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Başoğlu T, Sakin A, Erol C, Özden E, Çabuk D, Çılbır E, Tataroğlu Özyükseler D, Ayhan M, Şendur MA, Dogan M, Öksüzoğlu B, Eryılmaz MK, Er Ö, Taşçı EŞ, Özyurt N, Dülgar Ö, Özen M, Hacıbekiroğlu İ, Öner İ, Bekmez ET, Çağrı Yıldırım H, Yalçın Ş, Paydaş S, Yekedüz E, Aksoy A, Özçelik M, Oyman A, Almuradova E, Karabulut B, Demir N, Dinçer M, Özdemir N, Erdem D, Ak N, İnal A, Salim DK, Deniz Gİ, Şakalar T, Gülmez A, Kaçan T, Özdemir Ö, Alan Ö, Ünal Ç, Karakaş Y, Turhal S, Yumuk PF. Real life experience of patients with locally advanced gastric and gastroesophageal junction adenocarcinoma treated with neoadjuvant chemotherapy: a Turkish oncology group study. J Chemother 2022; 35:142-149. [PMID: 35579894 DOI: 10.1080/1120009x.2022.2073159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Neoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4%), DCF (17.4%) and ECF (8.1%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2%, R0 resection rate 86.4%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (24%), and R0 resection (84%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients' multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results.
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Affiliation(s)
- Tuğba Başoğlu
- Medical Oncology, Marmara University School of Medicine, İstanbul, Turkey
| | - Abdullah Sakin
- Medical Oncology, Van Yuzuncu Yil University Faculty of Medicine, Van, Turkey
| | - Cihan Erol
- Medical Oncology, Ankara Yildirim Beyazit Universtiy, Ankara, Turkey
| | - Ercan Özden
- Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Devrim Çabuk
- Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Ebru Çılbır
- Medical Oncology, Dışkapı Training and Research Hospital, Ankara, Turkey
| | | | - Murat Ayhan
- Medical Oncology, Kartal Dr.LütfiKırdar Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Ali Şendur
- Medical Oncology, Ankara Yildirim Beyazit Universtiy, Ankara, Turkey
| | - Mutlu Dogan
- Medical Oncology, Ankara Dr.Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Berna Öksüzoğlu
- Medical Oncology, Ankara Dr.Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | | | - Özlem Er
- Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Elif Şenocak Taşçı
- Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Neslihan Özyurt
- Medical Oncology, Giresun Education and Research Hospital, Giresun, Turkey
| | - Özgecan Dülgar
- Medical Oncology, İstanbul Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Miraç Özen
- Medical Oncology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | | | - İrem Öner
- Medical Oncology, Konya City Hospital, Konya, Turkey
| | | | | | - Şuayib Yalçın
- Medical Oncology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Semra Paydaş
- Medical Oncology, Cukurova University School of Medicine, Adana, Turkey
| | - Emre Yekedüz
- Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Asude Aksoy
- Medical Oncology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Melike Özçelik
- Medical Oncology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Abdilkerim Oyman
- Medical Oncology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | | | - Bülent Karabulut
- Medical Oncology, Ege University School of Medicine, İzmir, Turkey
| | - Nazan Demir
- Medical Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Murat Dinçer
- Medical Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Nuriye Özdemir
- Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Dilek Erdem
- Medical Oncology, VM Medical Park Samsun Hospital, Samsun, Turkey
| | - Naziye Ak
- Medical Oncology, İstanbul University, İstanbul, Turkey
| | - Ali İnal
- Medical Oncology, Mersin City Hospital, Mersin, Turkey
| | - Derya Kıvrak Salim
- Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gülhan İpek Deniz
- Medical Oncology, Sisli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Teoman Şakalar
- Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Ahmet Gülmez
- Medical Oncology, İnönü University, Elazığ, Turkey
| | - Turgut Kaçan
- Medical Oncology, Bursa High Specialized Education and Research Hospital, Bursa, Turkey
| | - Özlem Özdemir
- Medical Oncology, İzmir Bozyaka Research and Training Hospital, İzmir, Turkey
| | - Özkan Alan
- Medical Oncology, Tekirdağ State Hospital, Tekirdağ, Turkey
| | - Çağlar Ünal
- Medical Oncology, Florance Nightingale Hospital, İstanbul, Turkey
| | - Yusuf Karakaş
- Medical Oncology, Bodrum Acıbadem Hospital, Muğla, Turkey
| | - Serdar Turhal
- Medical Oncology, Anadolu SağlıkMerkezi Anadolu Health Center, İstanbul, Turkey
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Ponzetto A, Figura N. Gastric cancer prevention and Helicobacter pylori. J Gastroenterol 2018; 53:787-788. [PMID: 29600416 DOI: 10.1007/s00535-018-1453-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 03/21/2018] [Indexed: 02/04/2023]
Affiliation(s)
- Antonio Ponzetto
- Department Medical Science, University of Torino, corso AM Dogliotti 18, 10126, Turin, Italy.
| | - Natale Figura
- Department of Biotechnology Chemistry and Pharmacy, Via A. Moro, 53100, Siena, Italy
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Bajetta E, Verzoni E, Ferrario E, Dotti K, Gevorgyan A, Celio L. Feasibility Study of Biweekly Capecitabine, Oxaliplatin, and Irinotecan in Patients with Untreated Advanced Gastric Cancer. TUMORI JOURNAL 2018; 95:43-7. [DOI: 10.1177/030089160909500108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Capecitabine in combination with oxaliplatin and irinotecan (COI regimen) is active and well tolerated in metastatic colorectal cancer. Since there is no internationally adopted standard regimen, we have conducted a pilot study of COI in untreated advanced gastric cancer. Methods Patients received irinotecan, 180 mg/m2 infused over 90 min on day 1, followed by oxaliplatin, 85 mg/m2 in a 3-hr infusion on day 2, and capecitabine, 1000 mg/m2/day orally twice daily from days 2 to 6 of a biweekly schedule. Treatment was continued up to 8 cycles or until progression of disease occurred. Response (RECIST criteria) was assessed after the first three cycles and was to be confirmed at least 4 weeks following the first response. Results A total of 12 patients (5 men and 7 women) with a median age of 54 years (range, 42–65) was prospectively enrolled. Most of the patients (83%) had metastatic disease. Three complete responses, four partial responses and two disease stabilizations occurred in the intention-to-treat cohort, with an overall response rate of 58% (95% confidence interval, 28–85%). Median time to progressive disease and overall survival were 6.4 and 12 months, respectively. A total of 68 cycles was administered, with a median of 6 cycles per patient (range, 1–8). Grade 3 neutropenia occurred in two patients. The most common non-hematologic grade 3 toxicities were nausea (3 patients) and diarrhea (2 patients). Conclusions These preliminary findings suggest that biweekly COI is a feasible and promising triplet for the first-line treatment of advanced gastric cancer. A large multi-institutional phase II study of the combination has already been planned in this setting.
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Affiliation(s)
- Emilio Bajetta
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elena Verzoni
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Erminia Ferrario
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Katia Dotti
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Arpine Gevorgyan
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigi Celio
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Baili P, De Angelis R, Casella I, Grande E, Inghelmann R, Francisci S, Verdecchia A, Capocaccia R, Meneghini E, Micheli A. Italian Cancer Burden by Broad Geographical Area. TUMORI JOURNAL 2018; 93:398-407. [PMID: 17899872 DOI: 10.1177/030089160709300412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Cancer burden estimates in Italian regions are available for the period 1970-2010 as a result of the project “I TUMORI IN ITALIA” connected with EUROCHIP, the European project on cancer control. The Italian health-care system is organized at a regional level, so regional estimates of cancer indicators are useful to identify priorities for cancer plans. We compared cancer site-specific epidemiological estimates by 3 macro-areas (obtained by grouping regions) to suggest priorities for Italian cancer control plans, both at national and regional levels. Methods Mortality and incidence estimates for all cancers combined and for stomach, colorectal, lung, breast and prostate cancers were downloaded from the website www.tumori.net and aggregated in broad age classes (0-54, 55-74 and 75-84 years) and macro-areas (northern, central and southern Italy). Results Historically, Southern Italy had a lower cancer risk than the Center and North. After 2000 this epidemiological picture disappeared and the incidence and mortality rates in the Center are reaching those of the North. Also the weight of various cancer sites on all cancers has changed in Italy in the last decades. Lung cancer is still the most frequent cancer in the male population in the South, while in the Center-North it has been surpassed by prostate cancer and colorectal cancer. The lung cancer weight on all cancer deaths is increasing in women. Prostate cancer has become the most frequent male cancer in the Center-North in the age class 55-84. Breast cancer is the most frequent cancer in the female population and its incidence rates in the North are higher than those in the Center-South for all age classes. Colorectal cancer incidence rates have dramatically increased in men and colorectal cancer is nowadays the second cancer diagnosed in women in all age classes and macro-areas. Discussion From the epidemiological data here presented we derived the following suggestions and observations for cancer control plans: a) tobacco prevention should focus on the male population in the South, and on female populations in the country as a whole; b) prevention concerning diet and physical activity (risk factors for colorectal cancer) should be considered mainly for men at a national level; c) the coverage of breast cancer screening programs should be increased in the Center-South; d) colorectal cancer screening should be promoted at a national level; e) PSA testing (that is not actually included among the screening programs recommended) for prostate cancer is probably more widespread in the Center-North, resulting in an increased incidence without any evident decline in mortality as yet.
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Affiliation(s)
- Paolo Baili
- Unità di Epidemiologia Descrittiva e Programmazione Sanitaria, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Verdecchia A, De Angelis R, Francisci S, Grande E. Methodology for Estimation of Cancer Incidence, Survival and Prevalence in Italian Regions. TUMORI JOURNAL 2018; 93:337-44. [PMID: 17899863 DOI: 10.1177/030089160709300403] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The Italian health care system is based on a regional responsibility and organization. Incidence, survival and prevalence of cancer patients were estimated for major cancer sites by single regions in Italy within a collaborative project “I TUMORI IN ITALIA” aimed at providing epidemiological information in a web site, www.tumori.net , for health operators, health programmers, epidemiologists and the general public. The aim of this paper is to present the methodology used to derive regional estimates of cancer burden indicators in Italy for major cancer sites. Methods Estimates require a complex methodology to be used. We present herein the methodology to provide regional estimates that involves a combined use of multiple methods to model and extrapolate patient survival to derive incidence and prevalence estimates and future projections. Results Regional patient survival estimates in Italy are presented and discussed. Cancer survival has greatly improved over the years and differences between northern-central and southern regions have persisted. The fraction of patients cured from cancer is today over 50% for young men and women aged 15-44 and declines to 15%-25% at older ages (75-99). Discussion We integrated different methods to derive estimates of cancer burden in Italy, at a regional level, in order to take advantage of all information available and to obtain the most reliable estimates. The value of producing regional estimates of cancer burden indicators was motivated by the lack of such information systematically on the Italian national territory.
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Affiliation(s)
- Arduino Verdecchia
- Reparto di Epidemiologia dei Tumori, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
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6
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Capocaccia R, Buzzoni C, Grande E, Inghelmann R, Bellù F, Cassetti T, de Dottori M, Donato A, De Lisi V, Falcini F, Federico M, Ferretti S, Fusco M, Giacomin A, Guzzinati S, Mangone L, Piffer S, Rosso S, Sechi O, Tagliabue G, Tumino R, Vercelli M, Vitarelli S. Estimated and Observed Cancer Incidence in Italy: A Validation Study. TUMORI JOURNAL 2018; 93:387-91. [PMID: 17899870 DOI: 10.1177/030089160709300410] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background The study aimed to validate model-based incidence estimates by means of observed incidence rates provided by Italian cancer registries, for five major cancer sites (stomach, colon and rectum, lung, breast and prostate cancers) and for all cancers together. Methods Recent incidence rates observed by Italian population-based cancer registries were extracted from the data base of the Italian Association of Cancer Registries. Regional estimates of incidence rates for the same cancers were obtained by the MIAMOD method. Observed and estimated crude incidence rates and incidence trends were compared for the period of diagnosis 1985-2000. Eight Italian cancer registries and seven regions were selected for the analysis since they had incidence data available during the entire selected period. Results and conclusions An excellent agreement between estimated and observed crude incidence rates was found for all single cancer sites, regarding absolute incidence levels and time trends. A partial exception was breast, where empirical data showed a sudden increase in the last three years of observation, perhaps due to organized screenings in some Italian regions, and not captured by statistical models. Substantial underestimation of model-based incidence rates was found for all cancers combined, where the difference tended to increase with calendar year, up to a maximum of 20% in recent years. The greatest part of the discrepancy can be attributed to multiple cancers, which were included in cancer registries statistics but were not accounted for in MIAMOD estimates.
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Affiliation(s)
- Riccardo Capocaccia
- Reparto di Epidemiologia dei Tumori, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
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7
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Micheli A, Berrino F, Paci E, Verdecchia A, Pierotti MA. Strategies for Cancer Control in Italy. TUMORI JOURNAL 2018. [DOI: 10.1177/030089160709300402] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Andrea Micheli
- Unità di Epidemiologia Descrittiva e
Programmazione Sanitaria, Fondazione IRCCS “Istituto Nazionale dei Tumori”,
Milan
| | - Franco Berrino
- Unità di Epidemiologia Eziologia e
Prevenzione, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan
| | - Eugenio Paci
- Unità di Epidemiologia clinica e
descrittiva, Centro per lo Studio e la Prevenzione Oncologica, CSPO, Florence
| | - Arduino Verdecchia
- Reparto di Epidemiologia dei Tumori,
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto
Superiore di Sanità, Rome
| | - Marco A Pierotti
- Direzione Scientifica, Fondazione
IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
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8
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Gorini G, Giovannetti L, Masala G, Chellini E, Martini A, Mallone S, Costantini AS. Gastric Cancer Mortality Trends in Tuscany, Italy, 1971–2004. TUMORI JOURNAL 2018; 94:787-92. [DOI: 10.1177/030089160809400602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Aims, Background, and Methods In Tuscany, Italy, gastric cancer mortality has been decreasing since 1950, although with relevant geographical variability across the region. In Eastern Tuscan areas close to the mountains (high risk areas), gastric cancer mortality has been and is still significantly higher than that recorded in Western coastal areas and in the city of Florence (low risk areas). High-risk areas also showed higher Helicobacter pylori seroprevalence. Aim of this paper is to study gastric cancer mortality trends in high and low-risk areas, during the period 1971–2004, using age-period-cohort models. Results In high-risk areas, gastric cancer mortality rates declined from 61.4 per 100,000 in 1971–74 to 19.8 in 2000–2004 and in low-risk areas from 34.9 to 9.8. Mortality decline in high-risk areas was mainly attributable to a birth cohort effect, whereas in low-risk areas it was due either to a birth cohort effect or a period effect. In low- and high-risk areas, birth-cohort risks of dying decreased over subsequent generations, except for the birth cohorts born around the second world war. Conclusions Gastric cancer mortality in areas with higher H. pylori seroprevalence in Tuscany (high-risk areas) showed a predominant decline by birth cohort, in particular for younger generations, possibly due to the decrease of the infection for improvement of living conditions.
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Affiliation(s)
- Giuseppe Gorini
- Environmental and Occupational Epidemiology Unit, Institute for Study and Prevention of Cancer, Florence, Italy
| | - Lucia Giovannetti
- Environmental and Occupational Epidemiology Unit, Institute for Study and Prevention of Cancer, Florence, Italy
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Institute for Study and Prevention of Cancer, Florence, Italy
| | - Elisabetta Chellini
- Environmental and Occupational Epidemiology Unit, Institute for Study and Prevention of Cancer, Florence, Italy
| | - Andrea Martini
- Environmental and Occupational Epidemiology Unit, Institute for Study and Prevention of Cancer, Florence, Italy
| | - Sandra Mallone
- Environmental and Occupational Epidemiology Unit, Institute for Study and Prevention of Cancer, Florence, Italy
| | - Adele Seniori Costantini
- Environmental and Occupational Epidemiology Unit, Institute for Study and Prevention of Cancer, Florence, Italy
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Caggiari L, Miolo G, Canzonieri V, De Zorzi M, Alessandrini L, Corona G, Cannizzaro R, Santeufemia DA, Cossu A, Buonadonna A, De Re V. A new mutation of the CDH1 gene in a patient with an aggressive signet-ring cell carcinoma of the stomach. Cancer Biol Ther 2017; 19:254-259. [PMID: 29131691 PMCID: PMC5902241 DOI: 10.1080/15384047.2017.1394540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Germline mutations in CDH1, the gene coding for the E-cadherin adhesion protein, are known to cause hereditary diffuse gastric cancer. We identified a new truncating germline mutation (p.Asp538Thrfs*19) in exon 11 of the CDH1 gene in a 41-year-old male with a diffuse gastric cancer. Although he had no parental history of gastric cancer, the co-segregation study in the family detected the same mutation in his healthy 31-year-old brother. The mutation affects one of the extracellular repeat (CAD repeats) domains which is essential for the homophilic binding specificity that directs “E-cadherin” to bind with itself each others. In this case, immunohistochemical analysis showed no expression of E-cadherin in the tumor sample and was a useful prescreening tool to genetic testing. This finding was associated with a poor response to trastuzumab-based treatment.
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Affiliation(s)
- Laura Caggiari
- a Immunopathology and Cancer Biomarkers , IRCCS CRO National Cancer Institute , Aviano , Italy
| | - Gianmaria Miolo
- b Department of Medical Oncology , IRCCS CRO National Cancer Institute , Aviano , Italy
| | | | - Mariangela De Zorzi
- d Immunopathology and Cancer Biomarkers , IRCCS CRO National Cancer Institute , Aviano , Italy
| | | | - Giuseppe Corona
- f Immunopathology and Cancer Biomarkers , IRCCS CRO National Cancer Institute , Aviano , Italy
| | - Renato Cannizzaro
- g Gastroenterology, IRCCS CRO National Cancer Institute , Aviano , Italy
| | | | - Antonio Cossu
- i Operative Unit of Pathology , Azienda Ospedaliero Universitaria Sassari , Sassari , Italy
| | - Angela Buonadonna
- j Department of Medical Oncology , IRCCS CRO National Cancer Institute , Aviano , Italy
| | - Valli De Re
- k Immunopathology and Cancer Biomarkers , IRCCS CRO National Cancer Institute , Aviano , Italy
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Polom K, Marrelli D, Pascale V, Roviello G, Voglino C, Rho H, Vindigni C, Marini M, Macchiarelli R, Roviello F. High-risk and low-risk gastric cancer areas in Italy and its association with microsatellite instability. J Cancer Res Clin Oncol 2016; 142:1817-24. [DOI: 10.1007/s00432-016-2181-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/10/2016] [Indexed: 02/08/2023]
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HER2 Status in Premalignant, Early, and Advanced Neoplastic Lesions of the Stomach. DISEASE MARKERS 2015; 2015:234851. [PMID: 26494937 PMCID: PMC4606090 DOI: 10.1155/2015/234851] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 07/30/2015] [Indexed: 02/06/2023]
Abstract
Objectives. HER2 expression in gastric cancer (GC) has received attention as
a potential target for therapy with Trastuzumab. We reviewed the current knowledge on HER2
status in premalignant gastric lesions and in early (EGC) and advanced (AGC) GC to discuss
the possible pathogenetic and prognostic roles of HER2 overexpression in GC. Results.
HER2 overexpression was documented in gastric low-grade (LG) and high-grade intraepithelial neoplasia
(HG-IEN), with higher frequency in gastric type dysplasia. HER2 overexpression was significantly
associated with disease recurrence and poor prognosis in EGC representing an independent risk
factor for lymph node metastases. HER2 overexpression was more frequent in AGC characterized
by high grade, advanced stage, and high Ki-67 labeling index. The discordance in HER2
status was evidenced between primitive GC and synchronous or metachronous
metastases. Conclusions. HER2 overexpression in premalignant gastric
lesions suggests its potential involvement in the early steps of gastric carcinogenesis.
The assessment of HER2 status in EGC may be helpful for the identification of patients
who are at low risk for developing nodal metastases. Finally, the possible discordance in
HER2 status between primary GC and its synchronous metastases support routine assessment
of HER2 both in the primary GC and in its metastatic lesions.
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Aurello P, Magistri P, D'Angelo F, Valabrega S, Sirimarco D, Tierno SM, Nava AK, Ramacciato G. Treatment of Esophagojejunal Anastomosis Leakage: A Systematic Review from the Last Two Decades. Am Surg 2015. [DOI: 10.1177/000313481508100523] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Esophagojejunal anastomosis leakage is one of the major complications after total gastrectomy for gastric cancer and is an independent predictor of survival. Our aim is to systematically review the literature and discuss the reported therapeutic approaches to identify the best therapeutic approach. Pubmed, EMbase, Cochrane Library, CILEA Archive, BMJ Clinical Evidence, and Up ToDate databases were screened limiting the research to articles written in English from January 1992 through December 2013. This way a total of 474 manuscripts were retrieved for furthermore evaluation. Eleven manuscripts were considered eligible and the study is focused on those works. We analyzed a total of 3,893 patients and 114 cases of esophagojejunal anastomosis leakage. Different treatments were grouped into three main categories: conservative approach (66 cases), endoscopic approach (21 cases), and surgical approach (27 cases). The overall mortality rate is 26.32 per cent and surgical approach showed the higher rate. According to the reported data, a complete resolution of the leakage can be achieved in an interval ranging from 7 to 28 days in the group treated conservatively. Conservative approach should always be considered as the treatment of choice. Reoperation may be necessary in case of wide dehiscence or when other treatments fail; therefore, the high mortality rate related to this procedure is due to the comorbidities of patients undergoing relaparotomy. Finally, endoscopic approach with endoclips seems promising but needs furthermore studies.
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Affiliation(s)
- Paolo Aurello
- Departments of General Surgery, Sant'Andrea Hospital, Sapienza—Università di Roma, Rome, Italy
| | - Paolo Magistri
- Departments of General Surgery, Sant'Andrea Hospital, Sapienza—Università di Roma, Rome, Italy
| | - Francesco D'Angelo
- Departments of General Surgery, Sant'Andrea Hospital, Sapienza—Università di Roma, Rome, Italy
| | - Stefano Valabrega
- Departments of General Surgery, Sant'Andrea Hospital, Sapienza—Università di Roma, Rome, Italy
| | - Dario Sirimarco
- Departments of General Surgery, Sant'Andrea Hospital, Sapienza—Università di Roma, Rome, Italy
| | - Simone Maria Tierno
- Thoracic Surgery, Sant'Andrea Hospital, Sapienza—Università di Roma, Rome, Italy
| | | | - Giovanni Ramacciato
- Departments of General Surgery, Sant'Andrea Hospital, Sapienza—Università di Roma, Rome, Italy
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Peleteiro B, Bastos A, Ferro A, Lunet N. Prevalence of Helicobacter pylori infection worldwide: a systematic review of studies with national coverage. Dig Dis Sci 2014; 59:1698-709. [PMID: 24563236 DOI: 10.1007/s10620-014-3063-0] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/05/2014] [Indexed: 02/06/2023]
Abstract
The systematic assessment of large population-based surveys addressing the prevalence of Helicobacter pylori infection may provide robust evidence for understanding the trends in the exposure to this major risk factor across settings with distinct patterns of gastric cancer variation. Our aim was to describe the prevalence of H. pylori infection in different countries and periods, through systematic review of the literature. We searched PubMed from inception up to September 2013 to identify original studies reporting on the prevalence of H. pylori, and only those evaluating samples with national coverage were included. We identified 37 eligible studies including data for 22 countries. The prevalences were higher in Central/South America and Asia, and at least two-fold higher in countries with high gastric cancer incidence. In most countries presenting data for different time periods, the prevalences were usually lower in the most recent surveys. However, there was little variation in settings where prevalences were already low. Among countries with high prevalence of H. pylori infection there is an ample scope for reducing its burden in the next decades, whereas further declines in settings with already low prevalences will require more intensive efforts.
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Affiliation(s)
- Bárbara Peleteiro
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal,
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Caruso RA, Irato E, Branca G, Finocchiaro G, Fedele F, Arnese A. Gastric adenocarcinoma incidence in the province of Messina (Insular Italy): A cancer registry study. Oncol Lett 2013; 7:861-865. [PMID: 24520303 PMCID: PMC3919949 DOI: 10.3892/ol.2013.1758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 11/29/2013] [Indexed: 01/16/2023] Open
Abstract
The incidence of cancer by age, gender and tumor type at a population-based level is infrequently investigated. The aim of the present study was to describe the burden and outcome of gastric carcinomas (excluding cancers of the esophagogastric junction) experienced by the elderly, particularly for patients aged ≥81 years. A population-based series of 322 patients exhibiting gastric cancer, diagnosed between 2003 and 2005 and from the province of Messina (insular Italy; population, 662,450) was used. The median age of patients at the time of diagnosis was 72 years. The patients were categorized into three age groups according to interquartile range values, <64, 65-80 and >81 years. The cancer-specific survival rate at five years was lowest in the very elderly (P<0.001). Patients aged ≥81 years were less likely to receive surgery than younger patients (44 vs. 55 vs. 22% for the <64, 65-80 and >81 years age groups, respectively; P<0.01). In the resected cases, very elderly patients (age, >81 years) were more likely than younger patients to exhibit advanced stage pathological tumor-node-metastasis (P<0.05). It was concluded that patients aged ≥81 years accounted for 25% of total gastric carcinomas, were less likely to receive surgery and experienced worse outcomes when compared with younger patients.
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Affiliation(s)
- Rosario A Caruso
- Department of Human Pathology, University Hospital, Messina I-98125, Italy
| | - Eleonora Irato
- Department of Human Pathology, University Hospital, Messina I-98125, Italy
| | - Giovanni Branca
- Department of Human Pathology, University Hospital, Messina I-98125, Italy
| | | | - Francesco Fedele
- Department of Human Pathology, University Hospital, Messina I-98125, Italy
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Garziera M, Canzonieri V, Cannizzaro R, Geremia S, Caggiari L, De Zorzi M, Maiero S, Orzes E, Perin T, Zanussi S, De Paoli P, De Re V. Identification and characterization of CDH1 germline variants in sporadic gastric cancer patients and in individuals at risk of gastric cancer. PLoS One 2013; 8:e77035. [PMID: 24204729 PMCID: PMC3812172 DOI: 10.1371/journal.pone.0077035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 09/05/2013] [Indexed: 02/06/2023] Open
Abstract
Objective To screen and characterize germline variants for E-cadherin (CDH1) in non-hereditary gastric cancer (GC) patients and in subjects at risk of GC. Methods 59 GCs, 59 first degree relatives (FDRs) of GC, 20 autoimmune metaplastic atrophic gastritis (AMAGs) and 52 blood donors (BDs) were analyzed for CDH1 by direct sequencing, structural modelling and bioinformatics. Functional impact on splicing was assessed for intronic mutations. E-cadherin/β-catenin immunohistochemical staining and E-cadherin mRNA quantification using RT-PCR were performed. Results In GCs, 4 missense variants (p.G274S; p.A298T; p.T470I; p.A592T), 1 mutation in the 5′UTR (−71C>G) and 1 mutation in the intronic IVS12 (c.1937-13T>C) region were found. First pathogenic effect of p.A298T mutation was predicted by protein 3D modelling. The novel p.G274S mutation showed a no clear functional significance. Moreover, first, intronic IVS12 (c.1937-13T>C) mutation was demonstrated to lead to an aberrant CDH1 transcript with exon 11 deletion. This mutation was found in 2 GCs and in 1 BD. In FDRs, we identified 4 variants: the polymorphic (p.A592T) and 3 mutations in untranslated regions with unidentified functional role except for the 5′UTR (−54G>C) that had been found to decrease CDH1 transcription. In AMAGs, we detected 2 alterations: 1 missense (p.A592T) and 1 novel variant (IVS1 (c.48+7C>T)) without effect on CDH1 splicing. Several silent and polymorphic substitutions were found in all the groups studied. Conclusions Overall our study improves upon the current characterization of CDH1 mutations and their functional role in GC and in individuals at risk of GC. Mutations found in untranslated regions and data on splicing effects deserve a particular attention like associated with a reduced E-cadherin amount. The utility of CDH1 screening, in addition to the identification of other risk factors, could be useful for the early detection of GC in subjects at risk (i.e. FDRs and AMAGs), and warrants further study.
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Affiliation(s)
- Marica Garziera
- Departement of Translational Research, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Vincenzo Canzonieri
- Pathology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Renato Cannizzaro
- Gastroenterology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Silvano Geremia
- CEB-Centre of Excellence in Biocrystallography, Department of Chemical Sciences, University of Trieste, Trieste, Italy
| | - Laura Caggiari
- Departement of Translational Research, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Mariangela De Zorzi
- Departement of Translational Research, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Stefania Maiero
- Gastroenterology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Enrico Orzes
- Gastroenterology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Tiziana Perin
- Pathology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Stefania Zanussi
- Microbiology-Immunology and Virology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Paolo De Paoli
- Scientific Director, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Valli De Re
- Departement of Translational Research, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
- * E-mail:
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Marrelli D, Pedrazzani C, Morgagni P, de Manzoni G, Pacelli F, Coniglio A, Marchet A, Saragoni L, Giacopuzzi S, Roviello F. Changing clinical and pathological features of gastric cancer over time. Br J Surg 2011; 98:1273-83. [PMID: 21560122 DOI: 10.1002/bjs.7528] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of the present multicentre observational study was to evaluate potential changes in clinical and pathological features of patients with gastric cancer (GC) treated in a 15-year interval. METHODS A centralized prospective database including clinical, surgical, pathological and follow-up data from 2822 patients who had resection of a primary GC was analysed. The analysis focused on three periods: 1991-1995 (period 1), 1996-2000 (period 2) and 2001-2005 (period 3). Surgical procedure, pathological classification and follow-up were standardized among centres. RESULTS The number of resections decreased from 1024 in period 1 to 955 and 843 in periods 2 and 3 respectively. More advanced stages and a smaller number of intestinal-type tumours of the distal third were observed over time. Five-year survival rates after R0 resection (2320 patients) did not change over time (overall: 56·6 and 51·2 per cent in periods 1 and 3; disease-free: 66·8 and 61·1 per cent respectively). Decreases in survival in more recent years were related particularly to more advanced stage, distal tumours and tumours in women. Multivariable analysis showed a lower probability of overall and disease-free survival in the most recent interval: hazard ratio 1·22 (95 per cent confidence interval 1·06 to 1·40) and 1·29 (1·06 to 1·58) respectively compared with period 1. Recurrent tumours were more frequently peritoneal rather than locoregional. CONCLUSION Overall and disease-free survival rates after R0 resection of GC were unchanged over time.
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Affiliation(s)
- D Marrelli
- Department of Human Pathology and Oncology, Section of Surgical Oncology, University of Siena, Siena, Italy.
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Sánchez MJ, Payer T, De Angelis R, Larrañaga N, Capocaccia R, Martinez C. Cancer incidence and mortality in Spain: estimates and projections for the period 1981-2012. Ann Oncol 2011; 21 Suppl 3:iii30-36. [PMID: 20427358 DOI: 10.1093/annonc/mdq090] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND National indicators of cancer burden are essential information for cancer surveillance and health planning, so that in countries with partial registration coverage and geographically variable risk patterns, such as Spain, this is even more relevant. This article provides estimates of cancer incidence in Spain for all cancers combined, with the single exception of non-melanoma skin cancer, and for major cancer sites over the period 1981-2006, with projections up to 2012. PATIENTS AND METHODS Estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach, to derive incidence from mortality and relative survival data. RESULTS During the period 1981-2012, age-standardised incidence rates for all cancers rose from the beginning of the period and started to decline from 2000 onwards among men, and increased across the whole period among women. Differences in incidence trends between men and women might be attributable to the gender-specific case-mix of sites for all cancers, and to differences in risk factors specific to certain cancer sites in men and women, with smoking being the main factor accounting for these differences between the sexes. CONCLUSIONS Estimates and projections of cancer incidence and mortality show divergent trends in Spain by sex and tumour type. This information is basic for planning and enhancing public health strategies and resources.
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Affiliation(s)
- M J Sánchez
- Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain.
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Steevens J, Botterweck AAM, Dirx MJM, van den Brandt PA, Schouten LJ. Trends in incidence of oesophageal and stomach cancer subtypes in Europe. Eur J Gastroenterol Hepatol 2010; 22:669-78. [PMID: 19474750 DOI: 10.1097/meg.0b013e32832ca091] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Time trend studies in the USA have shown that the incidences of adenocarcinomas of the oesophagus and gastric cardia have risen strongly since the 1970s, whereas the incidence of squamous cell carcinomas of the oesophagus has declined. Earlier, we found that the incidence of these adenocarcinomas also rose in some European countries until the early 1990s. The main goal of this study was to investigate more recent trends in the incidence of oesophageal and stomach cancer subtypes in the European countries. METHODS Eurocim cancer incidence data of 23 cancer registries from 13 European countries were used to investigate the incidence trends in oesophageal and stomach cancer subtypes during the 1983-1997 period. We calculated estimated annual percentage changes (EAPCs) in European age-standardized incidence rates and 95% confidence intervals. RESULTS The incidence of adenocarcinomas of the oesophagus and gastric cardia rose in most, but not all, registration areas (EAPCs were usually 1-7%), the strongest in the UK and Ireland. Oesophageal squamous cell carcinoma incidence rose mostly in Northern European and Slovakian men (EAPCs: 1-5%) and in women from all regions (EAPCs: 1-8%), but declined mostly in Southern and Western European men (EAPCs: -1 to -5%). CONCLUSION Our results are partly in line with earlier findings on adenocarcinomas of the oesophagus and gastric cardia. There was, however, substantial heterogeneity in trends of subtypes of these cancers within Europe. There may be different risk factors for these cancers, and the prevalence of these risk factors may differ among countries.
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Affiliation(s)
- Jessie Steevens
- GROW - School for Oncology and Developmental Biology, Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
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Different pathological features and prognosis in gastric cancer patients coming from high-risk and low-risk areas of Italy. Ann Surg 2009; 250:43-50. [PMID: 19561483 DOI: 10.1097/sla.0b013e3181ad6487] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To compare clinicopathological features and long-term outcome in gastric cancer patients coming from high-risk and low-risk areas of Italy. SUMMARY BACKGROUND DATA Better survival rates have been reported from countries with higher incidence of gastric cancer. METHODS Data regarding 829 patients coming from Tuscany (group A) and 143 patients coming from Southern Italy (group B) were analyzed. Mean follow-up time was 56 +/- 57 months; it was 85 +/- 63 months in surviving patients or not tumor-related deaths. Prognostic factors were investigated by multivariate analysis with Cox proportional hazard model after verifying the assumption of proportionality of the risk associated with covariates. RESULTS Lauren diffuse-mixed histotype, younger age, extended lymphadenectomy, and advanced stages were more common in group B. Gastric cancer-related 10-year survival probability was 48% in group A versus 29% in group B (log-rank test: P < 0.001). By multivariate analysis, geographic area was confirmed as a significant prognostic factor (hazard ratio for group B vs. group A: 1.52, 95% confidence interval: 1.12-2.06, P = 0.006). The influence of this factor on long-term survival was independent from other clinical, surgical, and pathologic factors, and was notable in neoplasms involving the serosa (10-year survival probability: 15% in group A vs. 3% in group B, log-rank test: P = 0.005). CONCLUSIONS Patients coming from low-risk area of Italy showed distinct pathologic features, more advanced stage, and worse prognosis when compared with patients coming from high-risk area. These findings may be indicative of different tumor biology, and may contribute to partly explain worldwide geographic variability in prognosis reported in different series.
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The modern treatment of early gastric cancer: our experience in an Italian cohort. Surg Endosc 2009; 23:1581-6. [PMID: 19263148 DOI: 10.1007/s00464-009-0350-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Revised: 12/17/2008] [Accepted: 01/11/2009] [Indexed: 12/13/2022]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) has been developed as treatment for early gastric cancer (EGC) by Japanese authors. However, there are no reports about its possible implementation in the Western setting. The aim of the present work is to determine the safety and efficacy of the endoscopic treatments for EGC in an Italian cohort. METHODS Forty-five patients for a total of 48 gastric lesions were enrolled in the study. Thirty-six EMR procedures were performed with the strip biopsy technique using a double-channel endoscope. En bloc resection refers to resection in one piece, while piecemeal refers to resections in which the lesion was removed in multiple fragments. A total of 12 ESD were performed and completed with IT knife. We define as curative treatment lateral and vertical margins of the resected specimens free of cancer and repeat endoscopic finding of no recurrent disease. RESULTS Out of 36 EMR procedures, 10 were piecemeal resections (28%), while 26 were en bloc (72%). ESD led to en bloc resection in 11/12 cases (92%). Histological assessment of curability in the EMR group was achieved in 56% of the cases, and in 92% of the ESD group. Mean follow-up period was 31 months (range: 12-71 months). There was no local recurrence or distant metastasis in the curative group patients. CONCLUSIONS These results seem to confirm the safety and the clinical efficacy of the ESD procedure in the Western world too.
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Comella P, Franco L, Casaretti R, de Portu S, Menditto E. Emerging Role of Capecitabine in Gastric Cancer. Pharmacotherapy 2009; 29:318-30. [DOI: 10.1592/phco.29.3.318] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Low rates of loco-regional recurrence following extended lymph node dissection for gastric cancer. Eur J Surg Oncol 2009; 35:588-92. [PMID: 19162429 DOI: 10.1016/j.ejso.2008.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 12/19/2008] [Accepted: 12/23/2008] [Indexed: 12/31/2022] Open
Abstract
AIM The study by MacDonald et al. [Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725-30] has reported low loco-regional recurrence rates (19%) after gastric cancer resection and adjuvant radiotherapy. However, the lymph node dissection was often "inadequate". The aim of this retrospective study is to analyse if an extended lymph node dissection (D2) without adjuvant radiotherapy may achieve comparable loco-regional recurrence rates. METHODS A prospective database of 200 patients who underwent a curative resection for gastric carcinoma from January 2000 to December 2006 was analysed. D2 lymph node dissection was standard. Recurrences were categorized as loco-regional, peritoneal, or distant. No patients received neoadjuvant or adjuvant radiotherapy. RESULTS The in-hospital mortality rate was 1% (2 patients). The mean number of dissected lymph nodes was 25.9. Overall and disease-free survival at 5years were 60.7% and 61.2% respectively. During the follow-up, 60 patients (30%) have recurred at 76 sites: 38 (50%) distant metastases, 25 (32.9%) peritoneal metastases, and 13 (17.1%) loco-regional recurrences. The loco-regional recurrence was isolated in 6 patients and associated with peritoneal or distant metastases in 7 patients. The mean time to the first recurrence was 18.9 (95% confidence interval: 15.0-21.9) months. CONCLUSIONS Extended lymph node dissection is safe and warrants low loco-regional recurrence rates.
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Ciatto S. Article Commentary: Current Cancer Profiles of the Italian Regions: Should Cancer Incidence be Monitored at a National Level? TUMORI JOURNAL 2007; 93:529-31. [DOI: 10.1177/030089160709300601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Stefano Ciatto
- CSPO, Istituto per la Prevenzione Oncologica, Florence, Italy
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