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Lv CB, Tong LY, Zeng WM, Chen QX, Fang SY, Sun YQ, Cai LS. Efficacy of neoadjuvant chemotherapy combined with prophylactic intraperitoneal hyperthermic chemotherapy for patients diagnosed with clinical T4 gastric cancer who underwent laparoscopic radical gastrectomy: a retrospective cohort study based on propensity score matching. World J Surg Oncol 2024; 22:244. [PMID: 39256787 PMCID: PMC11389469 DOI: 10.1186/s12957-024-03526-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 09/01/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Clinical T4 (cT4) stage gastric cancer presents with frequent postoperative recurrence and poor prognosis. This study is to evaluate the oncological efficacy of laparoscopic radical total gastrectomy combined with postoperative prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with cT4N + M0 gastric cancer who received neoadjuvant chemotherapy. METHODS We reviewed the clinicopathological data of 174 patients with clinical T4 gastric cancer who underwent neoadjuvant chemotherapy followed by laparoscopic radical total gastrectomy between June 2017 and December 2021. Among them, 142 were included in the non-HIPEC group, and 32 in the HIPEC group. Patients in both groups were paired based on propensity score in a 2:1 ratio to assess disparities in tumor recurrence and long-term survival. RESULTS After matching, there were no significant differences in the clinicopathological data between the two groups. The peritoneum (16.1%) and distant organs (10.9%) were the most frequent locations for recurrence. Prior to matching, the recurrence rates were similar at all sites for both groups. Compared with those in the non-HIPEC cohort, the recurrence rates at all sites, the lung, and the peritoneum were notably lower in the HIPEC cohort. Prior to matching, the 3-year overall survival and disease-free survival rates were similar between the two groups; following matching, the HIPEC group exhibited notably greater survival rates than did the non-HIPEC group. The disparities in survival rates between the groups became even more pronounced after conducting a stratified analysis among patients with stage III disease. CONCLUSIONS Neoadjuvant chemotherapy combined with prophylactic HIPEC after laparoscopic radical gastrectomy can effectively reduce the rate of peritoneal metastasis in patients with cT4N + M0 advanced gastric cancer and significantly improve the prognosis of such patients, which is of great clinical value.
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Affiliation(s)
- Chen-Bin Lv
- Zhangzhou Affiliated Hospital of Fujian Medical University'sDepartment of Gastric Surgery, No.59 Sheng-li Road, Zhangzhou City, Fujian Province, China
| | - Lin-Yan Tong
- Zhangzhou Affiliated Hospital of Fujian Medical University'sDepartment of Gastric Surgery, No.59 Sheng-li Road, Zhangzhou City, Fujian Province, China
| | - Wei-Ming Zeng
- Zhangzhou Affiliated Hospital of Fujian Medical University'sDepartment of Gastric Surgery, No.59 Sheng-li Road, Zhangzhou City, Fujian Province, China
| | - Qiu-Xian Chen
- Zhangzhou Affiliated Hospital of Fujian Medical University'sDepartment of Gastric Surgery, No.59 Sheng-li Road, Zhangzhou City, Fujian Province, China
| | - Shun-Yong Fang
- Zhangzhou Affiliated Hospital of Fujian Medical University'sDepartment of Gastric Surgery, No.59 Sheng-li Road, Zhangzhou City, Fujian Province, China
| | - Yu-Qin Sun
- Zhangzhou Affiliated Hospital of Fujian Medical University'sDepartment of Gastric Surgery, No.59 Sheng-li Road, Zhangzhou City, Fujian Province, China
| | - Li-Sheng Cai
- Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou City, Fujian Province, China.
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Zheng C, Qian M, Huang T, Liu X, Zeng X, Chen X, Shen Y, Chen P, Wu F, Gu L. Exploring Individualized Follow-up of Gastric Cancer After Radical Surgery Based on pTNM Stage: A Retrospective Cohort Study From China. Clin Med Insights Oncol 2024; 18:11795549241272654. [PMID: 39233761 PMCID: PMC11372772 DOI: 10.1177/11795549241272654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 07/08/2024] [Indexed: 09/06/2024] Open
Abstract
Background Patients with gastric cancer (GC) who underwent radical surgery require long-term follow-up (usually 5 years). The purpose of this study was to explore individualized follow-up strategies for patients with GC. Methods This is a retrospective cohort study that established a clinicopathologic database of patients who underwent gastrectomy from January 2010 to December 2020 at Ningbo No. 2 Hospital. Follow-up was performed until March 2023. The rate of new-onset recurrence of patients with GC was explored annually according to different pTNM stages, defining a recurrence rate of less than 1% as adequate follow-up time. Results Of the 1606 patients who were eligible, the total number of patients who completed the 5- and 10-year follow-up was 1107 and 586, respectively. A total of 444 cases were diagnosed with recurrence. The recurrence rate for stage IA patients was consistently less than 1% during the follow-up time. The adequate follow-up time (the rate of new-onset recurrence less than 1%) was 5 years for stage IB and IIA patients, and 8 years for stage IIB and IIIA patients, respectively. In contrast, stage IIIB patients were always at risk of recurrence during the follow-up time (>1%). Time to a new recurrence rate for stage IIIC patients was 6 years. Conclusion Among patients who underwent radical gastrectomy, the rate of new-onset recurrence varied among patients with different pTNM stages. This study suggests that the follow-up of GC can be individualized and refer to pTNM stage.
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Affiliation(s)
- Cheng Zheng
- Department of General Surgery, Ningbo No. 2 Hospital, Ningbo, China
| | - Mengyi Qian
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Tongmin Huang
- Department of Hepatobiliary and Pancreatic Surgery and Zhejiang Provincial Key Laboratory of Pancreatic Disease, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xingchen Liu
- Intensive Care Unit, Ningbo No. 2 Hospital, Ningbo, China
| | - Xiangman Zeng
- Medical Record Statistics Department, Ningbo No. 2 Hospital, Ningbo, China
| | - Xiaotong Chen
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Shen
- Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Ping Chen
- Department of General Surgery, Ningbo No. 2 Hospital, Ningbo, China
| | - Feng Wu
- Department of General Surgery, Ningbo No. 2 Hospital, Ningbo, China
| | - Lihu Gu
- Department of General Surgery, Ningbo No. 2 Hospital, Ningbo, China
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Yu X, Bai C, Yu Y, Guo X, Wang K, Yang H, Luan X. Construction of a novel nomogram for predicting overall survival in patients with Siewert type II AEG based on LODDS: a study based on the seer database and external validation. Front Oncol 2024; 14:1396339. [PMID: 38912066 PMCID: PMC11193347 DOI: 10.3389/fonc.2024.1396339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Background In recent years, the incidence of adenocarcinoma of the esophagogastric junction (AEG) has been rapidly increasing globally. Despite advances in the diagnosis and treatment of AEG, the overall prognosis for AEG patients remains concerning. Therefore, analyzing prognostic factors for AEG patients of Siewert type II and constructing a prognostic model for AEG patients is important. Methods Data of primary Siewert type II AEG patients from the SEER database from 2004 to 2015 were obtained and randomly divided into training and internal validation cohort. Additionally, data of primary Siewert type II AEG patients from the China Medical University Dandong Central Hospital from 2012 to 2018 were collected for external validation. Each variable in the training set underwent univariate Cox analysis, and variables with statistical significance (p < 0.05) were added to the LASSO equation for feature selection. Multivariate Cox analysis was then conducted to determine the independent predictive factors. A nomogram for predicting overall survival (OS) was developed, and its performance was evaluated using ROC curves, calibration curves, and decision curves. NRI and IDI were calculated to assess the improvement of the new prediction model relative to TNM staging. Patients were stratified into high-risk and low-risk groups based on the risk scores from the nomogram. Results Age, Differentiation grade, T stage, M stage, and LODDS (Log Odds of Positive Lymph Nodes)were independent prognostic factors for OS. The AUC values of the ROC curves for the nomogram in the training set, internal validation set, and external validation set were all greater than 0.7 and higher than those of TNM staging alone. Calibration curves indicated consistency between the predicted and actual outcomes. Decision curve analysis showed moderate net benefit. The NRI and IDI values of the nomogram were greater than 0 in the training, internal validation, and external validation sets. Risk stratification based on the nomogram's risk score demonstrated significant differences in survival rates between the high-risk and low-risk groups. Conclusion We developed and validated a nomogram for predicting overall survival (OS) in patients with Siewert type II AEG, which assists clinicians in accurately predicting mortality risk and recommending personalized treatment strategies.
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Affiliation(s)
- Xiaohan Yu
- General Surgery Department, Dandong Central Hospital, China Medical University, Dandong, Liaoning, China
| | - Chenglin Bai
- General Surgery Department, Dandong Central Hospital, Jinzhou Medical University, Dandong, Liaoning, China
| | - Yang Yu
- The First Ward of General Surgery, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Xianzhan Guo
- General Surgery Department, Dandong Central Hospital, China Medical University, Dandong, Liaoning, China
| | - Kang Wang
- General Surgery Department, Dandong Central Hospital, China Medical University, Dandong, Liaoning, China
| | - Huimin Yang
- General Surgery Department, Dandong First Hospital, Jinzhou Medical University, Dandong, Liaoning, China
| | - Xiaodan Luan
- General Surgery Department, Dandong Central Hospital, Jinzhou Medical University, Dandong, Liaoning, China
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Liu C, Lu J, An L. Development and validation of nomograms for predicting the prognosis of early and late recurrence of advanced gastric cancer after radical surgery based on post-recurrence survival. Medicine (Baltimore) 2024; 103:e38376. [PMID: 39259073 PMCID: PMC11142773 DOI: 10.1097/md.0000000000038376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/21/2024] [Accepted: 05/06/2024] [Indexed: 09/12/2024] Open
Abstract
In this study, we aimed to explore the risk factors influencing post-recurrence survival (PRS) of early recurrence (ER) and late recurrence (LR) in stage advanced gastric cancer (AGC) patients after radical surgery, respectively, and to develop predictive models in turn. Medical records of 192 AGC patients who recurred after radical gastrectomy were retrospectively reviewed. They were randomly divided into the training and validation set at a ratio of 2:1. Nomograms were built based on risk factors influencing PRS of ER and LR explored by Cox regression analyses, respectively. Concordance index (C-index) values and calibration curves were used to evaluate predictive power of nomograms. Body mass index < 18.5 kg/m2, prealbumin level < 70.1 mg/L, positive lymph nodes ratio ≥ 0.486 and palliative treatment after recurrence were independent risk factors for the prognosis of ER. In contrast, prealbumin level < 170.1 mg/L, CEA ≥ 18.32 μg/L, tumor diameter ≥ 5.5 cm and palliative treatment after recurrence were independent risk factors for the prognosis of LR. The C-index values were 0.801 and 0.772 for ER and LR in the training set, respectively. The calibration curves of validation set showed a C-index value of 0.744 and 0.676 for ER and LR, respectively. Nomograms which were constructed to predict the prognosis of ER and LR of AGC after surgery showed great predictive power and could provide reference for clinicians' treatment strategies to some extent.
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Affiliation(s)
- Chenming Liu
- Department of General Surgery, Shaoxing People’s Hospital, Shaoxing, China
- Zhejiang University School of Medicine, Hangzhou, China
| | - Jialiang Lu
- Department of General Surgery, Shaoxing People’s Hospital, Shaoxing, China
- School of Medicine, Shaoxing University, Shaoxing, China
| | - Liang An
- Department of Gastrointestinal Surgery, Shaoxing People’s Hospital, Shaoxing, China
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Granieri S, Sileo A, Altomare M, Frassini S, Gjoni E, Germini A, Bonomi A, Akimoto E, Wong CL, Cotsoglou C. Short-Term Outcomes after D2 Gastrectomy with Complete Mesogastric Excision in Patients with Locally Advanced Gastric Cancer: A Systematic Review and Meta-Analysis of High-Quality Studies. Cancers (Basel) 2023; 16:199. [PMID: 38201626 PMCID: PMC10778561 DOI: 10.3390/cancers16010199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/17/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Complete mesogastric excision (CME) has been advocated to allow for a more extensive retrieval of lymph nodes, as well as lowering loco-regional recurrence rates. This study aims to analyze the short-term outcomes of D2 radical gastrectomy with CME compared to standard D2 gastrectomy. A systematic review of the literature was conducted according to the Cochrane recommendations until 2 July 2023 (PROSPERO ID: CRD42023443361). The primary outcome, expressed as mean difference (MD) and 95% confidence intervals (CI), was the number of harvested lymph nodes (LNs). Meta-analyses of means and binary outcomes were developed using random effects models to assess heterogeneity. The risk of bias in included studies was assessed with the RoB 2 and ROBINS-I tools. There were 13 studies involving 2009 patients that were included, revealing a significantly higher mean number of harvested LNs in the CME group (MD: 2.55; 95% CI: 0.25-4.86; 95%; p = 0.033). The CME group also experienced significantly lower intraoperative blood loss, a lower length of stay, and a shorter operative time. Three studies showed a serious risk of bias, and between-study heterogeneity was mostly moderate or high. Radical gastrectomy with CME may offer a safe and more radical lymphadenectomy, but long-term outcomes and the applicability of this technique in the West are still to be proven.
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Affiliation(s)
- Stefano Granieri
- General Surgery Unit, ASST Brianza—Vimercate Hospital, 20871 Vimercate, Italy; (E.G.); (A.G.)
| | - Annaclara Sileo
- General Surgery Residency Program, University of Milan, 20122 Milan, Italy; (A.S.); (A.B.)
| | - Michele Altomare
- Trauma Center and Emergency Surgery, ASST Great Metropolitan Hospital Niguarda, 20162 Milan, Italy;
| | - Simone Frassini
- General Surgery Residency Program, University of Pavia, 27100 Pavia, Italy;
| | - Elson Gjoni
- General Surgery Unit, ASST Brianza—Vimercate Hospital, 20871 Vimercate, Italy; (E.G.); (A.G.)
| | - Alessandro Germini
- General Surgery Unit, ASST Brianza—Vimercate Hospital, 20871 Vimercate, Italy; (E.G.); (A.G.)
| | - Alessandro Bonomi
- General Surgery Residency Program, University of Milan, 20122 Milan, Italy; (A.S.); (A.B.)
| | - Eigo Akimoto
- Department of General Surgery, Juntendo University Nerima Hospital, Tokyo 177-8521, Japan;
| | - Chun Lam Wong
- Ruttonjee & Tang Siu Kin Hospital, Hong Kong, China;
| | - Christian Cotsoglou
- General Surgery Unit, ASST Brianza—Vimercate Hospital, 20871 Vimercate, Italy; (E.G.); (A.G.)
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Huang B, Ding F, Li Y. A practical recurrence risk model based on Lasso-Cox regression for gastric cancer. J Cancer Res Clin Oncol 2023; 149:15845-15854. [PMID: 37672074 DOI: 10.1007/s00432-023-05346-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
INTRODUCTION Gastric cancer remains huge cancer threat worldwide. Detecting the recurrence of gastric cancer after treatment is especially important in improving the prognosis of patients. We aim to fit different risk models with different clinical variables for patients with gastric cancer, which further provides applicable guidance to clinical doctors for their patients. METHODS We collected the primary data from the medical record system in Lanzhou University Second Hospital and further cleaned the primary data via assessing data integrity artificially; meanwhile, detailed conclusion criteria and exclusion criteria were made. We used R software (version 4.1.3) and SPSS 25.0 to analyze data and build models, in which SPSS was used to analyze the correlation and difference of different items in the training set and testing set, and different R packages were used to run LASSO regression, Cox regression and nomogram for variable selection, model construction and model validation. RESULT A total of 649 patients were included in our data analysis and model building. In LASSO regression selection, seven variables, pathological stage, tumor size, the number of total lymph nodes, the number of metastatic lymph nodes, intraoperative blood loss (IBL), the level of AFP and CA199, showed their correlation to the dependent variable. The multivariable Cox regression model fitted using these seven variables showed medium prediction ability, with an AUC of 0.840 in the training set and 0.756 in the testing set. CONCLUSIONS Pathological stage, tumor size, the number of total lymph nodes, the number of metastatic lymph nodes, IBL, the level of AFP and CA199 are significant in identifying recurrence risk for gastric cancer patients after radical gastrectomy.
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Affiliation(s)
- Binjie Huang
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, China
- Lanzhou University, Lanzhou, China
| | - Feifei Ding
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, China
- Lanzhou University, Lanzhou, China
| | - Yumin Li
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.
- Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, China.
- Lanzhou University, Lanzhou, China.
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Wu X, Zhang W. Reminiscence therapy-based care program alleviates anxiety and depression, as well as improves the quality of life in recurrent gastric cancer patients. Front Psychol 2023; 14:1133470. [PMID: 37351436 PMCID: PMC10282646 DOI: 10.3389/fpsyg.2023.1133470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/12/2023] [Indexed: 06/24/2023] Open
Abstract
Objective Reminiscence therapy is a non-drug method that eases psychological burden and enhances quality of life by memories and communications in cancer patients. This study aimed to evaluate influence of reminiscence therapy-based care program on anxiety, depression, and quality of life in recurrent gastric cancer patients. Methods Totally, 96 recurrent gastric cancer patients were randomly assigned as 1:1 ratio into reminiscence therapy-based care group (N = 48) and usual care group (N = 48) to receive 12-week corresponding interventions. Besides, all patients were follow-up for 6 months. Results Hospital Anxiety and Depression Scales-anxiety score at 4th month (p = 0.031) and 6th month (p = 0.004), Hospital Anxiety and Depression Scales-depression score at 6th month (p = 0.018), and anxiety severity at 4th month (p = 0.041) and 6th month (p = 0.037) were lower in reminiscence therapy-based care group than in usual care group. Quality of Life Questionnaire-Core 30 global health status score at 2nd month (p = 0.048), 4th month (p = 0.036), and 6th month (p = 0.014), Quality of Life Questionnaire-Core 30 function score at 4th month (p = 0.014) and 6th month (p = 0.021) were higher, while Quality of Life Questionnaire-Core 30 symptoms score at 2nd month (p = 0.041) and 4th month (p = 0.035) were lower in reminiscence therapy-based care group than in usual care group. Furthermore, reminiscence therapy-based care was more effective on improving mental health and quality of life in recurrent gastric cancer patients with anxiety or depression at baseline than those without. Conclusion Reminiscence therapy-based care serves as an effective intervention, which relieves anxiety and depression, and improves quality of life in recurrent gastric cancer patients.
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Affiliation(s)
- Xing Wu
- Department of General Surgery, HanDan Central Hospital, Handan, China
| | - Weiwei Zhang
- Department of Hematology, HanDan Central Hospital, Handan, China
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8
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Lin GS, Lu J, Lin J, Zheng HL, Xu BB, Xue Z, Wu D, Shen L, Zheng CH, Li P, Xie JW, Chen QY, Huang CM. Value of the Preoperative D-Dimer to Albumin Ratio for Survival and Recurrence Patterns in Gastric Cancer. Ann Surg Oncol 2023; 30:1132-1144. [PMID: 36284056 DOI: 10.1245/s10434-022-12625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND D-dimer (DDI) and albumin are prognostic markers for numerous cancers; however, the predictive value of the preoperative DDI-to-albumin ratio (DAR) on the survival and recurrence patterns of gastric cancer (GC) remains unclear. OBJECTIVE The aim of this study was to explore the prognostic value of the DAR in GC. METHODS Our study included 1766 patients with GC, divided into training and testing cohorts at a ratio of 7:3. Patients were classified into either a high-DAR group (> 0.0145) or low-DAR group (≤ 0.0145) according to the cut-off value of receiver operating characteristic (ROC) curve analysis. The relationship between the DAR and recurrence pattern was analyzed in stage II/III patients. RESULTS Eight preoperative hematological factors were included and 17 composite inflammatory markers were constructed. ROC and random forest analyses indicated that among 17 markers, DAR was the best predictor for overall survival (OS) in GC (p < 0.01). High DAR was significantly associated with poor OS (hazard ratio [HR] 1.89, p < 0.001) and recurrence-free survival (RFS; HR 1.85, p < 0.001). Subgroup analysis showed no differences in OS and RFS between the high- and low-DAR groups in stage I or pT1/2 or pN0/1 patients; however, in stage II/III or pT3/4 or pN2/3 patients, the high-DAR group had shorter OS and RFS rates than the low-DAR group (p < 0.001). Similar results were found in the testing cohort. According to the multivariate analysis based on the training cohort, five indices, including DAR, cT stage, cN stage, age and body mass index (BMI), were incorporated to establish a nomogram model to predict the long-term prognosis of GC. The model showed comparable forecast performance in predicting OS (C-index: 0.773 vs. 0.786) and RFS (C-index: 0.788 vs. 0.795) compared with pTNM. Recurrence pattern analysis in stage II/III patients showed that the high-DAR group had a higher incidence of peritoneal implantation and early recurrence (ER) than the low-DAR group, and the post-recurrence survival in the high-DAR group was significantly shorter than that in the low-DAR group (p = 0.016). CONCLUSION The preoperative DAR is a new biomarker for the long-term survival prediction of GC. In advanced GC, a preoperative DAR > 0.0145 aids the timely detection of ER and peritoneal recurrence after surgery, thus guiding individual follow-up strategies.
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Affiliation(s)
- Guo-Sheng Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jun Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jia Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Hua-Long Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Bin-Bin Xu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Zhen Xue
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Dong Wu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Lili Shen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Chao-Hui Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Ping Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jian-Wei Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qi-Yue Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Chang-Ming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China. .,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China.
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Mita H, Katoh H, Komura D, Kakiuchi M, Abe H, Rokutan H, Yagi K, Nomura S, Ushiku T, Seto Y, Ishikawa S. Aberrant Cadherin11 expression predicts distant metastasis of gastric cancer. Pathol Res Pract 2023; 242:154294. [PMID: 36610328 DOI: 10.1016/j.prp.2022.154294] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022]
Abstract
The prognosis of gastric cancer (GC) is significantly affected by distant metastases and postoperative recurrences. Bone metastasis is one of the worst prognostic metastases in GC; however, its molecular mechanisms and predictive biomarkers remain elusive. In prostate and breast cancers, it has been reported that overexpression of Cadherin 11 (CDH11), a mesenchymal cell-cell contact factor, is known to be correlated with bone metastasis. Overexpression of CDH11 mRNA in bulk GC tissues has also been reported to be associated with a worse prognosis. However, a more precise evaluation of CDH11 expression in GC cells is necessary to establish a robust link between CDH11 and metastatic features of GC. We performed immunohistochemical analysis of CDH11 expression in 342 GC cases, of which specimens were obtained at the time of surgery, with a special focus on its aberrant membranous expression in GC cells. The correlations between aberrant CDH11 expression and distant metastases and the prognosis of GC cases were statistically investigated. Approximately half of the GC cases investigated showed aberrant expression of CDH11 in the GC cells of primary lesions. Aberrant CDH11 expression was statistically associated with bone metastasis of GCs. Moreover, metastases to the liver and distant lymph nodes were also statistically correlated with CDH11 expression. Aberrant CDH11 expression in GC cells in primary tumor lesions was shown to be a predictive biomarker of distant metastases in GC. GCs with CDH11 expression require preventive clinical attention for the detection of metastatic lesions.
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Affiliation(s)
- Hideaki Mita
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Hiroto Katoh
- Department of Preventive Medicine, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Daisuke Komura
- Department of Preventive Medicine, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Miwako Kakiuchi
- Department of Preventive Medicine, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Hiroyuki Abe
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Hirofumi Rokutan
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Koichi Yagi
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Sachiyo Nomura
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan
| | - Shumpei Ishikawa
- Department of Preventive Medicine, Graduate School of Medicine, The University of Tokyo, 113-0033 Tokyo, Japan.
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10
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Spolverato G, Capelli G, Mari V, Lorenzoni G, Gregori D, Poultsides G, Fields RC, Weber SM, Votanopoulos K, Cho CS, He J, Maithel SK, Pucciarelli S, Pawlik TM. Very Early Recurrence After Curative-Intent Surgery for Gastric Adenocarcinoma. Ann Surg Oncol 2022; 29:8653-8661. [PMID: 36018525 DOI: 10.1245/s10434-022-12434-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/31/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Recurrence after curative-intent surgery can occur in more than 50% of gastric cancer (GC) patients. We sought to identify predictors of very early recurrence (VER) among GC patients who underwent curative-intent surgery. METHODS A multi-institutional database of GC patients undergoing curative-intent surgery between 2000 and 2020 at 8 major institutions was queried. VER was defined as local or distant tumor recurrence within 6 months from surgery. Univariable Cox proportional hazard models were used to evaluate the predictive value of clinical-pathological features on VER. A regularized Cox regression model was employed to build a predictive model of VER and recurrence within 12 months. The discriminant ability of the Cox regularized models was evaluated by reporting a ROC curve together with the calibration plot, considering 200 runs. RESULTS Among 1133 patients, 65 (16.0%) patients experienced a VER. Preoperative symptoms (HR 1.198), comorbidities (HR 1.289), tumor grade (HR 1.043), LNR (HR 4.339) and T stage (HR 1.639) were associated with an increased likelihood of VER. Model performance was very good at predicting VER at 6 months (AUC of 0.722) and 12 months (AUC 0.733). Two nomograms to predict 6-month and 12-month VER were built based on the predictive model. A higher nomogram score was associated with worse prognosis. There was good prediction between observed and estimated VER with minimal evidence of overfitting and good performance on internal bootstrapping validation. CONCLUSION One in 6 patients experienced VER following curative-intent surgery for GC. Nomograms to predict risk of VER performed well on internal validation, and stratified patients into distinct prognostic groups relative to 6- and 12-months recurrence.
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Affiliation(s)
- Gaya Spolverato
- Department of Surgical Oncological and Gastrointestinal Science, University of Padova, Padova, Italy
| | - Giulia Capelli
- Department of Surgical Oncological and Gastrointestinal Science, University of Padova, Padova, Italy
| | - Valentina Mari
- Department of Surgical Oncological and Gastrointestinal Science, University of Padova, Padova, Italy
| | - Giulia Lorenzoni
- Department of Surgical Oncological and Gastrointestinal Science, University of Padova, Padova, Italy
| | - Dario Gregori
- Department of Surgical Oncological and Gastrointestinal Science, University of Padova, Padova, Italy
| | | | - Ryan C Fields
- Department of Surgery, Washington University, St. Louis, MO, USA
| | - Sharon M Weber
- Division of Surgical Oncology, Department of Surgery, University of Wisconsin, Madison, WI, USA
| | | | - Clifford S Cho
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Jin He
- Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Shishir K Maithel
- Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Salvatore Pucciarelli
- Department of Surgical Oncological and Gastrointestinal Science, University of Padova, Padova, Italy
| | - Timothy M Pawlik
- Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
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11
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Brochet T, Lapuyade-Lahorgue J, Huat A, Thureau S, Pasquier D, Gardin I, Modzelewski R, Gibon D, Thariat J, Grégoire V, Vera P, Ruan S. A Quantitative Comparison between Shannon and Tsallis–Havrda–Charvat Entropies Applied to Cancer Outcome Prediction. ENTROPY 2022; 24:e24040436. [PMID: 35455101 PMCID: PMC9031340 DOI: 10.3390/e24040436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022]
Abstract
In this paper, we propose to quantitatively compare loss functions based on parameterized Tsallis–Havrda–Charvat entropy and classical Shannon entropy for the training of a deep network in the case of small datasets which are usually encountered in medical applications. Shannon cross-entropy is widely used as a loss function for most neural networks applied to the segmentation, classification and detection of images. Shannon entropy is a particular case of Tsallis–Havrda–Charvat entropy. In this work, we compare these two entropies through a medical application for predicting recurrence in patients with head–neck and lung cancers after treatment. Based on both CT images and patient information, a multitask deep neural network is proposed to perform a recurrence prediction task using cross-entropy as a loss function and an image reconstruction task. Tsallis–Havrda–Charvat cross-entropy is a parameterized cross-entropy with the parameter α. Shannon entropy is a particular case of Tsallis–Havrda–Charvat entropy for α=1. The influence of this parameter on the final prediction results is studied. In this paper, the experiments are conducted on two datasets including in total 580 patients, of whom 434 suffered from head–neck cancers and 146 from lung cancers. The results show that Tsallis–Havrda–Charvat entropy can achieve better performance in terms of prediction accuracy with some values of α.
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Affiliation(s)
- Thibaud Brochet
- LITIS, Quantif, University of Rouen, 76000 Rouen, France; (T.B.); (J.L.-L.); (A.H.); (S.T.); (I.G.); (R.M.); (P.V.)
| | - Jérôme Lapuyade-Lahorgue
- LITIS, Quantif, University of Rouen, 76000 Rouen, France; (T.B.); (J.L.-L.); (A.H.); (S.T.); (I.G.); (R.M.); (P.V.)
| | - Alexandre Huat
- LITIS, Quantif, University of Rouen, 76000 Rouen, France; (T.B.); (J.L.-L.); (A.H.); (S.T.); (I.G.); (R.M.); (P.V.)
- Centre Henri Becquerel, 76038 Rouen, France
- Société Aquilab, 59120 Lille, France;
| | - Sébastien Thureau
- LITIS, Quantif, University of Rouen, 76000 Rouen, France; (T.B.); (J.L.-L.); (A.H.); (S.T.); (I.G.); (R.M.); (P.V.)
- Centre Henri Becquerel, 76038 Rouen, France
| | - David Pasquier
- Département de Radiothérapie, Centre Oscar Lambret, 59000 Lille, France;
| | - Isabelle Gardin
- LITIS, Quantif, University of Rouen, 76000 Rouen, France; (T.B.); (J.L.-L.); (A.H.); (S.T.); (I.G.); (R.M.); (P.V.)
- Centre Henri Becquerel, 76038 Rouen, France
| | - Romain Modzelewski
- LITIS, Quantif, University of Rouen, 76000 Rouen, France; (T.B.); (J.L.-L.); (A.H.); (S.T.); (I.G.); (R.M.); (P.V.)
- Centre Henri Becquerel, 76038 Rouen, France
| | | | - Juliette Thariat
- Département de Radiothérapie, CLCC Francois Baclesse, 14000 Caen, France;
| | - Vincent Grégoire
- Département de Radiothérapie, Centre Léon Berard, 69008 Lyon, France;
| | - Pierre Vera
- LITIS, Quantif, University of Rouen, 76000 Rouen, France; (T.B.); (J.L.-L.); (A.H.); (S.T.); (I.G.); (R.M.); (P.V.)
- Centre Henri Becquerel, 76038 Rouen, France
| | - Su Ruan
- LITIS, Quantif, University of Rouen, 76000 Rouen, France; (T.B.); (J.L.-L.); (A.H.); (S.T.); (I.G.); (R.M.); (P.V.)
- Correspondence:
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12
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Zhan Z, Wang X, Yu J, Zheng J, Zeng Y, Sun M, Peng L, Guo Z, Chen B. Intraperitoneal infusion of recombinant human indentation improves prognosis in gastric cancer ascites. Future Oncol 2022; 18:1259-1271. [PMID: 35114805 DOI: 10.2217/fon-2021-0896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: To investigate the efficacy and safety of intraperitoneal administration of recombinant human indentation in gastric cancer with malignant ascites. Methods: Clinical data of 90 patients (37 in an Endostar® combined with cisplatin group and 53 in a cisplatin group) were retrospectively analyzed. The primary end point was overall survival, and the secondary end points were objective response rate (ORR), disease control rate (DCR) and so on. Results: Median overall survival was longer in the combination group (9.7 vs 8.1 months; p = 0.01). ORR and DCR were higher in the combination group (ORR: 75.7% vs 54.7%; p = 0.04; DCR: 94.6% vs 75.5%; p = 0.02). There were no significant differences in adverse effects between the two groups. Conclusion: Intraperitoneal administration of recombinant human indentation improved efficacy and survival for gastric cancer with ascites.
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Affiliation(s)
- Zhouwei Zhan
- Department of Medical Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
| | - Xiaojie Wang
- Department of Medical Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
| | - Jiami Yu
- Department of Medical Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
| | - Jingxian Zheng
- Department of Medical Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
| | - Yi Zeng
- Department of Gastrointestinal Surgery, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
| | - Mingyao Sun
- Department of Clinical Nutrition, Fujian Provincial Hospital, Fuzhou, Fujian 350001, China
| | - Li Peng
- Department of Diagnostic Radiology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
| | - Zengqing Guo
- Department of Medical Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
| | - Bijuan Chen
- Department of Radiotherapy, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
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13
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Arai H, Inoue E, Yamaguchi K, Boku N, Hara H, Nishina T, Tsuda M, Shitara K, Shinozaki K, Nakamura S, Hyodo I, Muro K, Sasako M, Terashima M, Nakajima TE. Clinical implications of using both fluoropyrimidine and paclitaxel in patients with severe peritoneal metastasis of gastric cancer: A post hoc study of JCOG1108/WJOG7312G. Cancer Med 2021; 10:7673-7682. [PMID: 34655175 PMCID: PMC8559492 DOI: 10.1002/cam4.4303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/20/2021] [Accepted: 09/01/2021] [Indexed: 12/16/2022] Open
Abstract
Background In the JCOG1108/WJOG7312G trial, a combination (FLTAX) of 5‐fluorouracil (FU) /leucovorin (FL) and paclitaxel (PTX) did not show superiority in overall survival (OS) to FL in untreated patients with severe peritoneal metastasis of gastric cancer (GC‐SPM), some of whom received second‐line chemotherapy with PTX after FL. This post hoc study aimed to investigate the clinical implications of using both FU and PTX either sequentially or in combination for patients with GC‐SPM. Methods A total of 94 patients were enrolled and categorized into the following three subgroups: patients treated with (1) FL followed by PTX (FL/PTX, N = 25), (2) FL followed by best supportive care (BSC) (FL/BSC, N = 21), and (3) FLTAX (N = 48). OS was compared between the subgroups. By comparing baseline factors between the FL/PTX and FL/BSC subgroups, factors preventing the sequential use of PTX (SUP) were explored using logistic regression model. The efficacy of FL and FLTAX was compared according to the presence of risk factors preventing SUP. Results The FL/PTX subgroup showed better and equivalent OS compared to the FL/BSC (median 7.8 vs. 2.0 months, p < 0.01) and FLTAX (median 7.8 vs. 8.0, p = 0.49) subgroups, respectively. Glasgow Prognostic Score 2 and initially unresectable disease were identified as risk factors preventing SUP. Absence of both risks predicted SUP with a sensitivity of 13% and a specificity of 100%, whereas absence of any risks predicted SUP with a sensitivity of 67% and a specificity of 62%. FLTAX showed better OS than FL in patients with one or two of these risks but worse OS in those with none. Conclusions Although sequential use of FU and PTX showed equivalent survival to FLTAX in patients with GC‐SPM, FLTAX might be preferable given the difficulty in selecting patients likely to receive sequential use at the initiation of first‐line chemotherapy.
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Affiliation(s)
- Hiroyuki Arai
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - Eisuke Inoue
- Showa University Research Administration Center, Showa University, Tokyo, Japan
| | - Kensei Yamaguchi
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Narikazu Boku
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroki Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - Tomohiro Nishina
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Masahiro Tsuda
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Kohei Shitara
- Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Katsunori Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | | | - Ichinosuke Hyodo
- Department of Gastroenterology, University of Tsukuba, Tsukuba, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Mitsuru Sasako
- Department of Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | | | - Takako E Nakajima
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan.,Kyoto Innovation Center for Next Generation Clinical Trials and iPS Cell Therapy (Ki-CONNECT), Kyoto University Hospital, Kyoto, Japan
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14
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Liu J, Zhu X, Yan M, Li H. Development of a two-circular RNA panel as potential prognostic biomarker for gastric cancer. J Transl Med 2021; 19:412. [PMID: 34600555 PMCID: PMC8487552 DOI: 10.1186/s12967-021-03075-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background Circular RNAs (circRNAs) have attracted increasing attention in recent years for their potential application as disease biomarkers due to their high abundance and stability. In this study, we attempted to screen circRNAs that can be used to predict postoperative recurrence and survival in patients with gastric cancer (GC). Methods High-throughput RNA sequencing was used to identify differentially expressed circRNAs in GC patients with different prognoses. The expression level of circRNAs in the training set (n = 136) and validation set (n = 167) was detected by quantitative real-time PCR (qRT-PCR). Kaplan–Meier estimator, receiver operating characteristic (ROC) curve and cox regression analysis were used to evaluate the prognostic value of circRNAs on recurrence-free survival (RFS) and overall survival (OS) in GC patients. CeRNA network prediction, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed for the circRNAs with prognostic significance. Results A total of 259 differentially expressed circRNAs were identified in GC patients with different RFS. We found two circRNAs (hsa_circ_0005092 and hsa_circ_0002647) that highly expressed in GC patients with good prognoses, and subsequently established a predictive model for postoperative recurrence and prognosis evaluation, named circPanel. Patients with circPanellow might have shorter recurrence-free survival (RFS) and overall survival (OS). We also performed circRNA-miRNA-mRNA network prediction and functional analysis for hsa_circ_0005092 and hsa_circ_0002647. Conclusions CircPanel has the potential to be a prognostic biomarker in GC patients with greater accuracy than a single circRNA and certain traditional tumor markers (e.g., CEA, CA19-9 and CA724). Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-03075-y.
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Affiliation(s)
- Jing Liu
- Department of Gastrointestinal Cancer Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Cancer Immunology and Biotherapy, Tianjin, China.,National Clinical Research Center for Cancer, Tianjin, China
| | - Xingwu Zhu
- Department of Gastrointestinal Cancer Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Cancer Immunology and Biotherapy, Tianjin, China.,National Clinical Research Center for Cancer, Tianjin, China
| | - Meinan Yan
- Department of Gastrointestinal Cancer Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,Key Laboratory of Cancer Immunology and Biotherapy, Tianjin, China.,National Clinical Research Center for Cancer, Tianjin, China
| | - Hui Li
- Department of Gastrointestinal Cancer Biology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China. .,Key Laboratory of Cancer Immunology and Biotherapy, Tianjin, China. .,National Clinical Research Center for Cancer, Tianjin, China.
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