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Gastric Cancer

Koji Kono, Wei-Peng Yong, Hirokazu Okayama, Asim Shabbir, Tomoyuki Momma, Shinji Ohki, Seiichi Takenoshita, Jimmy So
Among 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 peritoneal metastasis of gastric cancer...
October 20, 2016: Gastric Cancer
Manami Inoue
Helicobacter pylori (H. Pylori) is known as the most important cause of gastric cancer. The prevalence of H. 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 in H. 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 decades, the prevalence of H...
October 18, 2016: Gastric Cancer
Yuri Tanaka, Mitsuro Kanda, Chie Tanaka, Daisuke Kobayashi, Akira Mizuno, Naoki Iwata, Masamichi Hayashi, Yukiko Niwa, Hideki Takami, Suguru Yamada, Tsutomu Fujii, Goro Nakayama, Hiroyuki Sugimoto, Michitaka Fujiwara, Yasuhiro Kodera
BACKGROUND: Gastrectomy 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...
October 12, 2016: Gastric Cancer
Kazuki Sumiyama
Methodology 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...
October 12, 2016: Gastric Cancer
Ha Young Woo, Yoon Sung Bae, Jie-Hyun Kim, Sang Kil Lee, Yong Chan Lee, Jae-Ho Cheong, Sung Hoon Noh, Hyunki Kim
BACKGROUND: Gastric "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. METHODS: We constructed tissue microarrays of 94 CRAs, 72 conventional-type differentiated adenocarcinomas (CDAs), and 71 intramucosal poorly cohesive adenocarcinomas (PCAs) from early gastric cancers to evaluate and compare the pathological and expression profiles of potential key molecules for molecular classification (EBV; four MMR proteins-MLH1, MSH2, PMS2, and MSH6; three RTKs-HER2, MET, and EGFR; PTEN; and p53)...
October 12, 2016: Gastric Cancer
Xiaofu Zhu, Yoo-Joung Ko, Scott Berry, Keya Shah, Esther Lee, Kelvin Chan
BACKGROUND: It is unclear which regimen is the most efficacious among the available therapies for advanced gastric cancer in the second-line setting. We performed a network meta-analysis to determine their relative benefits. METHODS: We conducted a systematic review of randomized controlled trials (RCTs) through the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases and American Society of Clinical Oncology abstracts up to June 2014 to identify phase III RCTs on advanced gastric cancer in the second-line setting...
October 8, 2016: Gastric Cancer
Haruhisa Suzuki, Ichiro Oda, Seiichiro Abe, Masau Sekiguchi, Satoru Nonaka, Shigetaka Yoshinaga, Yutaka Saito, Takeo Fukagawa, Hitoshi Katai
BACKGROUND: Clinical outcomes of early gastric cancer (EGC) patients after noncurative endoscopic submucosal dissection (ESD) have not been fully elucidated; we therefore aimed to clarify these outcomes. METHODS: A total of 3058 consecutive patients with 3474 clinically diagnosed EGCs at initial onset underwent ESD with curative intent at our hospital between 1999 and 2010. We retrospectively assessed the following clinical outcomes of noncurative gastric ESD patients with a possible risk of lymph node (LN) metastasis by dividing patients into two groups with different treatment strategies (additional gastrectomy and simple follow-up): presence of LN metastasis at the time of gastrectomy, incidence of LN and distant metastases during the follow-up period, clinicopathological factors associated with metastasis, and 5-year disease-specific survival (DSS)...
October 8, 2016: Gastric Cancer
Hitoshi Katai, Junki Mizusawa, Hiroshi Katayama, Masakazu Takagi, Takaki Yoshikawa, Takeo Fukagawa, Masanori Terashima, Kazunari Misawa, Shin Teshima, Keisuke Koeda, Souya Nunobe, Norimasa Fukushima, Takashi Yasuda, Yoshito Asao, Yoshiyuki Fujiwara, Mitsuru Sasako
BACKGROUNDS: No confirmatory randomized controlled trials (RCTs) have evaluated the efficacy of laparoscopy-assisted distal gastrectomy (LADG) compared with open distal gastrectomy (ODG). We performed an RCT to confirm that LADG is not inferior to ODG in efficacy. METHODS: We conducted a multi-institutional RCT. Eligibility criteria included histologically proven gastric adenocarcinoma in the middle or lower third of the stomach, clinical stage I tumor. Patients were preoperatively randomized to ODG or LADG...
October 7, 2016: Gastric Cancer
Kazuto Harada, Dilsa Mizrak Kaya, Yusuke Shimodaira, Jaffer A Ajani
To 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...
October 7, 2016: Gastric Cancer
Masahiro Maeda, Hiroshi Moro, Toshikazu Ushijima
Multiple pathogenic mechanisms by which Helicobacter 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...
October 7, 2016: Gastric Cancer
Magnus Nilsson
Follow-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...
October 7, 2016: Gastric Cancer
Hiroya Takeuchi, Osamu Goto, Naohisa Yahagi, Yuko Kitagawa
Recent 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...
October 6, 2016: Gastric Cancer
Mitsuhiro Fujishiro, Shuntaro Yoshida, Rie Matsuda, Akiko Narita, Hiroharu Yamashita, Yasuyuki Seto
BACKGROUND: Endoscopic resection for early gastric cancer (EGC) plays a central role in the treatment of EGC in Japan. However, there is still room for improvement, and it is necessary to summarize the recently obtained knowledge from Japan for further improvement. METHODS: We conducted a PubMed search to select relevant articles in the 5 years until September 18, 2016, using the keywords "gastric cancer" and "endoscopic treatment," "endoscopic submucosal dissection," "endoscopic mucosal resection," or "polypectomy" and filtering article types as "clinical study" or "clinical trial...
October 4, 2016: Gastric Cancer
Kohei Shitara
Differences 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 global or Asian studies...
October 3, 2016: Gastric Cancer
Masaki Aizawa, Michitaka Honda, Naoki Hiki, Takahiro Kinoshita, Hiroshi Yabusaki, Souya Nunobe, Hidehito Shibasaki, Atsushi Matsuki, Masahiro Watanabe, Takayuki Abe
OBJECTIVE: This study aimed to clarify the oncological safety of pylorus-preserving gastrectomy (PPG) compared with conventional distal gastrectomy (DG). METHODS: From three institutions specializing in cancer, the medical records for a cohort of 2898 consecutive patients who had undergone DG (n = 2208) or PPG (n = 690) for clinical stage I gastric cancer between January 2006 and December 2012 were analyzed. A propensity score for each patient was estimated on the basis of 38 preoperative clinical and tumor-related factors...
September 26, 2016: Gastric Cancer
Yeonjoo Choi, Jin Won Kim, Kyung Han Nam, Song-Hee Han, Ji-Won Kim, Sang-Hoon Ahn, Do Joong Park, Keun-Wook Lee, Hye Seung Lee, Hyung-Ho Kim
BACKGROUND: The 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. METHODS: Two 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...
September 24, 2016: Gastric Cancer
Yon Hee Kim, Ji Hye Park, Cheol Keun Park, Jie-Hyun Kim, Sang Kil Lee, Yong Chan Lee, Sung Hoon Noh, Hyunki Kim
BACKGROUND: The 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. METHODS: We 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 components...
September 23, 2016: Gastric Cancer
Shinsaku Honda, Etsuro Bando, Rie Makuuchi, Masanori Tokunaga, Yutaka Tanizawa, Taiichi Kawamura, Teiichi Sugiura, Yusuke Kinugasa, Katsuhiko Uesaka, Masanori Terashima
PURPOSE: In cases of carcinoma in the remnant stomach (CRS), the lymphatic flow may be altered by the initial surgery. In this study of CRS after gastrectomy, we investigated how the regions of lymph node metastasis and changes in lymphatic flow depend on initial disease status. METHOD: The study included 76 patients with CRS who underwent gastrectomy between September 2002 and November 2014. We analyzed and compared the clinicopathological factors and survival periods between patients after distal gastrectomy for malignant disease (group M, 33 patients) and patients after distal gastrectomy for benign disease (group B, 43 patients)...
September 16, 2016: Gastric Cancer
Akihito Kawazoe, Takeshi Kuwata, Yasutoshi Kuboki, Kohei Shitara, Akiko Kawano Nagatsuma, Masaaki Aizawa, Takayuki Yoshino, Toshihiko Doi, Atsushi Ohtsu, Atsushi Ochiai
BACKGROUND: Antibodies 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 investigate the clinical relevance of PD-L1 expression with TIL, MMR, and Epstein-Barr virus (EBV) status in GC...
September 14, 2016: Gastric Cancer
Yasushi Sato, Hiroyuki Ohnuma, Takayuki Nobuoka, Masahiro Hirakawa, Tamotsu Sagawa, Koshi Fujikawa, Yasuo Takahashi, Minami Shinya, Shinich Katsuki, Minoru Takahashi, Masahiro Maeda, Yutaka Okagawa, Uemura Naoki, Syouhei Kikuch, Koichi Okamoto, Hiroshi Miyamoto, Mitsuo Shimada, Ichiro Takemasa, Junji Kato, Tetsuji Takayama
No abstract text is available yet for this article.
September 14, 2016: Gastric Cancer
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