Prevalence of deep venous thrombosis detected by ultrasonography before surgery in patients with gastric cancer: a retrospective study of 1140 consecutive patients
ConclusionsFemale sex, older age, worse PS, the presence of CVC, and a history of preoperative chemotherapy were the independent risk factors for DVT. Routine lower-extremity venous ultrasonographic screening is useful for prevention of PTE because it can identify patients at high or low risk for PTE. (Source: Gastric Cancer)
Source: Gastric Cancer - December 16, 2016 Category: Gastroenterology Source Type: research

Comparison of long-term survival and immediate postoperative liver function after laparoscopic and open distal gastrectomy for early gastric cancer patients with liver cirrhosis
ConclusionsFor EGC patients with liver cirrhosis, especially Child A cirrhosis, laparoscopic or laparoscopy-assisted distal gastrectomy can be a safe surgical procedure in comparison to open distal gastrectomy in terms of the long-term survival rate and immediate postoperative liver function. (Source: Gastric Cancer)
Source: Gastric Cancer - December 10, 2016 Category: Gastroenterology Source Type: research

Side overlap esophagogastrostomy to prevent reflux after proximal gastrectomy
ConclusionsSOFY can be easily performed laparoscopically and may overcome the problems of postoperative reflux and stenosis. (Source: Gastric Cancer)
Source: Gastric Cancer - December 10, 2016 Category: Gastroenterology Source Type: research

Reply to “How should we define the no. 3b lesser curvature lymph node?”
(Source: Gastric Cancer)
Source: Gastric Cancer - December 8, 2016 Category: Gastroenterology Source Type: research

Interobserver agreement in detection of “white globe appearance” and the ability of educational lectures to improve the diagnosis of gastric lesions
AbstractBackgroundWhite globe appearance (WGA) refers to a small white lesion of globular shape underneath cancerous gastric epithelium that can be clearly visualized by magnifying endoscopy with narrowband imaging (M-NBI). WGA has been reported to be a novel endoscopic marker that is highly specific in differentiating early gastric cancer (GC) from low-grade adenoma, and has a significantly higher prevalence in early GCs than in noncancerous lesions. However, interobserver agreement in detecting WGA and whether training intervention can improve diagnostic accuracy are unknown.MethodsTwenty sets of M-NBI images were examin...
Source: Gastric Cancer - December 3, 2016 Category: Gastroenterology Source Type: research

Risk factors and management for gastric stenosis after endoscopic submucosal dissection for gastric epithelial neoplasm
ConclusionsA wide resection of more than three fourths of the circumferential extent was the significant risk factor for post-ESD stenosis in both cardia and antrum, and prophylactic EBD could be a promising procedure for the management of post-ESD stenosis. (Source: Gastric Cancer)
Source: Gastric Cancer - November 30, 2016 Category: Gastroenterology Source Type: research

Multi-institutional prospective feasibility study to explore tolerability and efficacy of oral nutritional supplements for patients with gastric cancer undergoing gastrectomy (CCOG1301)
AbstractBackgroundPostoperative malnutrition after gastrectomy is deemed inevitable, which could have prejudicial influence on survival for gastric cancer patients. A prospective feasibility study was conducted to evaluate the efficacy of postoperative oral nutritional supplements.MethodsStage I –III gastric cancer patients who underwent distal or total gastrectomy received oral administration of Racol® NF (Otsuka Pharmaceutical Factory, Japan), a liquid enteral nutritional formula, as a supplement to regular meals. Racol® NF administration at a recommended dosage of 400 kcal/400 ml per da...
Source: Gastric Cancer - November 24, 2016 Category: Gastroenterology Source Type: research

Examining the gastric cancer survival gap between Asians and whites in the United States
ConclusionsThis study characterizes distinctive gastric cancer survival patterns among the six major Asian groups and NHWs in the US. The favorable survival for Koreans is largely attributable to specific clinical factors, particularly stage at diagnosis. The causes of the survival disadvantage for NHWs remain elusive. (Source: Gastric Cancer)
Source: Gastric Cancer - November 19, 2016 Category: Gastroenterology Source Type: research

Intratumor stromal proportion predicts aggressive phenotype of gastric signet ring cell carcinomas
AbstractObjectiveThe aim of this study was to evaluate the prognostic significance of the intratumor stromal proportion in gastric signet ring cell (SRC) carcinomas.BackgroundCancer stroma, as exemplified by cancer-associated fibroblasts (CAFs), plays critical roles in cancer proliferation, invasion, and metastasis.MethodsOne hundred seventy-five SRC carcinoma cases were classified according to the intratumor desmoplastic stromal proportion to then analyze the clinicopathologic characteristics of stroma-rich cases. We also investigated the impact of CAFs on the migration as well as on the phenotypic changes of gastric SRC ...
Source: Gastric Cancer - November 17, 2016 Category: Gastroenterology Source Type: research

Irinotecan monotherapy as third-line treatment for advanced gastric cancer refractory to fluoropyrimidines, platinum, and taxanes
ConclusionIrinotecan monotherapy appears to be tolerated but was shown to have modest activity as third-line chemotherapy for advanced gastric cancer. (Source: Gastric Cancer)
Source: Gastric Cancer - November 17, 2016 Category: Gastroenterology Source Type: research

The contribution of Helicobacter pylori to excess gastric cancer in Indigenous and Pacific men: a birth cohort estimate
ConclusionsPolicy should focus on reducing the acquisition and prevalence ofH.  pylori infection in these populations. (Source: Gastric Cancer)
Source: Gastric Cancer - November 16, 2016 Category: Gastroenterology Source Type: research

Impact of progression type on overall survival in patients with advanced gastric cancer based on randomized phase III study of S-1 plus oxaliplatin versus S-1 plus cisplatin
ConclusionsProgression accompanied by new lesions had a strong negative impact on OS in patients treated with S-1 and platinum for AGC. (Source: Gastric Cancer)
Source: Gastric Cancer - November 7, 2016 Category: Gastroenterology Source Type: research

Clinical outcomes of endoscopic submucosa dissection for high-grade dysplasia from endoscopic forceps biopsy
ConclusionsCentral depression, nodular surface, surface redness, lesion location, large tumor size, and submucosal fibrosis were associated with EGC or submucosal cancer. Caution must be used in treating lesions with these features with ESD. (Source: Gastric Cancer)
Source: Gastric Cancer - November 7, 2016 Category: Gastroenterology Source Type: research

Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a multicenter collaborative study
AbstractObjectiveThe indications for endoscopic submucosal dissection (ESD) in patients with early gastric cancer (EGC) have been expanded. However, the long-term outcomes of ESD remain unclear. We retrospectively investigated the long-term outcomes of ESD in patients with EGC.MethodsWe retrospectively studied patients with EGC who underwent ESD at 11 institutions between January 2003 and December 2010. A total of 6456 patients (7979 lesions) who met the absolute indications for ESD and 4202 patients (5781 lesions) who met the expanded indications for ESD were studied. Clinicopathological features, clinical course, and out...
Source: Gastric Cancer - November 2, 2016 Category: Gastroenterology Source Type: research

Intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis
AbstractPeritoneal metastasis is the most frequent pattern of gastric cancer recurrence or metastasis and is a definitive determinant of prognosis. However, an effective means of treating peritoneal disease has not yet been established. Systemic chemotherapy has only a limited effect on peritoneal metastasis, although some progress has been shown in terms of median survival time, especially among patients with a minimal or moderate disease burden. Clinical research related to intraperitoneal administration of anticancer drugs is currently underway. An advantage of intraperitoneal chemotherapy is the ability to achieve high...
Source: Gastric Cancer - November 1, 2016 Category: Gastroenterology Source Type: research

Results of a nation-wide retrospective study of lymphadenectomy for esophagogastric junction carcinoma
ConclusionsComplete nodal clearance along the distal portion of the stomach offers marginal survival benefits for patients with EGJ cancers less than 4  cm in diameter. The optimal extent of esophageal resection and the benefits of mediastinal node dissection remain issues to be addressed in managing patients with esophagus-predominant EGJ cancers. (Source: Gastric Cancer)
Source: Gastric Cancer - October 28, 2016 Category: Gastroenterology Source Type: research

Clinicopathological features of Siewert type II adenocarcinoma: comparison of gastric cardia adenocarcinoma and Barrett ’s esophageal adenocarcinoma following endoscopic submucosal dissection
AbstractObjectivesSiewert type II esophagogastric junction adenocarcinoma encompasses both gastric cardia adenocarcinoma (GCA) and Barrett ’s esophageal adenocarcinoma (BEA) due to short-segment Barrett’s esophagus. We compared these two types of Siewert type II esophagogastric junction adenocarcinoma in terms of background factors and clinical outcomes of endoscopic submucosal dissection (ESD).MethodsWe enrolled 139 patients (142 lesions) who underwent ESD from 2006 to 2014 at our institution. Background factors evaluated were age, sex, body mass index, hypertension, hyperlipidemia, hyperuricemia, diabetes mel...
Source: Gastric Cancer - October 25, 2016 Category: Gastroenterology Source Type: research

Early detection of nonperitoneal recurrence may contribute to survival benefit after curative gastrectomy for gastric cancer
AbstractBackgroundThere is no evidence that strict follow-up using cross-sectional imaging after curative gastrectomy benefits survival; however, nonperitoneal recurrence detected early might be treated with additional surgery. The present study examined whether early detection of recurrence by imaging modalities could increase survival, particularly in patients with nonperitoneal recurrence.MethodsWe retrospectively analyzed 218 patients with recurrent gastric cancer after curative gastrectomy performed from 2002 to 2014. The patients were divided into an asymptomatic group (n = 117) and a symptomatic group (n&n...
Source: Gastric Cancer - October 24, 2016 Category: Gastroenterology Source Type: research

Intraperitoneal chemotherapy for gastric cancer with peritoneal disease: experience from Singapore and Japan
AbstractAmong advanced gastric cancer cases, peritoneal dissemination is a life-threatening mode of metastasis, and any strategy to control peritoneal metastasis will significantly improve treatment outcomes. Since intraperitoneal administration of anticancer drugs can induce an extremely high concentration of drugs in the peritoneal cavity, intraperitoneal chemotherapy would appear to be a reasonable and promising strategy to control the peritoneal dissemination. However, it has been reported in the past that intraperitoneal administration of mitomycin C or cisplatin resulted in no significant clinical effects against per...
Source: Gastric Cancer - October 20, 2016 Category: Gastroenterology Source Type: research

Changing epidemiology of Helicobacter pylori in Japan
AbstractHelicobacter pylori (H. Pylori) is known as the most important cause of gastric cancer. The prevalence ofH. pylori infection varies widely by geographic area, age, and socioeconomic status. In Japan,H. pylori infection has been highly correlated with the incidence rate of gastric cancer, and a reduction inH. pylori infection is therefore crucial for decreasing the incidence of gastric cancer, especially at the population level. Infection occurs during childhood, commonly before 5  years of age. In Japan, where gastric cancer has ranked as the most common cancer by incidence and mortality for the last several d...
Source: Gastric Cancer - October 18, 2016 Category: Gastroenterology Source Type: research

Distinct expression profile of key molecules in crawling-type early gastric carcinoma
AbstractBackgroundGastric “crawling-type” adenocarcinoma (CRA) is a tumor histologically characterized by irregularly fused glands with low-grade cellular atypia that tends to spread laterally in the mucosa. To date, the expression characteristics of the key molecules involved in CRA, including receptor tyrosine kinases (RTKs), mismatch repair (MMR) proteins, phosphatase and tensin homolog (PTEN), as well as the Epstein–Barr virus (EBV) status, have yet to be uncovered.MethodsWe constructed tissue microarrays of 94 CRAs, 72 conventional-type differentiated adenocarcinomas (CDAs), and 71 intramucosal poorl...
Source: Gastric Cancer - October 12, 2016 Category: Gastroenterology Source Type: research

Usefulness of preoperative estimated glomerular filtration rate to predict complications after curative gastrectomy in patients with clinical T2 –4 gastric cancer
AbstractBackgroundGastrectomy with systemic lymphadenectomy is the standard of care for resectable gastric cancer (GC), but it is sometimes associated with postoperative morbidity. Predicting complications is therefore an essential part of risk management in clinical practice. The renal function is routinely evaluated before surgery by blood examinations to determine dose of medication and infusion. However, the value of various parameters of renal function in prediction of postoperative complications remain unclear.MethodsWe included 315 patients who underwent curative D2 gastrectomy for clinical T2 –T4 GC without p...
Source: Gastric Cancer - October 12, 2016 Category: Gastroenterology Source Type: research

Past and current trends in endoscopic diagnosis for early stage gastric cancer in Japan
AbstractMethodology for the diagnosis and staging of early gastric cancer (EGC) has improved in Japan since the development of the gastro-camera and determination of a definition of EGC. Imaging technology has been steadily evolving in the endoscopy field. Improvements in the resolution of standard endoscopy images used in screening and surveillance provide greater opportunities to find gastric cancer earlier. Image enhancement endoscopy (IEE), such as narrow band imaging (NBI), highlights mucosal structures and vascularity. In particular, when NBI is used with magnifying endoscopy, it reveals fine details of subtle superf...
Source: Gastric Cancer - October 12, 2016 Category: Gastroenterology Source Type: research

Clinical outcomes of early gastric cancer patients after noncurative endoscopic submucosal dissection in a large consecutive patient series
ConclusionsAdditional gastrectomy should be performed particularly in noncurative gastric ESD patients with lymphovascular invasion or a positive vertical margin with submucosal invasion. (Source: Gastric Cancer)
Source: Gastric Cancer - October 8, 2016 Category: Gastroenterology Source Type: research

A Bayesian network meta-analysis on second-line systemic therapy in advanced gastric cancer
ConclusionsThis is the first network meta-analysis to compare all second-line regimens reported in phase III gastric cancer trials. The results suggest the paclitaxel plus ramucirumab combination is the most effective therapy and should be the reference regimen for future comparative trials. (Source: Gastric Cancer)
Source: Gastric Cancer - October 8, 2016 Category: Gastroenterology Source Type: research

Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer: Japan Clinical Oncology Group Study JCOG0912
This study is now in the follow-up stage. The primary endpoint is relapse-free survival (RFS) and the primary analysis is planned in 2018. Here, we compared the surgical outcomes of the two groups. This trial was registered at the UMIN Clinical Trials Registry as UMIN000003319.ResultsBetween March 2010 and November 2013, 921 patients (LADG 462, ODG 459) were enrolled from 33 institutions. Operative time was longer in LADG than in ODG (median 278 vs. 194  min,p 
Source: Gastric Cancer - October 7, 2016 Category: Gastroenterology Source Type: research

Global chemotherapy development for gastric cancer
AbstractTo combat the dismal mortality rates from metastatic gastric adenocarcinoma (GAC), new drugs and treatment strategies are needed. Today, metastatic GAC is predominantly treated by empiric chemotherapy. Combination of two cytotoxic agents has become commonplace in North America, Europe, and Asia. Human epidermal growth factor  2 (HER2) overexpression (protein or gene copy numbers) has resulted in the addition of trastuzumab in the first-line chemotherapy combination in patients whose tumor is HER2 positive. The addition of trastuzumab in this select population has provided a modest survival advantage. In this r...
Source: Gastric Cancer - October 7, 2016 Category: Gastroenterology Source Type: research

Postgastrectomy follow-up in the West: evidence base, guidelines, and daily practice
AbstractFollow-up after gastrectomy for gastric cancer has several purposes, including management of side effects of surgery, oncological recurrence surveillance, psychological support, and data collection for research. How follow-up after gastrectomy, and especially recurrence surveillance, is performed differs immensely between different Western countries, despite guidelines from Western oncological organizations quite unanimously advocating symptom-driven surveillance, without scheduled cross-sectional imaging, endoscopies, or analysis of tumor markers. Given a complete lack of randomized data, the available body of obs...
Source: Gastric Cancer - October 7, 2016 Category: Gastroenterology Source Type: research

Mechanisms for the induction of gastric cancer by Helicobacter pylori infection: aberrant DNA methylation pathway
AbstractMultiple pathogenic mechanisms by whichHelicobacter pylori infection induces gastric cancer have been established in the last two decades. In particular, aberrant DNA methylation is induced in multiple driver genes, which inactivates them. Methylation profiles in gastric cancer are associated with specific subtypes, such as microsatellite instability. Recent comprehensive and integrated analyses showed that many cancer-related pathways are more frequently altered by aberrant DNA methylation than by mutations. Aberrant DNA methylation can even be present in noncancerous gastric mucosae, producing an “epigeneti...
Source: Gastric Cancer - October 7, 2016 Category: Gastroenterology Source Type: research

Function-preserving gastrectomy based on the sentinel node concept in early gastric cancer
AbstractRecent meta-analyses and a prospective multicenter trial of sentinel node (SN) mapping in early gastric cancer have demonstrated acceptable SN detection rates and accuracy of determination of lymph node status. SN mapping may play a key role in obtaining individual metastatic information. It also allows modification of surgical procedures, including function-preserving gastrectomy in patients with early gastric cancer. A dual-tracer method that uses radioactive colloids and blue dye is currently considered the most reliable method for the stable detection of SNs in patients with early gastric cancer. New technologi...
Source: Gastric Cancer - October 6, 2016 Category: Gastroenterology Source Type: research

Updated evidence on endoscopic resection of early gastric cancer from Japan
ConclusionsEndoscopic resection for EGC is still developing toward an ideal form, pursuing a more reliable, safer, and faster minimally invasive treatment. (Source: Gastric Cancer)
Source: Gastric Cancer - October 4, 2016 Category: Gastroenterology Source Type: research

Chemotherapy for advanced gastric cancer: future perspective in Japan
AbstractDifferences in clinical outcomes between advanced gastric cancer (AGC) in Asia and that in other regions have been discussed for a long time, although no major significant differences in molecular profiles have been reported. The anti-human epidermal growth factor receptor  2 antibody trastuzumab and the anti-vascular endothelial growth factor receptor 2 monoclonal antibody ramucirumab were both approved as a treatment for AGC on the basis of global phase 3 trials including Japan. In recent years, others new agents for treatment of AGC have been investigated in glo bal or Asian studies. Randomized ph...
Source: Gastric Cancer - October 3, 2016 Category: Gastroenterology Source Type: research

Oncological outcomes of function-preserving gastrectomy for early gastric cancer: a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy
ConclusionsGiven the adequate estimation of the clinical tumor stage, the oncological safety of PPG for clinical T1N0 gastric cancer in the middle portion of the stomach was comparable to that of DG. (Source: Gastric Cancer)
Source: Gastric Cancer - September 26, 2016 Category: Gastroenterology Source Type: research

Systemic inflammation is associated with the density of immune cells in the tumor microenvironment of gastric cancer
AbstractBackgroundThe neutrophil –lymphocyte ratio (NLR) and the prognostic nutritional index (PNI) are markers of systemic inflammation known to be useful prognostic indicators of malignancy. However, little evidence has defined the influence of inflammation on the tumor microenvironment.MethodsTwo hundred eighty-eight patients who underwent curative surgery for gastric cancer were included. Preoperative peripheral blood samples were used to analyze the NLR and PNI. The optimal cutoff levels for the NLR and PNI were defined by receiver operating characteristic curve analysis for survival (NLR  = 2.7, PNI&n...
Source: Gastric Cancer - September 24, 2016 Category: Gastroenterology Source Type: research

Pre- and post-ESD discrepancies in clinicopathologic criteria in early gastric cancer: the NECA –Korea ESD for Early Gastric Cancer Prospective Study (N-Keep)
AbstractBackgroundDiscrepancies in the clinicopathologic parameters pre- and post-endoscopic submucosal dissection (ESD) sometimes necessitate additional surgical resection. The aim of this study was to assess such discrepancies in clinicopathologic parameters before and after ESD in the context of reducing the risk of failure of curative ESD.MethodsData on 712 early gastric cancer patients were prospectively collected from 12 university hospitals nationwide. The inclusion criteria were differentiated carcinoma
Source: Gastric Cancer - September 23, 2016 Category: Gastroenterology Source Type: research

Epstein –Barr virus positivity, not mismatch repair-deficiency, is a favorable risk factor for lymph node metastasis in submucosa-invasive early gastric cancer
AbstractBackgroundEpstein –Barr virus (EBV)-associated gastric cancer (GC) and microsatellite-instability-high GC are associated with a low prevalence of regional lymph node metastasis (LNM). To evaluate the feasibility of endoscopic treatment of EBV-associated and/or microsatellite-instability-high early GC (EGC), we anal yzed the risk factors for LNM using a large series (n = 756) of submucosa-invasive (SM) EGC.MethodsEBV-encoded RNA in situ hybridization (EBER ISH) and immunohistochemistry for four mismatch repair (MMR) proteins (MLH1, PMS2, MSH2, and MSH6) were performed. The clinicopathologic features ...
Source: Gastric Cancer - September 23, 2016 Category: Gastroenterology Source Type: research

Incidence of lymph node metastasis in intramucosal gastric cancer measuring 30  mm or less, with ulceration; mixed, predominantly differentiated-type histology; and no lymphovascular invasion: a multicenter retrospective study
ConclusionThe results of this retrospective study indicate that the risk of lymph node metastasis was less than 1  % among patients with the criteria defined here, considered to be criteria for noncurative resection as per the current guidelines, and suggest that observation alone without additional surgery may result in a good outcome. (Source: Gastric Cancer)
Source: Gastric Cancer - September 23, 2016 Category: Gastroenterology Source Type: research

Histologic purity of signet ring cell carcinoma is a favorable risk factor for lymph node metastasis in poorly cohesive, submucosa-invasive early gastric carcinoma
AbstractBackgroundThe prediction of biologic behavior of poorly cohesive early gastric carcinoma (EGC) is an important issue in the selection of the treatment modality. To elucidate the risk factors for lymph node metastasis (LNM) of poorly cohesive EGC, we focused on the histologic purity of the poorly cohesive component and evaluated the impact of this factor on LNM.MethodsWe divided poorly cohesive EGC into (1) pure signet ring cell (SRC) carcinoma, which was defined as composed only of signet ring cells or poorly cohesive cells and (2) mixed SRC carcinoma, defined as poorly cohesive carcinoma with minor tubular compone...
Source: Gastric Cancer - September 23, 2016 Category: Gastroenterology Source Type: research

Effects of initial disease status on lymph flow following gastrectomy in cases of carcinoma in the remnant stomach
ConclusionAs compared with group B, group M showed higher incidences of lymph node metastasis in the greater curvature, splenic hilum, and lymph nodes along the splenic artery, suggesting the predominance of lymphatic flows from the greater curvature to the splenic hilum and from the remnant stomach to the splenic artery. (Source: Gastric Cancer)
Source: Gastric Cancer - September 16, 2016 Category: Gastroenterology Source Type: research

Clinicopathological features of programmed death ligand  1 expression with tumor-infiltrating lymphocyte, mismatch repair, and Epstein–Barr virus status in a large cohort of gastric cancer patients
AbstractBackgroundAntibodies against programmed death 1 (PD-1) and its ligand programmed death ligand  1 (PD-L1) have recently demonstrated promising results in gastric cancer (GC). PD-L1 expression, the presence of tumor-infiltrating lymphocytes (TILs), and mismatch repair (MMR) deficiency have been proposed as predictive biomarkers for anti-PD-1/PD-L1 antibodies. The aim of this study was to inve stigate the clinical relevance of PD-L1 expression with TIL, MMR, and Epstein–Barr virus (EBV) status in GC.MethodsWe performed a tissue microarray analysis in 487 advanced GC patients who underwent gastrectomy. PD-L1...
Source: Gastric Cancer - September 14, 2016 Category: Gastroenterology Source Type: research

Erratum to: Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study
(Source: Gastric Cancer)
Source: Gastric Cancer - September 14, 2016 Category: Gastroenterology Source Type: research

Prognostic significance of performing universal HER2 testing in cases of advanced gastric cancer
ConclusionPatients treated at centers that took longer to implement HER2 testing exhibited worse clinical outcomes. The speed of implementation behaves as a quality-of-care indicator. Reviewed guidelines on HER2 testing should be used to achieve this goal in a timely manner. (Source: Gastric Cancer)
Source: Gastric Cancer - September 6, 2016 Category: Gastroenterology Source Type: research

Nonexposure laparoscopic and endoscopic cooperative surgery (closed laparoscopic and endoscopic cooperative surgery) for gastric submucosal tumor
AbstractLaparoscopic and endoscopic cooperative surgery (LECS) is increasingly applied for gastric submucosal tumors (SMTs) such as gastrointestinal stromal tumors. However, the conventional LECS procedure has the potential risk that gastric contents and even tumor cells could spread into the abdominal cavity because the gastric wall has to be opened during the resection. To avoid this problem, we have developed a modified LECS procedure named “closed LECS.” Ten patients underwent closed LECS for the resection of gastric SMTs. Closed LECS consists of the following steps: endoscopic submucosal layer dissection a...
Source: Gastric Cancer - September 6, 2016 Category: Gastroenterology Source Type: research

How should we define the no. 3b lesser curvature lymph node?
(Source: Gastric Cancer)
Source: Gastric Cancer - September 2, 2016 Category: Gastroenterology Source Type: research

Impact of clinical tumor –node–metastasis staging on survival in gastric carcinoma patients receiving surgery
AbstractBackgroundPreoperative clinical staging of gastric cancer is used to determine therapeutic strategies. However, the impact of the clinical stage on survival has not been completely investigated, although the relationship between pathologic staging and survival outcome has been reported. The aim of the present study was to clarify the predictability of patient survival based on clinical staging and to evaluate the usefulness of staging as an indicator for selecting the treatment modality.MethodsA total of 3033 patients who underwent surgery for gastric cancer were included. A survival analysis was conducted based on...
Source: Gastric Cancer - September 1, 2016 Category: Gastroenterology Source Type: research

Targeted therapies for advanced and metastatic adenocarcinoma of the gastroesophageal junction: is there something new?
In conclusion, considering the modest survival gain obtained overall, the high cost of these therapies and the quality of life issue must be primarily considered in treating these patients. (Source: Gastric Cancer)
Source: Gastric Cancer - August 27, 2016 Category: Gastroenterology Source Type: research

Institutional variation in short- and long-term outcomes after surgery for gastric or esophagogastric junction adenocarcinoma: correlative study of two randomized phase III trials (JCOG9501 and JCOG9502)
ConclusionsThere was some degree of interinstitutional variation in outcomes after standard surgery, but there was little variation in the hazard ratio for OS for experimental surgery, indicating that the final conclusions of the two randomized phase III trials can be generalized to their respective target populations. (Source: Gastric Cancer)
Source: Gastric Cancer - August 27, 2016 Category: Gastroenterology Source Type: research

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study
ConclusionsDCS safely induced a high conversion rate, with very high R0 and pathological response rates, and was associated with a good prognosis; these findings warrant further prospective investigations. (Source: Gastric Cancer)
Source: Gastric Cancer - August 23, 2016 Category: Gastroenterology Source Type: research

Modeling preoperative risk factors for potentially lethal morbidities using a nationwide Japanese web-based database of patients undergoing distal gastrectomy for gastric cancer
ConclusionsIn this study, we successfully constructed an acceptable risk model using preoperative risk factors to predict eight postoperative morbidities highly associated with mortality in gastric cancer patients. This risk model could help to tailor perioperative management and improve clinical outcomes for patients who undergo distal gastrectomy. (Source: Gastric Cancer)
Source: Gastric Cancer - August 23, 2016 Category: Gastroenterology Source Type: research

Short- and long-term outcomes of endoscopic submucosal dissection for early gastric cancer in elderly patients aged 75  years and older
ConclusionsIn elderly patients, ESD is an acceptable treatment for EGC in terms of both short- and long-term outcomes. Careful clinical assessment of elderly patients is necessary before ESD. After ESD, medical follow-up is important so that other malignancies and diseases that affect the elderly are not overlooked. (Source: Gastric Cancer)
Source: Gastric Cancer - August 19, 2016 Category: Gastroenterology Source Type: research