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Neoadjuvant and gastric cancer

Maciej Nowacki, Dariusz Grzanka, Wojciech Zegarski
We report the first application of pressurized intraperitoneal aerosol chemotherapy (PIPAC) as a rescue therapy before palliative D2 gastrectomy combined with liver metastasectomy performed in a 49-year-old woman with peritoneal carcinomatosis who was primarily diagnosed with and underwent surgery for a Krukenberg tumor. The PIPAC procedure was performed with the use of cisplatin at 7.5 mg/m2 and doxorubicin at 1.5 mg/m2 for 30 min at 37 °C. Eight weeks after the PIPAC procedure, the patient underwent open classic D2 gastrectomy with the creation of a Roux-en-Y anastomosis (RNY) combined with liver metastasectomy...
May 21, 2018: World Journal of Gastroenterology: WJG
Fengke Li, Yimin Wang, Chunfeng Li, Yan Ma, Yongle Zhang, Zhiguo Li, Yingwei Xue
OBJECTIVE: To compare clinicopathological features and prognosis between patients with carcinoma in the remnant stomach (CRS) and with gastric cancer, and to investigate the prognostic factors in CRS patients. METHODS: A retrospective cohort study was performed on clinicopathological data of 96 CRS patients (CRS group) and selected 440 patients with gastric cancer (GC group) treated at Harbin Medical University Cancer Hospital from January 1977 to December 2017...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Alaa A Elzarkaa, Waleed Shaalan, Doaa Elemam, Hassan Mansour, Mahmoud Melis, Eduard Malik, Amr A Soliman
OBJECTIVE: A numerical score, the peritoneal cancer index (PCI), was developed to reflect the extent of tumor growth in gastric and colorectal cancers and to tailor treatment. This study aimed to examine the value of the PCI score in advanced epithelial ovarian cancer (EOC) regarding completeness of surgical cytoreduction and survival. METHODS: This was a prospective observational cohort study. Patients with primary serous EOC at International Federation of Gynecology and Obstetrics (FIGO) stages IIIB or higher were included...
March 8, 2018: Journal of Gynecologic Oncology
Olzhas Zhandossov, Galina Kaussova, Avraam Koten
BACKGROUND/AIMS: Gastric cancer is one of the most common oncological diseases. It can develop in any part of the stomach and spread to other organs, especially the esophagus, lungs, and liver. The aim of our study was to investigate the effectiveness of our proposed therapy. MATERIALS AND METHODS: Our research promises more effective neoadjuvant therapy, including immunotherapy and multi-agent chemotherapy. Of the 62 patients involved in our study, 32 underwent neoadjuvant chemotherapy in combination with surgery, whereas the rest underwent neoadjuvant chemoimmunotherapy with surgery...
March 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Ziyu Li, Yinkui Wang, Fei Shan, Xiangji Ying, Zhouqiao Wu, Kan Xue, Rulin Miao, Yan Zhang, Jiafu Ji
BACKGROUND: This study aims to evaluate the new ypTNM staging system in Chinese gastric cancer patients. METHODS: We conducted retrospective survival and regression analyses using a database of gastric cancer patients who underwent neoadjuvant chemotherapy at the Peking University Cancer Hospital and Institute from January 2007 to January 2015. RESULTS: A total of 473 patients were included in the study with 28 pathological complete response (pCR) cases, 3 ypT0N1 cases, 65 stage I cases, 126 stage II cases, and 251 stage III cases...
May 10, 2018: Gastric Cancer
Paul M Schneider, Dilmurodjon Eshmuminov, Tamara Rordorf, Diana Vetter, Patrick Veit-Haibach, Achim Weber, Peter Bauerfeind, Panagiotis Samaras, Kuno Lehmann
BACKGROUND: Pathologic response to neoadjuvant chemotherapy (neoCTX) is a prognostic factor in many cancer types, and early prediction would help to modify treatment. In patients with gastric and esophagogastric junction (AEG) cancer, the accuracy of FDG PET-CT to predict early pathologic response after neoadjuvant chemotherapy (neoCTX) is currently not known. METHODS: From a consecutive cohort of 72 patients, 44 patients with resectable, locally-advanced gastric cancer or AEG Siewert type II and III received neoCTX after primary staging with endoscopic ultrasound, PET-CT and laparoscopy...
May 9, 2018: BMC Cancer
Gerassimos N Douridas, Stefanos K Pierrakakis
Although D2 constitutes the level of lymph node dissection which most surgical associations endorse in their treatment guidelines for gastric cancer more extended D3 dissection has also been attempted to improve oncologic outcomes. Existing literature pertinent with the provisional therapeutic impact of D3 lymphadenectomy in advanced gastric cancer is studied in this mini review. Seven non-randomized comparisons, three randomized trials and five meta-analyses, almost exclusively of Asian origin, were identified and examined...
2018: Frontiers in Surgery
Wenxian Hu, Yongxia Chen, Kezhen Lv
BACKGROUND: The microRNA let-7a contains three copies of genes and is associated with various types of cancer, including gastric cancer. In this study, we aim to investigate the differential expression patterns of microRNA let7a in PBMCs from patients of gastric cancer (GC) before and after neoadjuvant chemotherapy. METHODS: The differential expression levels of let-7a were detected in PBMCs from 22 patients with GC before and after neoadjuvant chemotherapy by reverse transcription quantitative polymerase chain reaction (RT-qPCR)...
May 1, 2018: Clinical Laboratory
Maria Antonietta Mazzei, Giulio Bagnacci, Francesco Gentili, Andrea Nigri, Veronica Pelini, Carla Vindigni, Francesco Giuseppe Mazzei, Gian Luca Baiocchi, Frida Pittiani, Paolo Morgagni, Enrico Petrella, Gianni Mura, Beatrice Verdelli, Maria Bencivenga, Simone Giacopuzzi, Daniele Marrelli, Franco Roviello, Luca Volterrani
Aim: To investigate the role of maximum tumour diameter (D-max) reduction rate at CT examination in predicting histopathological tumour regression grade (TRG according to the Becker grade), after neoadjuvant chemotherapy (NAC), in patients with resectable advanced gastric cancer (AGC). Materials and Methods: Eighty-six patients (53 M, mean age 62.1 years) with resectable AGC (≥T3 or N+), treated with NAC and radical surgery, were enrolled from 5 centres of the Italian Research Group for Gastric Cancer (GIRCG)...
2018: Gastroenterology Research and Practice
Li Yang, Yong Li, Gao-Feng Shi, Tao Zhou, Bi-Bo Tan
OBJECTIVE: This study aims to explore the association between iodine concentration (IC) in perigastric adipose tissue (PAT), quantified by dual-energy computed tomography (DECT) and serosal invasion (SI) in patients with gastric cancer post-neoadjuvant chemotherapy (NAC). METHODS: Forty-three patients with T4-staged gastric cancer were enrolled. IC and standardized IC in PAT (ICPAT and SICPAT) were quantified by DECT pre and post NAC. A postoperative pathologic examination was performed to stage gastric cancer...
April 26, 2018: Digestion
Eduardo Henrique Cunha Neves Filho, Adriana Pinheiro Bezerra Pires, Rosane Oliveira de Sant'Ana, Silvia Helena Barem Rabenhorst, Carlos Gustavo Hirth, Maria Do Perpétuo Socorro Saldanha da Cunha
Although the introduction of the perioperative chemotherapy on the management of gastric cancer has improved patients survival, heterogeneity of clinical outcomes has been evidenced in parallel to different histopathological regression pattern of gastric cancer cells. Thus, this study evaluated the tumor regression grading (TRG) in a series of post-treatment gastric tumors and its associations with HER2, MET, and FOXP3 expression. Material of 54 gastric cancer samples was available for TRG evaluation and immunohistochemistry...
May 2018: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
S D Nelen, K Bosscha, V E P P Lemmens, H H Hartgrink, R H A Verhoeven, J H W de Wilt
BACKGROUND: This study investigated age-related differences in surgically treated patients with gastric cancer, and aimed to identify factors associated with outcome. METHODS: Data from the Dutch Upper Gastrointestinal Cancer Audit were used. All patients with non-cardia gastric cancer registered between 2011 and 2015 who underwent surgery were selected. Patients were analysed by age group (less than 70 years versus 70 years or more). Multivariable logistic regression was used to assess the influence of clinicopathological factors on morbidity and mortality...
April 23, 2018: British Journal of Surgery
Yang Li, Yao Wei, Qi He, Xulin Wang, Chaogang Fan, Guoli Li
This study was designed to investigate the prognostic value of circulating blood cell counts and subsets for patients with advanced gastric cancer (AGC) treated with neoadjuvant chemotherapy (NAC) and the factors determining pathological complete response (pCR). In 112 patients with AGC, we retrospectively examined the ratios of lymphocyte, monocyte, and neutrophil during and after NAC before surgery, and the percentages of CD3+, CD3+ CD4+, CD3+ CD8+ and CD4+/CD8+ lymphocytes as well. We also investigated their associations with the pCR rate and overall survival (OS)...
April 18, 2018: Scientific Reports
Junko Kuroda, Hisae Aoki, Naoko Kondou, Toshiyuki Sumita, Kei Itoh, Senichirou Agawa
A 56-year-old man was diagnosed with advanced adenocarcinoma of the esophagogastric junction. He received 1 course of neoadjuvant chemotherapy with S-1. After neoadjuvant chemotherapy, the primary tumor showed a remarkable decrease in size. Subtotalesophagectomy, D2 lymph node dissection, and reconstruction with a gastric tube through the posterior mediastinal route were performed. Pathological examination showed that most of the cancer cells had been destroyed, with a part where adenocarcinoma mucosa was seen...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Bang Wool Eom, Sohee Kim, Ja Yeon Kim, Hong Man Yoon, Mi-Jung Kim, Byung-Ho Nam, Young-Woo Kim, Young-Iee Park, Sook Ryun Park, Keun Won Ryu
Purpose: It has been reported that the survival of patients with locally advanced gastric cancer (LAGC) is better in East Asia countries than in developed western countries; however, the prognosis of LAGC remains poor. This study aimed to evaluate the effects of perioperative chemotherapy on the long-term survival of East Asia patients with LAGC. Materials and Methods: From October 2006 through August 2008, 43 patients with LAGC received perioperative S-1 combined with weekly docetaxel in a phase II study (neoadjuvant group)...
March 2018: Journal of Gastric Cancer
M Navidi, A W Phillips, S M Griffin, K E Duffield, A Greystoke, K Sumpter, R C F Sinclair
BACKGROUND: Neoadjuvant chemotherapy may have a detrimental impact on cardiorespiratory reserve. Determination of oxygen uptake at the anaerobic threshold by cardiopulmonary exercise testing (CPET) provides an objective measure of cardiorespiratory reserve. Anaerobic threshold can be used to predict perioperative risk. A low anaerobic threshold is associated with increased morbidity after oesophagogastrectomy. The aim of this study was to establish whether neoadjuvant chemotherapy has an adverse effect on fitness, and whether there is recovery of fitness before surgery for oesophageal and gastric adenocarcinoma...
March 30, 2018: British Journal of Surgery
Ashish Goel, Swati H Shah, Veda Padma Priya Selvakumar, Shubha Garg, Kapil Kumar
Neoadjuvant chemoradiation has become the standard of care for esophageal cancer, especially for middle third esophageal lesions and those with squamous histology. Although more and more thoracic surgeons and surgical oncologists have now shifted to video-assisted and robot-assisted thoracoscopic esophagectomy; there is still limited experience for the use of minimal-assisted approaches in patients undergoing surgery after neoadjuvant chemoradiation. Most surgeons have concerns of feasibility, safety, and oncological outcomes as well as issues related to difficult learning curve in adopting robotic esophagectomy in patients after chemoradiation...
February 2018: Indian Journal of Surgery
Hui Luo, Liangqun Peng, Nan Wang, Jiangong Zhang, Xiaoli Zheng, Yanan Sun, Chengcheng Fan, Hong Ge
Advanced gastric cancer with a pathological complete response to neoadjuvant chemotherapy and surgery followed by early brain metastasis is rare. A 52-year-old male patient who was diagnosed with advanced gastric cancer (cT4N2M0, stage ШB). Radiological examinations after three cycles of preoperative chemotherapy with a modified FOLFOX6 (mFOLFOX6) regimen showed a partial response (PR) had been achieved. The patient underwent curative surgery consisting of proximal gastrectomy, and D2 lymph node dissection...
March 26, 2018: Cancer Biology & Therapy
Guopeng Deng, Jianjun Qu, Shengyong Zhai, Yiran Shi, Xinbo Wang
OBJECTIVE: To study the effect of neoadjuvant chemotherapy on nutritional status in patients with locally advanced gastric cancer. METHODS: Cases inclusion criteria: (1)18-65 years old; (2) Gastric cancer confirmed by gastroscopic biopsy; (3) Preoperative TNM stage III( according to the AJCC stage 2000 standard; (4) Kamosfsky functional status score> 60 points; (5)Receiving neoadjuvant chemotherapy voluntarily and signing the informed consent form. Case exclusion criteria: (1)Having contraindications of chemotherapy and surgery; (2) Suffering from heart, liver and kidney and other underlying diseases; (3) Concurrent with malignant diseases, wasting disease or other digestive diseases...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Yinkui Wang, Ziyu Li, Fei Shan, Lianhai Zhang, Shuangxi Li, Yongning Jia, Yufan Chen, Kan Xue, Rulin Miao, Zhemin Li, Xiangyu Gao, Chao Yan, Shen Li, Zhouqiao Wu, Jiafu Ji
OBJECTIVE: To compare the short-term safety and costs between laparoscopic assisted or totally laparoscopic uncut Roux-en-Y and Billroth II((BII() + Braun reconstruction after radical gastrectomy of distal gastric cancer. METHODS: Clinical data from our prospective database of radical gastrectomy were systematically analyzed. The patients who underwent laparoscopic gastrectomy with uncut Roux-en-Y or BII(+ Braun reconstruction between March 1st, 2015 and June 30th, 2017 were screened out for further analysis...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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