yang
- Department of Experimental Research, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Miao-Zhen Qiu
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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15
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A Rare Case of an Advanced Gastric Adenocarcinoma in a Teenage Syrian Boy. Case Rep Oncol Med 2018; 2018:9140593. [PMID: 30538876 PMCID: PMC6261075 DOI: 10.1155/2018/9140593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/24/2018] [Accepted: 10/30/2018] [Indexed: 11/17/2022] Open
Abstract
In this report, we describe a case of a gastric cancer in young age group with delayed diagnosis and poor prognosis. We report a rare case of a 16-year-old teenager with an advanced moderately differentiated gastric adenocarcinoma without any relevant history. He presented mainly with dysphagia, postprandial vomiting, and eventually hematemesis. On exploratory laparotomy, the tumor was in advanced stage, the excision was not performed, multiple biopsies and a feeding jejunostomy were done, and the patient was referred to receive a palliative therapy. Reporting such cases introduces a better understanding of the relation between gastric cancer and young ages.
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16
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Giryes A, Oweira H, Mannhart M, Decker M, Abdel-Rahman O. Exploring the differences between early-onset gastric cancer and traditional-onset gastric cancer. J Gastrointest Oncol 2018; 9:1157-1163. [PMID: 30603136 DOI: 10.21037/jgo.2018.06.11] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The current study sought to explore the potential clinical, epidemiological and genetic differences between early-onset gastric cancer (E-gastric cancer: defined as 20-39 years) and traditional-onset gastric cancer (T-gastric cancer: defined as ≥40 years). Methods Datasets from the following sources were searched: Surveillance, Epidemiology and End Results database [2000-2014], Behavioral Risk Factor Surveillance Survey and the cancer genome atlas (TCGA). Clinicopathological characteristics, trends, and genetic findings were compared between E-gastric cancer and T-gastric cancer. Moreover, correlations with relevant risk factors were sought after. Results A total of 95,323 gastric cancer patients were identified in the period from 2000 to 2014. While T-gastric cancer was decreasing during the study period (-1.4; P<0.05), E-gastric cancer was stable during the study period. E-gastric cancer is less prevalent in males (51.1% vs. 61.0%; P<0.0001), and white patients (68.9% vs. 71.4%; P<0.0001). E-gastric cancer patients usually present with poorly differentiated histology (55.3% vs. 48.0%; P<0.0001) as well as more aggressive histological subtypes (e.g., diffuse histology or linitis plastica). No difference can be detected with regards to risk factor correlations between E-gastric cancer and T-gastric cancer. Only four patients with E-gastric cancer were available in the provisional TCGA dataset at the time of the study. Conclusions E-gastric cancer is a potentially distinct disease entity with specific clinicopathological and trend patterns compared to conventional T-gastric cancer. Further studies are needed to explore the potential etiologic basis as well as to investigate the clinical consequences of this distinction. The impact of this distinction on minority populations requires further assessment as well.
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Affiliation(s)
| | - Hani Oweira
- Gastrointestinal Tumor Zentrum, Zürich, Switzerland
| | | | - Michael Decker
- Oncology Department, Zentrum für Integrative Onkologie, Zürich, Switzerland
| | - Omar Abdel-Rahman
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
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17
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Nakayama I, Chin K, Takahari D, Ogura M, Ichimura T, Wakatsuki T, Osumi H, Ota Y, Suzuki T, Suenaga M, Shinozaki E, Yamaguchi K. Treatment features of systemic chemotherapy in young adults with unresectable advanced or recurrent gastric cancer. Cancer Manag Res 2018; 10:5283-5290. [PMID: 30464625 PMCID: PMC6219402 DOI: 10.2147/cmar.s179219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose Gastric cancer in young adults (GCYA) is known to have distinct clinicopathological features, including a female predominance and diffuse-type histology. Previous reports have focused on patients who had undergone gastrectomy with curative intent. Information concerning the treatment of unresectable advanced- or recurrent-stage GCYA is lacking. Therefore, we aimed to investigate whether the distinct clinicopathological features of GCYA affect the outcome of systemic chemotherapy. Patients and methods We conducted a retrospective cohort study at a single institution in Japan. GCYA was classified as a disease in individuals who were <40 years of age at diagnosis. Initial systemic chemotherapy regimens for GCYA were investigated with a focus on patients who received S-1 plus cisplatin (SP) as a representative standard regimen. The efficacy, safety, and feasibility of systemic chemotherapy were evaluated. Results Eighty-nine (7.5%) of 1,184 consecutive patients who received systemic chemotherapy at our institute between December 2005 and June 2016 were enrolled. As reported previously, the female sex (57.3%) and diffuse-type histology (91.0%) were the dominant features of GCYA. Thirty-two patients (36.0%) received SP as first-line treatment. The median overall survival and progression-free survival times were 13.2 (95.0% CI: 9.5-18.7) and 5.6 (95.0% CI: 4.7-7.9) months, respectively. The median number of treatment cycles, relative dose intensity, and cumulative dose of cisplatin were 4.5 (range: 1-10), 92.0% (IQR: 83.5-98.3), and 286.5 mg/m2 (IQR: 172.5-367.5), respectively. The most common adverse event of Grade 3 or higher was neutropenia (n=5 patients; 15.6%). No patient had febrile neutropenia. Non-hematological adverse events of Grade 3 or higher were only observed in 2 (6.3%) of 32 patients. Conclusion Standard chemotherapy used for general-aged GC patients has similar efficacy, reduced toxicity, and higher intensity in GCYA patients.
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Affiliation(s)
- Izuma Nakayama
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Keisho Chin
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Daisuke Takahari
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Mariko Ogura
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Takashi Ichimura
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Takeru Wakatsuki
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Hiroki Osumi
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Yumiko Ota
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Takeshi Suzuki
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Mitsukuni Suenaga
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Eiji Shinozaki
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
| | - Kensei Yamaguchi
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,
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18
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Cormedi MCV, Katayama MLH, Guindalini RSC, Faraj SF, Folgueira MAAK. Survival and prognosis of young adults with gastric cancer. Clinics (Sao Paulo) 2018; 73:e651s. [PMID: 30281703 PMCID: PMC6131359 DOI: 10.6061/clinics/2018/e651s] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Survival data for young adults (YA) with gastric cancer is conflicting and scarce in Brazil. The aim of this study was to compare the clinicopathological factors and survival rates of younger and older patients with gastric cancer. METHODS Hospital registries for 294 gastric cancer patients from a reference cancer hospital in São Paulo, Brazil, were consulted for the retrieval of clinicopathological information and follow-up time. Patients were placed into the following groups: YA (≤40 years; N=71), older adult (OA: 41 to 65 years; N=129) and elderly (E: ≥66 years; N=94). Differences were assessed through Pearson's χ2 test, Kaplan-Meier analysis, Log rank test and Cox regression. RESULTS More YA were diagnosed with advanced disease (clinical stage III/IV: 86.7% YA, 69.9% OA, and 67% E); however, fewer E patients underwent surgery (64.3% YA, 72.7% OA, and 52.4% E). The median overall survival among all patients was 16 months, and the overall survival rate was not significantly different among the age groups (p=0.129). There were no significant differences in the disease-free survival rate. Metastatic disease at diagnosis (HR=4.84; p<0.01) was associated with an increased hazard of death for YA. CONCLUSION Overall survival was similar among age groups. Metastatic disease at diagnosis was the only factor associated with a poorer prognosis in YA. These results suggest that younger patients deserve special attention regarding the detection of early stage disease.
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Affiliation(s)
- Marina Candido Visontai Cormedi
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Maria Lucia Hirata Katayama
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Rodrigo Santa Cruz Guindalini
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Sheila Friedrich Faraj
- Departamento de Patologia, Instituto do Câncer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Maria Aparecida Azevedo Koike Folgueira
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
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19
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Quach DT, Ha DV, Hiyama T. The Endoscopic and Clinicopathological Characteristics of Early-onset Gastric Cancer in Vietnamese Patients. Asian Pac J Cancer Prev 2018; 19:1883-1886. [PMID: 30049355 PMCID: PMC6165641 DOI: 10.22034/apjcp.2018.19.7.1883] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/08/2018] [Indexed: 02/07/2023] Open
Abstract
Aim: To assess the endoscopic and clinicopathological features of early-onset gastric cancer (EOGC) in Vietnamese, a population with intermediate risk of gastric cancer. Patients and methods: Consecutive patients diagnosed with gastric adenocarcinoma were prospectively recruited. The demographic, clinical data in each patient were collected. The location and macroscopic type of all gastric lesions suspected to be malignant were reported according to the Japanese classification. The histologic tumor type of gastric cancer (GC) was classified according to the Lauren classification. Helicobacter pylori (H. pylori) infection were diagnosed by rapid urease test and urinary H. pylori antibody test. The infection was diagnosed when at least one of the two tests was positive. Results: The rate of EOGC (i.e. ≤ 40 years of age) was 16.3% (23/141). The median age of patients with EOGC was 35 (range 28 – 40) years and the male-to-female was 1:1.09. Compared to the older group (i.e. ≥ 50 years of age), the rates of positive family history, H. pylori infection and alarm features in the EOGC group were not significantly different (0.0% vs. 5.4%, p = 0.581; 73.9% vs. 66.3%, p = 0.620; and 60.8% vs. 79.3%, p = 0.100; respectively). The EOGC group had significantly higher rate of tumor extending to entire stomach (21.7% vs. 3.4%, p = 0.003); but the rate of diffuse-type GC between the two groups were not significantly different (87.0% vs. 71.7%, p = 0.181). Conclusions: Vietnamese patients with EOGC had higher rate of tumor extending to entire stomach compared to the older group. But the family history of GC, H. pylori infection and the pathological characteristics were not significantly different between the two groups. Environmental factors which play important roles in the development of EOGC in Vietnam should be investigated in future study.
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Affiliation(s)
- Duc Trong Quach
- Department of Internal Medicine, University of Medicine and Pharmacy at Hochiminh City, Vietnam.
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20
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Martinson HA, Shelby NJ, Alberts SR, Olnes MJ. Gastric cancer in Alaska Native people: A cancer health disparity. World J Gastroenterol 2018; 24:2722-2732. [PMID: 29991877 PMCID: PMC6034149 DOI: 10.3748/wjg.v24.i25.2722] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 05/09/2018] [Accepted: 06/02/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate recent trends in gastric cancer incidence, response to treatment, and overall survival among Alaska Native (AN) people. METHODS A retrospective analysis of the Alaska Native Medical Center patient database was performed. Patient history, clinical, pathological, response to treatment and patient outcomes were collected from one-hundred and thirty-two AN gastric cancer patients. The Surveillance, Epidemiology and End Result database 18 was used to collect comparison United States non-Hispanic White (NHW) and AN gastric cancer patient data between 2006-2014. RESULTS AN gastric cancer patients have a higher incidence rate, a poorer overall survival, and are diagnosed at a significantly younger age compared to NHW patients. AN patients differ from NHW patients in greater prevalence of non-cardia, diffuse subtype, and signet ring cell carcinomas. AN females were more likely to be diagnosed with later stage cancer, stage IV, compared to AN males. Diminished overall survival was observed among AN patients with increasing stage, O+ blood type, < 15 lymph nodes examined at resection, and no treatment. This study is the first report detailing the clinicopathologic features of gastric cancer in AN people with outcome data. CONCLUSION Our findings confirm the importance of early detection, treatment, and surgical resection for optimizing AN patient outcomes. Further research on early detection markers are warranted.
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Affiliation(s)
- Holly A Martinson
- WWAMI School of Medical Education, University of Alaska Anchorage, Anchorage, AK 99508, United States
| | - Nancy J Shelby
- WWAMI School of Medical Education, University of Alaska Anchorage, Anchorage, AK 99508, United States
| | - Steven R Alberts
- Department of Oncology, Mayo Clinic Cancer Center, Rochester, MN 55905, United States
| | - Matthew J Olnes
- Hematology and Medical Oncology Department, Alaska Native Medical Center, Anchorage, AK 99508, United States
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21
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Patne SCU, Abhilash VB, Dixit VK, Katiyar R, Kumar S, Singh GP. Immunohistochemical Expression of Human Epidermal Growth Factor Receptor 2 (HER2) and p53 in Gastric Adenocarcinoma: A Pilot Study from Northern India. J Clin Diagn Res 2017; 11:EC43-EC45. [PMID: 28658772 DOI: 10.7860/jcdr/2017/25650.9921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/05/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION After the recent approval of Trastuzumab (anti-HER2 antibody) for the treatment of HER2 overexpressed Gastric Adenocarcinoma (GA), importance of HER2 testing is increasingly recognized. However, there is paucity of studies for HER2 overexpression in the Indian patients of GA. Similarly, study of p53 expression in the Indian patients of GA is infrequent. AIM To study immunohistochemical expression of HER2 and p53 in GA biopsy samples. MATERIALS AND METHODS This was a cross-sectional observational study. The expression of HER2 and p53 by immunohistochemistry were analyzed in 50 cases of GA. The HER2 expression was scored as negative (0 and 1+), equivocal (2+), and overexpression (3+). The p53 expression was quantified as negative (0-9% tumour cells) and positive (≥10% tumour cells). The intensity of p53 expression was assessed as strong and weak. RESULTS Mean age of the patients was 56.8±14.8 years. Male:female ratio was 2:1. Histological types of adenocarcinoma were intestinal (68%), diffuse (28%), and indeterminate (4%). HER2 overexpression and equivocal results were present in 10% cases, each. Overall, a positive expression of p53 was seen in 72% (strong and weak intensities: 66.7% and 33.3% cases, respectively). CONCLUSION As compared to HER2 overexpression, a higher incidence of p53 expression was seen (10% vs.72%) in GA.
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Affiliation(s)
- Shashikant C U Patne
- Associate Professor, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - V B Abhilash
- Ex-Senior Resident, Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vinod Kumar Dixit
- Professor and Head, Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Richa Katiyar
- Senior Resident, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sandip Kumar
- Associate Professor, Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Gyan Prakash Singh
- Professor, Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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22
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Chen XD, Mao CC, Wu RS, Zhang WT, Lin J, Sun XW, Chi CH, Lou N, Wang PF, Shen X, Zhu GB, Shen SR. Use of the combination of the preoperative platelet-to-lymphocyte ratio and tumor characteristics to predict peritoneal metastasis in patients with gastric cancer. PLoS One 2017; 12:e0175074. [PMID: 28384215 PMCID: PMC5383064 DOI: 10.1371/journal.pone.0175074] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/19/2017] [Indexed: 12/18/2022] Open
Abstract
The aims of the present study were to evaluate the predictive value of the platelet-to-lymphocyte ratio for peritoneal metastasis in patients with gastric cancer and to construct an available preoperative prediction system for peritoneal metastasis. A total of 1080 patients with gastric cancer were enrolled in our study. The preoperative platelet-to-lymphocyte ratio and other serum markers and objective clinical tumor characteristics were evaluated by receiver operating characteristic curves. A logistic analysis was performed to determine the independent predictive indicators of peritoneal metastasis. A prediction system that included the independent predictive indicators was constructed and evaluated by receiver operating characteristic curves. Based on the receiver operating characteristic curves, the ideal platelet-to-lymphocyte ratio cutoff value to predict peritoneal metastasis was 131.00. The logistic analysis showed that the platelet-to-lymphocyte ratio was an independent indicator to predict peritoneal metastasis. The area under the receiver operating characteristic curve was 0.599. When integrating all independent indicators (i.e., platelet-to-lymphocyte ratio, invasion depth, lymphatic invasion, pathological type), the prediction system more reliably predicted peritoneal metastasis with a higher area under the receiver operating characteristic curve (0.769). The preoperative platelet-to-lymphocyte ratio was an indicator that could be used to predict peritoneal metastasis. Our prediction system could be a reliable instrument to discriminate between patients with gastric cancer with and those without peritoneal metastasis.
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Affiliation(s)
- Xiao-dong Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chen-chen Mao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Rui-sen Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei-teng Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ji Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiang-wei Sun
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chu-huai Chi
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Neng Lou
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Peng-fei Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xian Shen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guan-bao Zhu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shu-rong Shen
- Department of Breast Surgery, Wenzhou integrated traditional Chinese and Western Medicine Hospital, Wenzhou, Zhejiang, China
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23
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Habeebu MY, Salako O, Okediji PT, Mabadeje B, Awofeso OM, Ajekigbe AT, Abdulkareem FB. THE DISTRIBUTION, HISTOLOGIC PROFILE AND CLINICAL PRESENTATION OF GASTROINTESTINAL MALIGNANCIES IN LAGOS, NIGERIA. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2017; 7:9-31. [PMID: 29951453 PMCID: PMC6018038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Gastrointestinal malignancies have continued to record higher incidence and therefore pose significant public health burden in terms of morbidity and mortality. AIM To evaluate the sociodemographic, histologic and clinical distribution of patients with gastrointestinal malignancies diagnosed between July 2009 and March 2016. SETTING Lagos University Teaching Hospital, Idi-Araba, south-west Nigeria. METHODOLOGY Using a retrospective study design, all the patients with histologic diagnosis of gastrointestinal malignancies were recruited and their bio-data, clinical, histologic and treatment data were extracted from their hospital records. RESULTS Of the 106 cases of gastrointestinal malignancies in this study, the age range was 30-82 years with a mean of 55.9±13 years and a peak age bracket of 50-59 years; the male/female ratio was 1.2:1. The most common sites were colorectum (79.3%), stomach (7.6%), anus (6.6%), liver (4.7%), and pancreas (0.9%). Adenocarcinoma was the most common histologic subtype (89.62%), followed by squamous cell carcinoma (2.83%) and gastrointestinal stromal tumors (1.89%). The most common complaints were abdominal pain (54.7%), constipation (38.7%), palpable abdominal swelling/masses (35.9%), bleeding (33.0%), and weight loss (17.0%). The tumors were treated with chemotherapy, surgery, and radiotherapy, either singly or in combination, in 97.2%, 83.0%, and 30.2% respectively. CONCLUSION In this study, colorectal cancers are still the most prevalent type of gastrointestinal malignancies with a male preponderance, and individuals between 40-59 years are at greater risk. The significant involvement of individuals who constitute the bulk of the workforce and are the most productive labor in the country points at the need to develop strategies aimed at reducing the incidence of gastrointestinal malignancies.
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Affiliation(s)
- M Y Habeebu
- Department of Radiotherapy, Lagos University Teaching Hospital, Idi-Araba, Lagos
| | - O Salako
- Department of Radiotherapy, Lagos University Teaching Hospital, Idi-Araba, Lagos
| | - P T Okediji
- Research & Development, Sebeccly Cancer Care, Yaba, Lagos
| | - B Mabadeje
- Department of Radiotherapy, Lagos University Teaching Hospital, Idi-Araba, Lagos
| | - O M Awofeso
- College of Medicine, University of Lagos, Idi-Araba, Lagos
| | - A T Ajekigbe
- Department of Radiotherapy, Lagos University Teaching Hospital, Idi-Araba, Lagos
| | - F B Abdulkareem
- Department of Histopathology, Lagos University Teaching Hospital, Idi-Araba, Lagos
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24
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Park CH, Kim EH, Chung H, Park JC, Shin SK, Lee YC, An JY, Kim HI, Cheong JH, Hyung WJ, Noh SH, Kim CB, Lee SK. Periodic Endoscopies Might Not Increase the Detection of Early Gastric Cancer in a Young Population. PLoS One 2016; 11:e0159759. [PMID: 27448311 PMCID: PMC4957784 DOI: 10.1371/journal.pone.0159759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 07/07/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Screening endoscopies in individuals 40 years or older in regions where gastric cancer is prevalent increase the diagnosis of gastric cancer at an early stage. However, the benefits of screening endoscopies in a young population (<40 years) have not been evaluated. METHODS We reviewed data from patients less than 40 years old who underwent endoscopic submucosal dissection or surgery for initial-onset gastric cancer. We also administered a questionnaire to gather information concerning periodic endoscopic inspections and the period from the penultimate endoscopy to diagnosis. RESULTS Of the 564 patients in this study, 101 (17.9%) patients underwent screening endoscopy within 24 months of their gastric cancer diagnosis. Lesion size was significantly smaller in the ≤24 months group than in the >24 month group (23.8 mm [standard deviation, 22.2 mm] vs. 30.5 mm [standard deviation, 23.1 mm], P = 0.008). However, the proportion of patients with early gastric cancer did not differ between the two groups (≤24 months vs. >24 months group; 67.6% vs. 65.7%, P = 0.712). On multivariable analysis, periodic endoscopies did not influence the early diagnosis of gastric cancer (with >24 months as the reference group: ≤24 months, odds ratio = 0.939, 95% confidence interval = 0.583-1.513). CONCLUSION Although periodic endoscopies aided in the detection of gastric cancer when lesions were smaller in size, they seemed not to increase the proportion of patients with early gastric cancer in young patients diagnosed with resectable gastric cancer.
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Affiliation(s)
- Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Eun Hye Kim
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunsoo Chung
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Chul Park
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Kwan Shin
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Chan Lee
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Yeong An
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoung-Il Kim
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Ho Cheong
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Jin Hyung
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Hoon Noh
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Choong Bae Kim
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Kil Lee
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
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25
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Takatsu Y, Hiki N, Nunobe S, Ohashi M, Honda M, Yamaguchi T, Nakajima T, Sano T. Clinicopathological features of gastric cancer in young patients. Gastric Cancer 2016; 19:472-478. [PMID: 25752270 DOI: 10.1007/s10120-015-0484-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/24/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Early-onset gastric cancer is relatively rare. To evaluate the clinicopathological features and surgical outcome of young patients with gastric cancer, this retrospective comparative study was conducted. METHODS From 2000 to 2010, 4882 patients underwent surgery for gastric adenocarcinoma in our institution. A total of 136 patients under 40 years old were enrolled as the young group, and a total of 1435 patients aged between 60 and 69 were identified as the control group for this study. The patient's characteristics, pathological findings, surgical and clinical outcomes were reviewed, and the risk factors of recurrence were compared between the two groups. RESULTS Among the young group, patients had significantly fewer comorbidities and postoperative complications. The patient proportion having 7 or more lymph node metastases was higher in the young group (25 %) than in the control group (16 %). The presence of lymph node metastasis was identified as a strong risk factor for recurrence (odds ratio = 4.31) in the young group according to the results of the step-wise logistic regression analysis. Although the disease-specific survival at stage II was relatively better in the young group (p = 0.0439) than in the control group, there were no significant differences in overall survival for all stages. CONCLUSION Early-onset gastric cancer is likely to present lymph node metastases. The survival rate of gastric cancer in young patients was equivalent to that in patients in their 60s, which is the typical age at onset.
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Affiliation(s)
- Yukiko Takatsu
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan
| | - Naoki Hiki
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan. .,Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Souya Nunobe
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan
| | - Manabu Ohashi
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan
| | - Michitaka Honda
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan
| | - Toshiharu Yamaguchi
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan
| | - Toshifusa Nakajima
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan
| | - Takeshi Sano
- Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital of JFCR, Tokyo, Japan
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26
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Park CH, Kim B, Chung H, Lee H, Park JC, Shin SK, Lee SK, Lee YC. Endoscopic quality indicators for esophagogastroduodenoscopy in gastric cancer screening. Dig Dis Sci 2015; 60:38-46. [PMID: 25063206 DOI: 10.1007/s10620-014-3288-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 07/10/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Quality indicators of screening esophagogastroduodenoscopy are essential to improve the detection rate of gastric cancer. However, a reliable, practical indicator of the performance of endoscopists in screening esophagogastroduodenoscopy has not yet been identified. AIMS We aimed to identify quality indicators of esophagogastroduodenoscopy for the detection of early gastric neoplasms, including gastric dysplasia and early gastric cancer, focusing on the endoscopic findings. METHODS The records of 54,889 individuals who underwent esophagogastroduodenoscopy for gastric cancer screening at the Yonsei University Severance Hospital Health Promotion Center, Seoul, Korea, between February 2006 and July 2013 were analyzed. The detection rates for various gastric lesions including early gastric neoplasms were analyzed for each endoscopist. RESULTS Gastric dysplasia, early gastric cancer, and advanced gastric cancer were detected in 97 (0.18 %), 54 (0.10 %), and 21 (0.04 %) of 54,889 individuals, respectively. Multivariate analysis showed that the detection rates of gastric subepithelial lesions and gastric diverticuli were independent factors associated with the detection rate of early gastric neoplasms (regression coefficients of 0.096 and 0.532, respectively). A quality score formula was deduced using these regression coefficients to predict the ability of an endoscopist to detect early gastric neoplasms. A trend test confirmed that the group of endoscopists with a higher quality score showed a significantly higher rate of early gastric neoplasm detection (P < 0.001). CONCLUSIONS The detection rates of gastric subepithelial lesions and gastric diverticuli are well correlated with that of early gastric neoplasms. In addition, the proposed quality scoring system could be a good quality indicator for the detection of early gastric neoplasms.
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Affiliation(s)
- Chan Hyuk Park
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea,
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