Recurrence after preoperative chemotherapy and surgery for gastric adenocarcinoma: a multicenter study

This study examines patterns of recurrence in patients receiving perioperative chemotherapy with surgery for gastric cancer in a real-world setting.MethodsAll patients diagnosed with gastric adenocarcinoma between 2010 and 2015 who underwent at least preoperative chemotherapy and a gastrectomy with curative intent (cT1N+/cT2-4a,X; any cN; cM0) in 18 Dutch hospitals were selected from the Netherlands Cancer Registry. Additional data on chemotherapy and recurrence were collected from medical records. Rates, patterns, and timing of recurrence were examined. Multivariable Cox proportional hazard analyses were used to determine prognostic factors for recurrence.Results408 patients were identified. After a median follow-up of 27.8  months, 36.8% of the gastric cancer patients had a recurrence of which the majority (88.8%) had distant metastasis. The 1-year recurrence-free survival was 71.8%. The risk of recurrence was higher in patients with an ypN+ stage (HR 4.92, 95% CI 3.35–7.24), partial or no tumor regression (HR 2.63 , 95% CI 1.22–5.64), 3 instead of ≥ 6 chemotherapy cycles (HR 3.04, 95% CI 1.99–4.63), R1 resection (HR 1.52, 95% CI 1.02–2.26), and
Source: Gastric Cancer - Category: Gastroenterology Source Type: research

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CONCLUSION: The modified ypTNM staging system improves the accuracy of OS prediction for patients treated with neoadjuvant chemotherapy followed by gastrectomy with D2 lymphadenectomy. PMID: 31197829 [PubMed - as supplied by publisher]
Source: The British Journal of Surgery - Category: Surgery Authors: Tags: Br J Surg Source Type: research
AbstractBackgroundHow the interval between surgery and S-1 adjuvant chemotherapy (ACT), and S-1 relative dose intensity (RDI) affect prognosis in patients with stage II/III gastric cancer who undergo gastrectomy with D2 lymph node dissection followed by S-1 ACT is unclear.MethodsWe enrolled 95 patients with histopathologically confirmed gastric adenocarcinoma treated with gastrectomy with D2 dissection, followed by S-1 ACT.ResultsPer ROC analysis, we used 32  days as the optimal cut-off interval to divide patients into the delayed group (started ACT ≥ 32 days) and the non-delayed group ( 
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: The newly developed radiomic signature was a powerful predictor of LN metastasis and the radiomics nomogram could facilitate the preoperative individualized prediction of LN status. Introduction Gastric cancer (GC) is one of the most common malignant tumors and the second leading cause of cancer-related deaths worldwide (1). Accurate evaluation of lymph node metastasis (LNM) status in GC patients is vital for prognosis and treatment decisions (2–4). Some histopathologic factors and biomarkers (e.g., lymphatic invasion, matrix metalloproteinase-2) are found to be able to predict LNM in GC, but mos...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionA solitary cerebellum metastasis from primary gastric adenocarcinoma is a very rare presentation. Early detection of metastatic lesion and successful treatment is challenging.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
We report the case of a 49-year-old woman presenting with proximal muscle weakness, weight loss, severe anemia, and melena. One year before, the diagnosis of a "fundic gland polyposis" was presumed after endoscopic evaluation for iron deficiency anemia had shown numerous polyps limited to the gastric mucosa. On admission, the diagnosis of dermatomyositis was made based on laboratory results with a marked elevated creatine kinase as well as the presence of characteristic clinical findings and muscle histology. Upper endoscopy revealed multiple pedunculated, edematous polyps in the stomach without apparent cancerou...
Source: Zeitschrift fur Gastroenterologie - Category: Gastroenterology Authors: Tags: Z Gastroenterol Source Type: research
CONCLUSIONCombined laparoscopic and robotic surgery for synchronous GC and PCa allows for minimally invasive radical resection and appropriate adjuvant therapy.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
CONCLUSIONSimultaneous occurrence of gastric GIST and gallbladder adenocarcinoma has not been reported before and, thus, any information about it may help in the management of those patients.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Publication date: Available online 8 February 2019Source: Arab Journal of GastroenterologyAuthor(s): Mohamed M. Abdelfatah, Eric M. GochanourAbstractA 53-year-old male was diagnosed with invasive adenocarcinoma of the pre-pyloric region. Imaging studies ruled out metastatic disease. The patient underwent neo-adjuvant chemotherapy followed by a partial gastrectomy. CT scan at 18 months’ post-resection demonstrated right upper quadrant lesions suspicious for metastatic disease. EUS exam shows two round hypoechoic lesions. Fine needle aspiration with suction was performed with on-site cytology confirming malignant cel...
Source: Arab Journal of Gastroenterology - Category: Gastroenterology Source Type: research
AbstractBackgroundTo compare the efficacy of oxaliplatin-based and oxaliplatin-free adjuvant chemotherapies in patients with different Lauren type gastric cancers after D2 gastrectomy.MethodsFrom our established gastric cancer database, patients with pathological stage II and III gastric cancer who received adjuvant chemotherapy after D2 gastrectomy at Zhongshan Hospital of Fudan University were analyzed. Patients who received different adjuvant chemotherapy regimens were divided into two subgroups: oxaliplatin-based and oxaliplatin-free subgroup. Clinical outcomes were analyzed according to pathological stage and differen...
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
We report a rare case of long-term survival in a patient who received local therapy and salvage chemotherapy for recurrent metastases, along with a literature review. A 65-year-old male patient underwent subtotal gastrectomy for advanced gastric adenocarcinoma. Six months after gastrectomy, 2 metastatic intra-abdominal lymph node enlargements were detected, which were treated with radiotherapy. At 55 months after gastrectomy, an abdominal wall mass was detected, which was treated by surgical resection. The patient received 5-fluorouracil/leucovorin/irinotecan chemotherapy for 27 months before and after radiotherapy and doc...
Source: Journal of Gastric Cancer - Category: Gastroenterology Tags: J Gastric Cancer Source Type: research
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