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Neoadjuvant and gastric cancer

L-C Horn, C E Brambs, R Handzel, S Lax, I Sändig, D Schmidt, K Schierle
The World Health Organization (WHO) classification from 2014 differentiates between different subtypes of mucinous adenocarcinoma of the uterine cervix. A gastric subtype was recently described that showed no association with high-risk human papillomavirus (HPV) infections, has a poor prognosis, is mainly diagnosed in women of Asian origin and can occur in patients with Peutz-Jeghers syndrome. Although no clear grading system has been recommended in the WHO classification, it is likely that grading of adenocarcinomas of the uterine cervix will partly be based on the different patterns of invasion...
October 20, 2016: Der Pathologe
Nadia F Nocera, M Catherine Lee, Lucy M De La Cruz, Cinthia Rosemblit, Brian J Czerniecki
The ErbB/B2 (HER-2/neu) oncogene family plays a critical role in the development and metastatic spread of several tumor types including breast, ovarian and gastric cancer. In breast cancer, HER-2/neu is expressed in early disease development in a large percentage of DCIS lesions and its expression is associated with an increased risk of invasion and recurrence. Targeting HER-2 with antibodies such as trastuzumab or pertuzumab has improved survival, but patients with more extensive disease may develop resistance to therapy...
2016: Frontiers in Pharmacology
Lucas Goense, Peter S N van Rossum, Jelle P Ruurda, Marco van Vulpen, Stella Mook, Gert J Meijer, Richard van Hillegersberg
BACKGROUND: Concerns have been raised regarding the toxicity of neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer that could contribute to an increased risk of postoperative complications. The aim of this study was to determine the influence of the radiation dose to the gastric fundus on the risk of postoperative anastomotic leakage in patients undergoing nCRT followed by transthoracic esophagectomy. METHODS: Between January 2012 and July 2015, 97 consecutive patients who underwent nCRT followed by transthoracic esophagectomy were included in this single-center cohort study...
October 17, 2016: Annals of Thoracic Surgery
Tetsushi Nakajima, Tsutomu Sato, Kazuki Kano, Yukio Maezawa, Kenki Segami, Hirohito Fujikawa, Kousuke Ikeda, Takanobu Yamada, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa
A 63-year-old man with dysphagia was referred to our hospital. He was found to have a type 2 tumor extending from the lower thoracic esophagus to the esophagogastric junction via upper gastrointestinal endoscopy. A biopsy revealed adenocarcinoma with overexpression of the human epidermal growth factor type 2(HER2). The tumor was type I according to Siewert's classification, as the epicenter of the tumor was 27mm to the oral side from the esophago-gastric junction. The clinical diagnosis was T3N1M1, stage IV according to the Japanese Classification of Gastric Carcinoma, and T3N2M0, stage III per the Japanese Classification of Esophageal Cancer...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Takaki Yoshikawa, Tsutomu Sato, Takanobu Yamada, Toru Aoyama, Takashi Ogata, Haruhiko Cho
Adjuvant chemotherapy aims to eradicate residual micro-metastatic tumor cells existing at distant sites outside the surgical field. The current standard adjuvant chemotherapy is S-1 for 1 year or capecitabine plus oxaliplatin for 6 months after D2 gastrectomy. However, there are some rooms in the overall survival of Stage III. Neoadjuvant chemotherapy(NAC)is a promising approach that combines intensive chemotherapy with high compliance; however, it is under development in Japan. Two JCOG phase II trials suggested that NAC was effective for bulky nodal disease...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Jianjun Liu, Mingxue Su, Jing Wang, Gan Zhang, Jing Zhou, Anqing Zhang, Zixue Ren, Xucai Zheng, Shikai Hong, Shengying Wang, Rongxin Zhang
Although local advanced gastric cancer (AGC) could benefit from neoadjuvant radiotherapy (NRT), there are few studies evaluating patients' survival after NRT. In current study, we aimed to investigate the value of prognostic factors in AGC patients after NRT and to evaluate whether post-therapy pathological characteristics were predictive factors in these patients. We retrospectively analyzed AGC patients who underwent NRT from Surveillance, Epidemiology, and End Results (SEER) Database. The patients' clinical and post-therapy pathological characteristics were analyzed...
October 11, 2016: Oncotarget
Xin Ji, Tao Fu, Zhao-De Bu, Ji Zhang, Xiao-Jiang Wu, Xiang-Long Zong, Zi-Yu Jia, Biao Fan, Yi-Nan Zhang, Jia-Fu Ji
BACKGROUND: Surgery for advanced gastric cancer (AGC) often includes dissection of splenic hilar lymph nodes (SHLNs). This study compared the safety and effectiveness of different approaches to SHLN dissection for upper- and/or middle-third AGC. METHODS: We retrospectively compared and analyzed clinicopathologic and follow-up data from a prospectively collected database at the Peking University Cancer Hospital. Patients were divided into three groups: in situ spleen-preserved, ex situ spleen-preserved and splenectomy...
October 3, 2016: BMC Cancer
Daisuke Taniguchi, Hiroshi Saeki, Yuichiro Nakashima, Ryosuke Tsutsumi, Sho Nishimura, Kensuke Kudou, Yu Nakaji, Hirotada Tajiri, Satoshi Tsutsumi, Takafumi Yukaya, Ryota Nakanishi, Masahiko Sugiyama, Hideto Sonoda, Kippei Ohgaki, Eiji Oki, Yoshihiko Maehara
A 65-year-old man with cT3N2M0 stage III cervical esophageal cancer underwent subtotal esophagectomy and gastric tube reconstruction through the retrosternal route after neoadjuvant chemoradiotherapy. The anastomosis was located adjacent to the left side of the trachea, and a circular stapler was used for anastomosis. Postoperative anastomotic leakage occurred, and an esophagotracheal fistula between the esophagogastric anastomotic site and cartilage portion of the trachea was observed on postoperative day 44...
December 2016: Surgical Case Reports
K Lehmann, D Eshmuminov, P Bauerfeind, C Gubler, P Veit-Haibach, A Weber, H Abdul-Rahman, M Fischer, C Reiner, P M Schneider
INTRODUCTION: The accuracy of preoperative lymph-node staging in patients with adenocarcinoma of the esophagogastric junction (AEG) or gastric cancer (GC) is low. The aim of this study was to assess the accuracy of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT) for lymph-node staging in patients with AEG or GC, with or without neoadjuvant treatment. PATIENTS AND METHODS: 221 consecutive patients with GC (n = 88) or AEG (n = 133) were evaluated...
September 7, 2016: European Journal of Surgical Oncology
F Klevebro, M Lindblad, J Johansson, L Lundell, M Nilsson
BACKGROUND: Randomized trials have shown that neoadjuvant treatment improves survival in the curative treatment of oesophageal and gastro-oesophageal junction cancer. Results from population-based observational studies are, however, sparse and ambiguous. METHODS: This prospective population-based cohort study included all patients who had oesophagectomy for cancer in Sweden, excluding clinical T1 N0, recorded in the National Register for Oesophageal and Gastric Cancer, 2006-2014...
September 30, 2016: British Journal of Surgery
Fuxi Zhen, Sailei Shi, Lei Xue, Jinyuan Liu, Jinhua Luo
OBJECTIVE: To examine the relationship between gastric conduit width and postoperative early delayed gastric emptying (DGE) in patients with middle-lower esophageal carcinoma who underwent Ivor-Lewis operation. METHODS: Clinical data of 282 consecutive patients with middle-lower esophageal cancer who underwent the Ivor-Lewis operation by same surgical team in our department from January 2013 to June 2015 were retrospectively analyzed. Patients were divided into three groups according to the width of gastric conduit: width > 5...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
H Nienhüser, S Blank, L Sisic, R Kunzmann, U Heger, K Ott, M W Büchler, T Schmidt, A Ulrich
BACKGROUND: Gastric stump carcinoma develops in the gastric remnant after partial gastrectomy. While the frequency of gastric cancer is declining, the incidence of gastric stump carcinoma has remained stable due to the long latency period. As the surgical treatment of gastric ulcers by partial gastrectomy has become much less important, more and more gastric stump carcinomas develop after oncological resection. AIM: This study compared the surgical therapy of gastric stump carcinoma with the therapy of primary gastric cancer...
September 27, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
H Ptok, I Gastinger, F Meyer, A Ilsemann, H Lippert, C Bruns
BACKGROUND: The impact of hospital and surgeon volume on the treatment outcome based on data obtained from cohort and register studies has been controversially discussed in the international literature. The results of large-scale prospective observational studies within the framework of clinical healthcare research may lead to relevant recommendations in this ongoing discussion. MATERIAL AND METHODS: Within the framework of the prospective multicenter German Gastric Cancer Study 2 (QCGC 2), from 1 January 2007 to 31 December 2009 a total of 2897 patients with the histological diagnosis of gastric cancer from 140 surgical departments were registered and analyzed...
September 27, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Alex Yuang-Chi Chang, Kian Fong Foo, Wen-Hsin Koo, Simon Ong, Jimmy So, Daniel Tan, Khong Hee Lim
BACKGROUND: Neoadjuvant chemotherapy improves survival of locally advanced gastric cancer patients. However, benefit is limited and the best regimen remains controversial. OBJECTIVES: Our primary objective of this prospective, multicenter phase 2 study was to evaluate the pathological complete response rate (PCR) with 2 cycles of docetaxel and capecitabine. METHODS: To be eligible, patients had to have histologically documented gastric cancer, a ECOG performance status 0 or 1, T3or4 Nany M0 staging after oesophagogastroduodenoscopy (OGD), endoscopic ultrasound (EUS), CT scan of thorax and abdomen, and negative laparoscopic examination and peritoneal washing...
2016: BMJ Open Gastroenterology
Florian Lordick, Masanori Terashima
From a global perspective, gastric cancer is one of the most common and lethal forms of cancer. The incidence of gastric cancer is very high in East Asia and varies considerably in countries of the Western hemisphere. Even after curative resection, the relapse rates are high in stages II and III. Therefore, adjuvant treatment with chemotherapy has been studied with positive results, especially in East Asian populations. In the Western World, where many locally advanced and borderline resectable gastric cancers are diagnosed, perioperative chemotherapy has become a standard of care...
August 2016: Best Practice & Research. Clinical Gastroenterology
Nikhil Suresh Ghadyalpatil, Chopra Supriya, Patil Prachi, Dsouza Ashwin, Saklani Avanish
GI cancer is not one cancer but is a term for the group of cancers that affect the digestive system including gastric cancer (GC), colorectal cancer (CRC), hepatocellular carcinoma (HCC), esophageal cancer (EC), and pancreatic cancer (PC). Overall, the GI cancers are responsible for more cancers and more deaths from cancer than any other organ. 5 year survival of these cancers remains low compared to western world. Unlike the rest of the world where organ based specialities hepatobiliary, pancreatic, colorectal and esophagogastric exist, these cancers are managed in India by either a gastrointestinal surgeons, surgical oncologist, or a general surgeon with varying outcomes...
July 2016: South Asian Journal of Cancer
Wojciech Leszczyński, Paweł Polanowski, Paulina Leszczyńska, Leszek Hawrylewicz, Iwona Brąclik, Rafał Kawczyński, Jerzy Wydmański
AIM: The purpose of this study was to compare conformal radiotherapy techniques used in the treatment of gastric cancer patients. The study is dedicated to radiotherapy centres that have not introduced dynamic techniques in clinical practice. BACKGROUND: The implementation of multi-field technique can minimise the toxicity of treatment and improve dose distribution homogeneity in the target volume with simultaneous protection of organs at risk (OaRs). Treatment plan should be personalised for each patient by taking into account the planning target volume and anatomical conditions of the individual patient...
May 2016: Reports of Practical Oncology and Radiotherapy
Lu Wang, Yanli Chang, Jianjun Xu, Qingyun Zhang
The study aims to evaluate serum VEGF expression in gastric cancer patients and investigate its relationship with clinicopathological parameters. We also examined the serum VEGF levels in GC patients having received surgery or chemotherapy treatment to assess its predictive and prognostic value as a biomarker. We enrolled 154 GC patients having not received neoadjuvant treatment and 100 healthy controls. In the treatment groups, 13 surgery patients and 15 chemotherapy patients were investigated. 42 chemotherapy patients with different chemotherapy efficacy were recruited as well...
2016: BioMed Research International
M A West, L Loughney, G Ambler, B D Dimitrov, J J Kelly, M G Mythen, R Sturgess, P M A Calverley, A Kendrick, M P W Grocott, S Jack
BACKGROUND: In 2014 approximately 21,200 patients were diagnosed with oesophageal and gastric cancer in England and Wales, of whom 37 % underwent planned curative treatments. Potentially curative surgical resection is associated with significant morbidity and mortality. For operable locally advanced disease, neoadjuvant chemotherapy (NAC) improves survival over surgery alone. However, NAC carries the risk of toxicity and is associated with a decrease in physical fitness, which may in turn influence subsequent clinical outcome...
2016: BMC Cancer
Ji-Chun Zhou, Ju-Feng Guo, Rong-Yue Teng, Qin-Chuan Wang, Ji Wang, Qun Wei, Zi-Duo Li, Jian-Guo Shen, Lin-Bo Wang
BACKGROUND: Although the correlation between metabolic abnormality and gastric cancer has been extensively investigated, the question of whether metabolic parameters might influence the efficacy of chemotherapy in locally advanced gastric cancer is still unanswered. In our present study, we investigated the relationship between serum fasting glucose, lipid levels, and histopathological response of neoadjuvant chemotherapy (NAC) in locally advanced gastric cancers. PATIENTS AND METHODS: A total of 128 patients were identified from a prospectively maintained database of patients with locally advanced gastric cancer who received NAC between July 2004 and December 2012...
2016: OncoTargets and Therapy
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