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Pérez-Wert P, Custodio A, Jimenez-Fonseca P, Carmona-Bayonas A, Lecumberri A, Cacho Lavin D, Losantos García I, Fernández Montes A, Cano JM, Limón ML, Hernández San Gil R, Diez M, Vidal Tocino R, Macías Declara I, Visa L, Pimentel Cáceres P, Gil Raga M, Martínez Moreno E, Sauri T, Martín Richard M, Granja M, Cerdà P, Gómez González L, Mérida-García A, Ruiz Martín M, Gallego J. Efficacy and safety of chemotherapy in young patients with advanced gastroesophageal adenocarcinoma: data from the Spanish AGAMENON-SEOM registry. Gastric Cancer 2024; 27:131-145. [PMID: 37964032 DOI: 10.1007/s10120-023-01443-9] [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: 05/26/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Gastroesophageal adenocarcinoma in young adults (GCYA) counts for 10-15% of diagnoses. Previous studies have mainly focused on surgical outcomes in patients with resectable tumors; however, systemic therapy for advanced GCYA remains under-evaluated. This study aims to assess the efficacy-related outcomes and safety of first-line chemotherapy (CT) in younger versus older patients with advanced gastroesophageal adenocarcinoma. METHODS Patients with advanced gastroesophageal adenocarcinoma from the AGAMENON-SEOM registry treated with first-line polychemotherapy between January 2008 and October 2022 were included. We compared clinicopathological features, therapies received, efficacy-related outcomes, and toxicity between individuals aged < and ≥ 45 years. RESULTS Out of 3386 patients, 263 (7.8%) were < 45 years. Young patients exhibited a higher proportion of females affected, lower ECOG-PS ≥ 2, fewer comorbidities, and more aggressive disease-related features, such as higher proportion of diffuse subtype, signet-ring cells, plastic linitis, grade 3, peritoneal metastases and metastatic disease at diagnosis. They received more triple-agent combinations and underwent more surgeries in metastatic setting. No significant differences were observed between groups in overall response rate (53.1% vs. 52.3% in < and ≥ 45 years, respectively, p = 0.579), progression-free survival (6.1 vs. 6.83 months, p = 0.158) and overall survival (11.07 vs. 10.81 months, p = 0.82), even after adjusting for potential confounding factors. Grade 3-4 adverse events were comparable in both groups, although toxicity leading to treatment discontinuation was more frequent in older patients. CONCLUSIONS In the AGAMENON-SEOM registry, younger patients with GCYA exhibited more aggressive clinicopathological features, and despite receiving more aggressive treatments, similar efficacy outcomes and toxicity profiles were achieved compared to their older counterparts. In the AGAMENON-SEOM registry, GEAC in < 45 years showed more aggressive clinicopathological features and, although treated with more intense first-line CT regimens, similar efficacy outcomes and toxicity were achieved compared to older patients.
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Affiliation(s)
- Pablo Pérez-Wert
- Medical Oncology Department, Hospital Universitario La Paz, CIBERONC CB16/12/00398, Paseo de La Castellana, 261, 28046, Madrid, Spain.
| | - Ana Custodio
- Medical Oncology Department, Hospital Universitario La Paz, CIBERONC CB16/12/00398, Paseo de La Castellana, 261, 28046, Madrid, Spain
| | - Paula Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Alberto Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain
| | - Arturo Lecumberri
- Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Diego Cacho Lavin
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | | | - Juana María Cano
- Medical Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - María Luisa Limón
- Medical Oncology Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | - Marc Diez
- Medical Oncology Department, Hospital Universitario Val d´Hebron, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Rosario Vidal Tocino
- Medical Oncology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Salamanca, Spain
| | | | - Laura Visa
- Medical Oncology Department, Hospital Universitario El Mar, Barcelona, Spain
| | - Paola Pimentel Cáceres
- Medical Oncology Department, Hospital General Universitario Santa Lucía, Cartagena, Spain
| | - Mireia Gil Raga
- Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain
| | - Elia Martínez Moreno
- Medical Oncology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Tamara Sauri
- Medical Oncology Department, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | | | - Mónica Granja
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Paula Cerdà
- Medical Oncology Department, Hospital Universitario Santa Creu I Sant Pau, Barcelona, Spain
| | - Lucía Gómez González
- Medical Oncology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | | | - Maribel Ruiz Martín
- Medical Oncology Department, Hospital Universitario Río Carrión, Palencia, Spain
| | - Javier Gallego
- Medical Oncology Department, Hospital General Universitario of Elche, Elche, Spain
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Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15030591. [PMID: 36765547 PMCID: PMC9913127 DOI: 10.3390/cancers15030591] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Experiencing pain and insufficient relief can be devastating and negatively affect a patient's quality of life. Developments in oncology such as new treatments and adjusted pain management guidelines may have influenced the prevalence of cancer pain and severity in patients. This review aims to provide an overview of the prevalence and severity of pain in cancer patients in the 2014-2021 literature period. A systematic literature search was performed using the databases PubMed, Embase, CINAHL, and Cochrane. Titles and abstracts were screened, and full texts were evaluated and assessed on methodological quality. A meta-analysis was performed on the pooled prevalence and severity rates. A meta-regression analysis was used to explore differences between treatment groups. We identified 10,637 studies, of which 444 studies were included. The overall prevalence of pain was 44.5%. Moderate to severe pain was experienced by 30.6% of the patients, a lower proportion compared to previous research. Pain experienced by cancer survivors was significantly lower compared to most treatment groups. Our results imply that both the prevalence of pain and pain severity declined in the past decade. Increased attention to the assessment and management of pain might have fostered the decline in the prevalence and severity of pain.
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Braga LLBC, Ferreira AF, Pinheiro FAS, Benigno TGDS, Heukelbach J, de Castro DB, Queiroz DMM, Miyajima F, Ramos AN. Temporal trends and spatial clusters of gastric cancer mortality in Brazil. Rev Panam Salud Publica 2022; 46:e101. [PMID: 36016835 PMCID: PMC9395278 DOI: 10.26633/rpsp.2022.101] [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: 10/13/2021] [Accepted: 05/02/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To identify nationwide temporal trends and spatial patterns of gastric cancer-related mortality in Brazil. Methods An ecological study was performed using death certificates registered from 2000 to 2019 in which gastric cancer was recorded as any cause of death (an underlying or associated cause). Trends over time were assessed using joinpoint regression models. Spatial and spatiotemporal clusters were identified by Kulldorff's space-time scan statistics to identify high-risk areas. Results In 276 897/22 663 091 (1.22%) death certificates gastric cancer was recorded as any cause of death. Age-adjusted gastric cancer-related mortality increased significantly over time (annual percentage change [APC]: 0.7, 95% confidence interval [CI]: 0.5 to 0.8). The increase in mortality was more pronounced in the less-developed North and Northeast Regions (North Region, APC: 3.1, 95% CI: 2.7 to 3.5; Northeast Region, APC: 3.1, 95% CI: 2.5 to 3.7). Eight spatiotemporally associated high-risk clusters of gastric cancer-related mortality were identified in the North, South, Northeast and Central-West Regions, as well as a major cluster covering a wide geographical range in the South and Southeast Regions of Brazil during the first years of the study period (2000 to 2009). Conclusions More recently, during 2010 to 2019, clusters of gastric cancer have been identified in the Northeast Region. The nationwide increase in mortality in this analysis of 20 years of data highlights the persistently high burden of gastric cancer in Brazil, especially in socioeconomically disadvantaged regions. The identification of these areas where the population is at high risk for gastric cancer-related mortality emphasizes the need to develop effective and intersectoral control measures.
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Affiliation(s)
- Lucia Libanez Bessa Campelo Braga
- Department of Internal Medicine School of Medicine Federal University of Ceará Fortaleza Brazil Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Anderson Fuentes Ferreira
- Postgraduate Program of Public Health School of Medicine Federal University of Ceará Fortaleza Brazil Postgraduate Program of Public Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Fernando Antônio Siqueira Pinheiro
- Department of Surgery School of Medicine Federal University of Ceará Fortaleza Brazil Department of Surgery, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Tiago Gomes da Silva Benigno
- Postgraduate Program of Medical-Surgical Sciences School of Medicine Federal University of Ceará Fortaleza Brazil Postgraduate Program of Medical-Surgical Sciences, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Jorg Heukelbach
- Postgraduate Program of Public Health School of Medicine Federal University of Ceará Fortaleza Brazil Postgraduate Program of Public Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Daniel Barros de Castro
- Health Surveillance Foundation AmazonasManaus Brazil Health Surveillance Foundation, Amazonas, Manaus, Brazil
| | - Dulciene Maria Magalhães Queiroz
- Laboratory of Research in Bacteriology School of Medicine Federal University of Minas Gerais Belo Horizonte Brazil Laboratory of Research in Bacteriology, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fábio Miyajima
- Oswaldo Cruz Foundation Ceará Campus FIOCRUZ-CE Eusebio Brazil Oswaldo Cruz Foundation, Ceará Campus, FIOCRUZ-CE, Eusebio, Brazil
| | - Alberto Novaes Ramos
- Department of Community Health School of Medicine Federal University of Ceará Fortaleza Brazil Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
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Qiu WW, Chen QY, Zheng WZ, He QC, Huang ZN, Xie JW, Wang JB, Lin JX, Lu J, Cao LL, Lin M, Tu RH, Lin JL, Zheng HL, Lin GT, Lin GS, Zheng CH, Huang CM, Li P. Postoperative follow-up for gastric cancer needs to be individualized according to age, tumour recurrence pattern, and recurrence time. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2022; 48:1790-1798. [DOI: 10.1016/j.ejso.2022.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
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Thrastardottir TO, Copeland VJ, Constantinou C. The Association Between the Gut Microbiome, Nutritional Habits, Antibiotics, and Gastric Cancer: a Scoping Review. Curr Nutr Rep 2022; 11:19-38. [PMID: 35020173 DOI: 10.1007/s13668-021-00391-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW: Gastric cancer (GC) represents one of the leading causes of cancer-related deaths worldwide. The prevalence of GC among the younger population has been increasing in recent years, and the latter is associated with late detection and advanced disease status. The factors involved in the development of GC have been the focus of investigation in the past few years; yet no consistent conclusions or preventative solutions have been suggested. This scoping review aims to explore and report on research studies conducted to investigate the association between GC, the gut microbiome, and nutritional habits. RECENT FINDINGS : Using a predefined protocol in compliance with the PRISMA guidelines, a search was conducted on four separate databases including Google Scholar, Cochrane Library, ProQuest, and PubMed to investigate the association between GC, microbiome, and nutrition. A total of 1219 articles were identified through this process. Forty-three articles met the initial screening criteria and following full-article analysis, and 10 articles met the full inclusion criteria and were included in the current review. The results of the study support that there are differences in the gut microbiota between GC patients and healthy controls and that GC patients may have increased microbiota richness and lower diversity compared to healthy controls. In addition, the detection of pre/early GC may be possible through the analysis of the microbiota using fecal sampling. Nutritional habits, probiotics, and antibiotics may also play an important role in affecting GC development. Preliminary studies support a role for the gut microbiota in developing GC. Yet, the lack of sufficient randomized controlled studies investigating the association between GC, the gut microbiota, and nutritional habits demonstrates the need for further clinical research to develop preventative strategies that will aim to reduce the increased incidence of GC among all age groups including younger populations.
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Affiliation(s)
- Tinna Osk Thrastardottir
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, 1700, Nicosia, Cyprus
| | - Viana Jacquline Copeland
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, 1700, Nicosia, Cyprus
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, 1700, Nicosia, Cyprus.
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Cheng YX, Tao W, Liu XY, Yuan C, Zhang B, Zhang W, Peng D. The outcome of young vs. old gastric cancer patients following gastrectomy: a propensity score matching analysis. BMC Surg 2021; 21:399. [PMID: 34798854 PMCID: PMC8603584 DOI: 10.1186/s12893-021-01401-1] [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: 09/15/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose The purpose of the current study was to compare the postoperative complications, overall survival and disease-free survival in young and old gastric cancer patients after gastrectomy using propensity score matching (PSM). Methods Adult patients (aged ≥ 18 years) who underwent gastrectomy for gastric cancer in a single clinical center from January 2013 to December 2017 were enrolled continuously for retrospective analysis. To minimize the selection bias between the young and old groups, the PSM was conducted in this study. Results A total of 558 patients were included in this study, with 51 patients in the young group (aged ≤ 45 years) and 507 patients in the old group (aged > 45 years). After 1:1 matching according to PSM, 51 patients in the young group were matched to 51 patients in the old group. After PSM, there was no difference in the baseline information. In terms of short-term outcomes, no difference was found in operation time (P = 0.190), intraoperative blood loss (P = 0.336), retrieved lymph nodes (P = 0.948), blood transfusion (P = 0.339), postoperative hospital stay (P = 0.194), or postoperative complications (P = 0.477) between the two groups. For overall survival, no statistically significant difference was found in all stages (P = 0.383), stage I (P = 0.431), stage II (P = 0.875) or stage III (P = 0.446) gastric cancer. Furthermore, regarding disease-free survival, no differences were found between the two groups in all stages (P = 0.378), stage I (P = 0.431), stage II (P = 0.879) or stage III (P = 0.510) gastric cancer. Conclusion Age might not be an independent prognostic factor for short-term outcomes, OS, or DFS in gastric cancer patients who underwent gastrectomy. The pTNM stage of GC might be an independent prognostic factor for OS and DFS.
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Affiliation(s)
- Yu-Xi Cheng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wei Tao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiao-Yu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Chao Yuan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Bin Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wei Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Huang Q, Zheng X, Jiao Y, Lei Y, Li X, Bi F, Guo F, Wang G, Liu M. A Distinct Clinicopathological Feature and Prognosis of Young Gastric Cancer Patients Aged ≤ 45 Years Old. Front Oncol 2021; 11:674224. [PMID: 34513668 PMCID: PMC8426597 DOI: 10.3389/fonc.2021.674224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 08/06/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose The aim of this retrospective study was to probe into clinicopathological features and prognosis of early-onset gastric cancer (EOGC) patients aged ≤ 45 years old. Methods This study selected 154 young gastric cancer patients aged ≤ 45 years old and 158 elderly gastric cancer patients aged > 50 years old admitted to West China Hospital of Sichuan University in 2009-2019 as the research object. These patients were further divided into two groups according to whether tumor can be resected radically. The following parameters were analyzed: age, gender, helicobacter pylori (HP) infection status, Her-2 status, pathological type and stage, chemotherapy, tumor differentiation degree, overall survival (OS). Results More than 3,000 patients with gastric carcinoma were screened, and 154 young gastric cancer patients aged ≤ 45 years old were identified as EOGC. Among them, the number of female patients in EOGC group was significantly higher than that of males, accounting for 63.6%. In addition, EOGC were associated with diffuse Laur´en type and poorly differentiated tumors. Interestingly, the Kaplan-Meier method showed that the OS of unresectable EOGC group was significantly lower than that of unresectable LOGC group (P = 0.0005) and chemotherapy containing paclitaxel tended to be more effective in the young people (P = 0.0511). Nevertheless, there was no significant difference in OS between young and elderly patients with gastric cancer in the radical resection group (P = 0.3881). Conclusion EOGC patients have a worse prognosis than late-onset gastric cancer (LOGC) patients with advanced unresectable gastric cancer. Palliative surgery or chemotherapy containing paclitaxel may improve the OS of unresectable young individuals with gastric cancer. Additional randomized controlled trials are required for guiding clinical practice.
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Affiliation(s)
- Qian Huang
- Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiufeng Zheng
- Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Jiao
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, Sichuan, China
| | - Yanna Lei
- Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoying Li
- Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Feng Bi
- Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Fukun Guo
- Division of Experimental Hematology and Cancer Biology, Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Gang Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, Sichuan, China
| | - Ming Liu
- Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, China
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Chen GL, Huang Y, Zhang W, Pan X, Feng WJ, Zhao XY, Zhu XD, Li WH, Huang M, Chen ZY, Guo WJ. Three-Tier Prognostic Index in Young Adults With Advanced Gastric Cancer. Front Oncol 2021; 11:667655. [PMID: 34568007 PMCID: PMC8462089 DOI: 10.3389/fonc.2021.667655] [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: 02/14/2021] [Accepted: 08/17/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To characterize clinical features and identify baseline prognostic factors for survival in young adults with advanced gastric cancer (YAAGC). MATERIALS AND METHODS A total of 220 young inpatients (age less than or equal to 40 years) with an initial diagnosis of advanced gastric cancer were retrospectively enrolled in this study. RESULTS Of a consecutive cohort of 220 patients with YAAGC, the median overall survival (OS) time was 16.3 months. One-year survival rate was 43.6% (95% CI: 36.5 to 50.7). In this cohort, a female (71.4%, n = 157) predominance and a number of patients with poorly differentiated tumors (95.9%, n = 211) were observed. In the univariate analysis, OS was significantly associated with neutrophil-lymphocyte ratio (NLR) (≥3.12), hypoproteinemia (<40 g/L), presence of peritoneal or bone metastases, and previous gastrectomy of primary tumor or radical gastrectomy. In multivariate Cox regression analysis, hypoproteinemia [hazard ratio (HR) 1.522, 95% CI 1.085 to 2.137, p = 0.015] and high NLR level (HR 1.446, 95% CI 1.022 to 2.047, p = 0.021) were two independent poor prognostic factors, while previous radical gastrectomy was associated with a favorable OS (HR 0.345, 95% CI 0.205 to 0.583, p = 0.000). A three-tier prognostic index was constructed dividing patients into good-, intermediate-, or poor-risk groups. Median OS for good-, intermediate-, and poor-risk groups was 36.43, 17.87, and 11.27 months, respectively. CONCLUSIONS Three prognostic factors were identified, and a three-tier prognostic index was devised. The reported prognostic index may aid clinical decision-making, patient risk stratification, and planning of future clinical studies on YAAGC.
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Affiliation(s)
- Guang-Liang Chen
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Yan Huang
- Department of Oncology and Chemotherapy, Red Cross Hospital of Yulin City, Yulin, China
| | - Wen Zhang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Xu Pan
- Department of Medical Oncology, Yixing Traditional Chinese Medicine Hospital, Wuxi, China
| | - Wan-Jing Feng
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Xiao-Ying Zhao
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Xiao-Dong Zhu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Wen-Hua Li
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Mingzhu Huang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Zhi-Yu Chen
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
| | - Wei-Jian Guo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China
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Zhou L, Jiang Z, Gu W, Han S. STROBE-clinical characteristics and prognosis factors of gastric cancer in young patients aged ≤30 years. Medicine (Baltimore) 2021; 100:e26336. [PMID: 34190151 PMCID: PMC8257836 DOI: 10.1097/md.0000000000026336] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/27/2021] [Indexed: 01/04/2023] Open
Abstract
We aimed to determine the clinical characteristics and prognosis factors of young patients with gastric cancer (GC).A total of 101 young patients with GC referred to Zhengzhou University People's Hospital, Henan province, China between January 1st, 2003 and June 1st, 2015 were retrospectively reviewed. The medical records included ages, genders, marital status, family history of tumors, comorbidity, Helicobacter pylori (H.pylori) infection, fibrinogen, prealbumin, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), tumor location, tumor size, TNM stage, differentiation of the tumor, WHO type, treatment method and prognostic factors effect were further assessed.The mean age of GC patients in our group was 26.0 years. The incidence was slightly higher in females (female: male = 1.1:1). Some patients had the family history of tumor and H.pylori infection (2.0%, 6.9%). The tumor sizes were mainly under 5 cm (52.4%) and the most locations were in the antrum (43.5%) and body (42.5%). A large number of patients were diagnosed as adenocarcinomas (66.3%) and the main histological of GC was poor differentiated (72.3%). Moreover, a high proportion of patients were diagnosed at the stages III-IV (61.4%), and most patients received surgery combined chemotherapy (63.4%), however, the survival outcome was poor. In univariate Cox analysis, tumor sizes, TNM stage were significantly associated with overall survival (OS) and the multivariate Cox analysis demonstrated that TNM stage was significantly associated with OS.GC in young patients has its unique biological and clinical features. A large majority of young patients were diagnosed at their advanced stages with poor prognostic. TNM stage was an independent prognostic factor for young patients with GC, early GC screening in young people should be actively promoted.
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El Halabi M, Horanieh R, Tamim H, Mukherji D, Jdiaa S, Temraz S, Shamseddine A, Barada K. The impact of age on prognosis in patients with gastric cancer: experience in a tertiary care centre. J Gastrointest Oncol 2021; 11:1233-1241. [PMID: 33456996 DOI: 10.21037/jgo-20-139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Gastric cancer (GC) is a leading cause of cancer-related death in the world and most patients have advanced disease upon presentation. The effect of age on prognosis in GC is controversial. We aimed to determine the impact of age on survival in patients with GC. Methods This was a retrospective study of the medical records of Lebanese patients diagnosed with GC at the American University of Beirut Medical Center (AUBMC) between 2005 and 2014. Patients were divided into young (<65 years) and older groups (≥65 years). A multivariate analysis was done to determine the independent predictors of survival. Kaplan-Meier method was used for analysis of long-term survival outcomes. Results The sample consisted of 156 patients. The mean age was 62.15 (SD 13.54). Most patients presented with stage 4 disease (62.2%) and poorly differentiated histology (66.4%). The most common symptoms were abdominal pain and weight loss. On bivariate analysis, advanced stage (P=0.02) and higher grade (P=0.04) were associated with increased mortality. Patients <65 years of age were significantly more likely to have poorly differentiated tumours, while patients ≥65 years had more comorbidities (P=0.001). The 5-year DFS were 35% and 37% for patients <65 years of age and ≥65 years of age, respectively (P=0.15). Conclusions Higher grade and advanced stage are associated with worse survival in patients with GC, but age did not seem to have an impact. Screening high risk patients and early diagnosis are necessary to improve survival.
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Affiliation(s)
- Maan El Halabi
- Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon.,Division of Gastroenterology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Renee Horanieh
- Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon.,Division of Hematology and Oncology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Sara Jdiaa
- Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Sally Temraz
- Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon.,Division of Hematology and Oncology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Ali Shamseddine
- Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon.,Division of Hematology and Oncology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Kassem Barada
- Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon.,Division of Gastroenterology, American University of Beirut Medical Centre, Beirut, Lebanon
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11
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A Medical Decision Support System to Assess Risk Factors for Gastric Cancer Based on Fuzzy Cognitive Map. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2020; 2020:1016284. [PMID: 33082836 PMCID: PMC7556058 DOI: 10.1155/2020/1016284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/19/2020] [Accepted: 07/14/2020] [Indexed: 12/12/2022]
Abstract
Gastric cancer (GC), one of the most common cancers around the world, is a multifactorial disease and there are many risk factors for this disease. Assessing the risk of GC is essential for choosing an appropriate healthcare strategy. There have been very few studies conducted on the development of risk assessment systems for GC. This study is aimed at providing a medical decision support system based on soft computing using fuzzy cognitive maps (FCMs) which will help healthcare professionals to decide on an appropriate individual healthcare strategy based on the risk level of the disease. FCMs are considered as one of the strongest artificial intelligence techniques for complex system modeling. In this system, an FCM based on Nonlinear Hebbian Learning (NHL) algorithm is used. The data used in this study are collected from the medical records of 560 patients referring to Imam Reza Hospital in Tabriz City. 27 effective features in gastric cancer were selected using the opinions of three experts. The prediction accuracy of the proposed method is 95.83%. The results show that the proposed method is more accurate than other decision-making algorithms, such as decision trees, Naïve Bayes, and ANN. From the perspective of healthcare professionals, the proposed medical decision support system is simple, comprehensive, and more effective than previous models for assessing the risk of GC and can help them to predict the risk factors for GC in the clinical setting.
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12
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Gastric Carcinoma in Young Patients and Its Clinicopathological Characteristics and Prognosis. Gastroenterol Res Pract 2020; 2020:7378215. [PMID: 32765602 PMCID: PMC7374208 DOI: 10.1155/2020/7378215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/19/2020] [Accepted: 06/11/2020] [Indexed: 12/29/2022] Open
Abstract
Background Gastric cancer is usually an age-related disease and mostly diagnosed after the sixth decade of life, though it may also be diagnosed earlier. Objective The aim of this study is to explore the clinicopathological characteristics and prognosis of gastric carcinoma in young patients. Methods A total of 1379 patients younger than 75 years histologically diagnosed with primary gastric carcinoma underwent gastrectomy. Patients were categorized into three groups based on their age which included young age group (≤40 years), middle-aged group (age 41-60 years), and elderly group (age 61-75 years). The young age group was further subdivided into two groups: Group A (age ≤35 years) and Group B (age 35-40 years). The analysis of the clinicopathological characteristics and prognosis followed thereafter. Results Females predominate in young group (p < 0.001). A significantly higher undifferentiated histological pattern was found in the young age group from the other two groups (p < 0.001). Tumor location in the lower third of the stomach was significantly higher in the young group than the other groups (p < 0.001). T4 stage was common in young patients similar to the middle and old age group (p = 0.049). Distal gastrectomy was performed more in the young age group rather than the middle and old age groups with the following percentage ratios: young group 74.5% (123/165), middle age group 59.9% (429/716), and old age group 52.2% (260/498) (p < 0.001). The 5-year overall survival rate of the young, middle, and old age groups were 46%, 48%, and 39%, respectively, whereas the 5-year overall survival rates of the subgroups of young patients, Group A and Group B, were 33% and 49%, respectively. Multivariate analysis revealed that independent negative prognostic factors were as follows: tumor location (L), p = 0.016, OR = 0.795, 95%CI = [0.659; 0.959]; larger tumor size, p = 0.026, OR = 1.727, 95%CI = [1.067; 2.797]; resection margin, p < 0.001, OR = 2.167, 95%CI = [1.751; 2.682]; tumor stage (T4), p < 0.001, OR = 2.572, 95%CI = [1.709; 3.870]; and nodal involvement N1, p = 0.005, OR = 1.506, 95%CI = [1.123; 2.020]; N2, p < 0.001, OR = 1.708, 95%CI = [1.289; 2.263]; and N3, p < 0.001, OR = 2.986, 95%CI = [2.314; 3.854]. Conclusion The young age groups of patients were predominantly female and had a higher proportion of poorly differentiated and undifferentiated type of tumor; moreover, patients aged <35 years had a poor prognosis. In addition, gastric cancer can occur in patients less than 30 years old, and symptoms suggestive of gastric cancer should be investigated aggressively; therefore, a close scrutiny and monitoring should be done in younger patients especially those associated with high-risk factors which could indicate the presence of the disease at an early stage.
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13
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Dos Santos Pereira E, Magalhães Albuquerque L, de Queiroz Balbino V, da Silva Junior WJ, Rodriguez Burbano RM, Pordeus Gomes JP, Barem Rabenhorst SH. Helicobacter pylori cagE, cagG, and cagM can be a prognostic marker for intestinal and diffuse gastric cancer. INFECTION GENETICS AND EVOLUTION 2020; 84:104477. [PMID: 32736040 DOI: 10.1016/j.meegid.2020.104477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 01/15/2023]
Abstract
It is known that Helicobacter pylori is the main cause of peptic ulceration and gastric cancer. However, there is a lack of information on whether H. pylori strains may differ in gastric cancer histological subtypes. This study aimed to investigate different H. pylori strains considering six cag Pathogenicity Island - cagPAI genes (cagA, cagE, cagG, cagM, cagT, and virb11), and vacuolating cytotoxin - vacA alleles, and their relation to gastric cancer histologic subtypes. For this purpose, tumor samples from 285 patients with gastric carcinoma were used. H. pylori infection and genotypes were determined by polymerase chain reaction (PCR). H. pylori was detected in 93.9% of gastric tumors. For comparative analyzes between histopathological subtypes considering H. pylori cagPAI genes the strains were grouped according to the vacA s1/s2 alleles. In the vacAs1 group, the strains cagA(-)cagE(+), cagA(+)cagE(+)cagG(+), cagA(+)cagM(+), or only cagE(+) strains were more frequent in the intestinal subtype (P = .009; P = .024; P = .046, respectively). In contrast, cagM(+)cagG(+)cagA(-) and cagE(-) were associated with diffuse tumors (P = .036), highlighting the presence of cagE in the development of intestinal tumors, and the presence of cagG and absence of cagE in diffuse tumors. Furthermore, WEKA software and Decision Tree (CART) analyses confirmed these findings, in which cagE presence was associated with intestinal tumors, and cagE absence and cagG(+) with diffuse tumors. In conclusion our results showed that vacAs1 (cagG + cagM) strains, mainly cagG positive with cagE absence, were relevant in the studied population for the diffuse outcome, while the presence of cagE was relevant for the intestinal outcome. These findings suggest the relevance of these H. pylori genes as potential markers for gastric cancer histological outcomes.
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Affiliation(s)
- Eliane Dos Santos Pereira
- Department of Pathology and Forensic Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Valdir de Queiroz Balbino
- Department of Genetics, Biomedical Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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14
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Behar D, Boublenza L, Chabni N, Hassaine H, Dahmani B, Masdoua N, Nahet A, Meguenni K. Retrospective epidemiological study on stomach cancer in a region of western Algeria: about 394 cases between 2011 and 2015. J Gastrointest Cancer 2020; 52:706-710. [PMID: 32705578 DOI: 10.1007/s12029-020-00459-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Stomach cancer is a major global health problem; it is one of the ten most common cancers with poor survival, and its incidence is characterized by wide variation. The aim of this work is to carry out a retrospective epidemiological study on gastric cancer in the wilaya of Tlemcen (West Algeria) over a period of 5 years (2011-2015). METHODS The data set was provided by the cancer registry of the Tlemcen wilaya. The statistical analysis was performed using software SPSS.21. RESULTS During this period, 394 cases of gastric cancers were collected, including 199 patients with gastric adenocarcinoma (50.50%); gastric cancer was ranked in 5th rank of the ten most answered cancers in the wilaya. The average age of the patients was 60.5 ± 14.208 years (60.618 ± 13.556 men, 56.654 ± 14.8761 women) with an extremity ranging from 18 to 91 years. A predominance of men has been observed with 60.4% against 39.6% of women, with a sex ratio of 1.5 and a significant difference between the two sexes (p = 0.08). Patients over 50 years of age represented the predominant age group (73.4%). The tumor topography was antropyloric in 6.09% of the cases, and the vast majority of the diagnosed cases was in the local stage (17.01%). CONCLUSION Stomach cancer remains one of the top ten cancers in the Tlemcen willaya, so extensive research on the risk factors for gastric cancer remains important to plan effective preventive and curative strategies to reduce this burden.
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Affiliation(s)
- Dalale Behar
- Department of Biology, Laboratory of Microbiology Applied to the Food Industry, to Biomedical and to the Environment (LAMAABE), University Abou-Bekr Belkaid, Ex biomedical complex Imama Bloc C BP 119, 13000, Tlemcen, Algeria.
| | - Lamia Boublenza
- Department of Biology, Laboratory of Microbiology Applied to the Food Industry, to Biomedical and to the Environment (LAMAABE), University Abou-Bekr Belkaid, Ex biomedical complex Imama Bloc C BP 119, 13000, Tlemcen, Algeria
- Department of Medicine Cancer Laboratory, Abou-Bekr Belkaid University, Tlemcen, Algeria
| | - Nafissa Chabni
- Department of Medicine Cancer Laboratory, Abou-Bekr Belkaid University, Tlemcen, Algeria
- Department of Epidemiology, Dr Tidjani Damerdji University Hospital, Abou-Bekr Belkaid University, Tlemcen, Algeria
| | - Hafida Hassaine
- Department of Biology, Laboratory of Microbiology Applied to the Food Industry, to Biomedical and to the Environment (LAMAABE), University Abou-Bekr Belkaid, Ex biomedical complex Imama Bloc C BP 119, 13000, Tlemcen, Algeria
| | - Bouchra Dahmani
- Department of Biology, Laboratory of Microbiology Applied to the Food Industry, to Biomedical and to the Environment (LAMAABE), University Abou-Bekr Belkaid, Ex biomedical complex Imama Bloc C BP 119, 13000, Tlemcen, Algeria
| | - Nabila Masdoua
- Department of Biology, Laboratory of Microbiology Applied to the Food Industry, to Biomedical and to the Environment (LAMAABE), University Abou-Bekr Belkaid, Ex biomedical complex Imama Bloc C BP 119, 13000, Tlemcen, Algeria
| | - Amira Nahet
- Department of Biology, Laboratory of Microbiology Applied to the Food Industry, to Biomedical and to the Environment (LAMAABE), University Abou-Bekr Belkaid, Ex biomedical complex Imama Bloc C BP 119, 13000, Tlemcen, Algeria
| | - Kaouel Meguenni
- Department of Medicine Cancer Laboratory, Abou-Bekr Belkaid University, Tlemcen, Algeria
- Department of Epidemiology, Dr Tidjani Damerdji University Hospital, Abou-Bekr Belkaid University, Tlemcen, Algeria
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15
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Sandeep B, Huang X, Li Y, Mao L, Gao K, Xiao Z. Gastric Carcinoma in Young Patients and Its Clinicopathological Characteristics and Prognosis. Gastroenterol Res Pract 2020; 2020:1-8. [DOI: https:/doi.org/10.1155/2020/7378215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Background. Gastric cancer is usually an age-related disease and mostly diagnosed after the sixth decade of life, though it may also be diagnosed earlier. Objective. The aim of this study is to explore the clinicopathological characteristics and prognosis of gastric carcinoma in young patients. Methods. A total of 1379 patients younger than 75 years histologically diagnosed with primary gastric carcinoma underwent gastrectomy. Patients were categorized into three groups based on their age which included young age group (≤40 years), middle-aged group (age 41-60 years), and elderly group (age 61-75 years). The young age group was further subdivided into two groups: Group A (age ≤35 years) and Group B (age 35-40 years). The analysis of the clinicopathological characteristics and prognosis followed thereafter. Results. Females predominate in young group (p<0.001). A significantly higher undifferentiated histological pattern was found in the young age group from the other two groups (p<0.001). Tumor location in the lower third of the stomach was significantly higher in the young group than the other groups (p<0.001). T4 stage was common in young patients similar to the middle and old age group (p=0.049). Distal gastrectomy was performed more in the young age group rather than the middle and old age groups with the following percentage ratios: young group 74.5% (123/165), middle age group 59.9% (429/716), and old age group 52.2% (260/498) (p<0.001). The 5-year overall survival rate of the young, middle, and old age groups were 46%, 48%, and 39%, respectively, whereas the 5-year overall survival rates of the subgroups of young patients, Group A and Group B, were 33% and 49%, respectively. Multivariate analysis revealed that independent negative prognostic factors were as follows: tumor location (L), p=0.016, OR=0.795, 95%CI=0.659;0.959; larger tumor size, p=0.026, OR=1.727, 95%CI=1.067;2.797; resection margin, p<0.001, OR=2.167, 95%CI=1.751;2.682; tumor stage (T4), p<0.001, OR=2.572, 95%CI=1.709;3.870; and nodal involvement N1, p=0.005, OR=1.506, 95%CI=1.123;2.020; N2, p<0.001, OR=1.708, 95%CI=1.289;2.263; and N3, p<0.001, OR=2.986, 95%CI=2.314;3.854. Conclusion. The young age groups of patients were predominantly female and had a higher proportion of poorly differentiated and undifferentiated type of tumor; moreover, patients aged <35 years had a poor prognosis. In addition, gastric cancer can occur in patients less than 30 years old, and symptoms suggestive of gastric cancer should be investigated aggressively; therefore, a close scrutiny and monitoring should be done in younger patients especially those associated with high-risk factors which could indicate the presence of the disease at an early stage.
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Affiliation(s)
- Bhushan Sandeep
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Xin Huang
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Yuan Li
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Long Mao
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Ke Gao
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Zongwei Xiao
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
- Department of Anesthesiology, Chengdu Second People’s Hospital, Chengdu Sichuan 610017, China
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Abstract
OBJECTIVE. The purpose of this case-based article is to discuss the pathophysiologic findings, common pathways of spread, and imaging features associated with Krukenberg tumors. CONCLUSION. Not all ovarian metastases are Krukenberg tumors. Krukenberg tumors are the most common subtype of ovarian metastases, and they are histologically characterized by signet ring cell mucinous features. Common primary tumor sites include the stomach or colon. Although often difficult, distinguishing between Krukenberg tumors and primary ovarian malignancy on imaging is important because of management and prognostic implications.
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17
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Sandeep B, Huang X, Li Y, Mao L, Gao K, Xiao Z. Gastric Carcinoma in Young Patients and Its Clinicopathological Characteristics and Prognosis. Gastroenterol Res Pract 2020. [DOI: https://doi.org/10.1155/2020/7378215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background. Gastric cancer is usually an age-related disease and mostly diagnosed after the sixth decade of life, though it may also be diagnosed earlier. Objective. The aim of this study is to explore the clinicopathological characteristics and prognosis of gastric carcinoma in young patients. Methods. A total of 1379 patients younger than 75 years histologically diagnosed with primary gastric carcinoma underwent gastrectomy. Patients were categorized into three groups based on their age which included young age group (≤40 years), middle-aged group (age 41-60 years), and elderly group (age 61-75 years). The young age group was further subdivided into two groups: Group A (age ≤35 years) and Group B (age 35-40 years). The analysis of the clinicopathological characteristics and prognosis followed thereafter. Results. Females predominate in young group (p<0.001). A significantly higher undifferentiated histological pattern was found in the young age group from the other two groups (p<0.001). Tumor location in the lower third of the stomach was significantly higher in the young group than the other groups (p<0.001). T4 stage was common in young patients similar to the middle and old age group (p=0.049). Distal gastrectomy was performed more in the young age group rather than the middle and old age groups with the following percentage ratios: young group 74.5% (123/165), middle age group 59.9% (429/716), and old age group 52.2% (260/498) (p<0.001). The 5-year overall survival rate of the young, middle, and old age groups were 46%, 48%, and 39%, respectively, whereas the 5-year overall survival rates of the subgroups of young patients, Group A and Group B, were 33% and 49%, respectively. Multivariate analysis revealed that independent negative prognostic factors were as follows: tumor location (L), p=0.016, OR=0.795, 95%CI=0.659;0.959; larger tumor size, p=0.026, OR=1.727, 95%CI=1.067;2.797; resection margin, p<0.001, OR=2.167, 95%CI=1.751;2.682; tumor stage (T4), p<0.001, OR=2.572, 95%CI=1.709;3.870; and nodal involvement N1, p=0.005, OR=1.506, 95%CI=1.123;2.020; N2, p<0.001, OR=1.708, 95%CI=1.289;2.263; and N3, p<0.001, OR=2.986, 95%CI=2.314;3.854. Conclusion. The young age groups of patients were predominantly female and had a higher proportion of poorly differentiated and undifferentiated type of tumor; moreover, patients aged <35 years had a poor prognosis. In addition, gastric cancer can occur in patients less than 30 years old, and symptoms suggestive of gastric cancer should be investigated aggressively; therefore, a close scrutiny and monitoring should be done in younger patients especially those associated with high-risk factors which could indicate the presence of the disease at an early stage.
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Affiliation(s)
- Bhushan Sandeep
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Xin Huang
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Yuan Li
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Long Mao
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Ke Gao
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
| | - Zongwei Xiao
- Department of Surgery, Chengdu Second People’s Hospital, Chengdu, Sichuan 610017, China
- Department of Anesthesiology, Chengdu Second People’s Hospital, Chengdu Sichuan 610017, China
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18
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Puhr HC, Karner A, Taghizadeh H, Jomrich G, Schoppmann SF, Preusser M, Ilhan-Mutlu A. Clinical characteristics and comparison of the outcome in young versus older patients with upper gastrointestinal carcinoma. J Cancer Res Clin Oncol 2020; 146:3313-3322. [PMID: 32617700 PMCID: PMC7679328 DOI: 10.1007/s00432-020-03302-x] [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: 04/23/2020] [Accepted: 06/24/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The clinical behaviour and outcome of young patients with gastroesophageal tumours (GET) is surmised to differ from older patients, yet data on the comparison of these two patient subgroups is scarce. This study focuses on the investigation of the clinical characteristics and survival outcome of younger-age people with GET, when compared to older patients. METHODS Patients diagnosed with GET at the Medical University of Vienna between 2004 and 2016 were included in this study. Clinical parameters and the overall survival (OS) were compared between young (≤ 45 years) and elderly (≥ 65 years) patients. RESULTS Among 796 patients, who were eligible for this analysis, fifty-eight patients (7%) were ≤ 45 years at the initial onset of the disease. These 58 young patients were then matched to elderly patients based on the gender, tumour stage, histology and tumour location. The number of metastatic lesions was significantly higher among young patients (p < 0.05). In a non-metastatic setting younger patients showed a significant longer OS than older patients (median 1226 versus 801 days, p = 0.028). Furthermore, young patients with extensive metastatic disease (2 or more metastatic site) had a significantly poorer OS than elderly patients (median 450 versus 646 days, p = 0.033). CONCLUSION These results indicate that young patients might be diagnosed very late, which might lead to the development of a more aggressive disease compared to older patients, but a relatively long OS when diagnosed and treated in a non-metastatic setting. Thus, screening methods for younger patients might be considerable to enhance the outcome of young patients with GET.
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Affiliation(s)
- Hannah Christina Puhr
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Alexander Karner
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Hossein Taghizadeh
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Gerd Jomrich
- Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Sebastian Friedrich Schoppmann
- Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria
| | - Aysegül Ilhan-Mutlu
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. .,Upper-GI Tumours Unit, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Vienna, Austria.
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19
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Cheng L, Chen S, Wu W, Kuo ZC, Wei Z, Meng S, Chen C, Zhang C, He Y. Gastric cancer in young patients: a separate entity with aggressive features and poor prognosis. J Cancer Res Clin Oncol 2020; 146:2937-2947. [PMID: 32451690 DOI: 10.1007/s00432-020-03268-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/18/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the clinicopathological features and survival outcomes between young and old patients with gastric cancer (GC), and further determine the role of young age in the prognosis of GC. METHODS Patients with stage I-III gastric adenocarcinomas undergoing curative surgery were enrolled, divided into young (aged 18-49 years, YG), middle-aged (50-59 years, MG), and old (≥ 60 years, OG) groups. Exclusion criteria were neoadjuvant therapy and history of malignant tumors. Clinicopathological features, overall survival (OS), disease-free survival (DFS), and recurrence patterns were compared among three groups. RESULTS 1131 patients were finally included, with 270, 314, and 547 cases in the YG, MG, and OG, respectively. Compared to others, YG had higher proportion of female, middle-third gastric cancer, poor differentiation, N3b stage, and adjuvant chemotherapy. YG demonstrated poorer 5-year OS than MG (62.4% vs. 70.8%, P = 0.019), but better than OG (62.4% vs. 58.7%, P = 0.031). YG also suffered inferior 5-year DFS (75.2% vs. 82.8%, P = 0.040) compared with MG, and higher incidence of peritoneal recurrence than MG (15.1% vs. 5.2%, P < 0.001) and OG (15.1% vs. 4.1%, P < 0.001). Multivariate analysis identified young age as the independent prognostic factor for OS [hazard ratio (HR) = 1.347, 95% CI 1.018-1.781, P = 0.037], DFS (HR = 1.601, 95% CI 1.079-2.376, P = 0.019), and peritoneal recurrence (HR = 2.936, 95% CI 1.505-5.726, P = 0.002). CONCLUSIONS Young GC patients demonstrated aggressive features with poor prognosis and enhanced management may be warranted for this subgroup.
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Affiliation(s)
- Lyujia Cheng
- Digestive Disease Center, Seventh Affiliated Hospital, Sun Yat-Sen University, 628 Zhenyuan Road, Shenzhen, 518107, China.,Gastrointestinal Surgery Center, First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, China
| | - Songyao Chen
- Digestive Disease Center, Seventh Affiliated Hospital, Sun Yat-Sen University, 628 Zhenyuan Road, Shenzhen, 518107, China.,Gastrointestinal Surgery Center, First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, China
| | - Wenhui Wu
- Digestive Disease Center, Seventh Affiliated Hospital, Sun Yat-Sen University, 628 Zhenyuan Road, Shenzhen, 518107, China
| | - Zi Chong Kuo
- Digestive Disease Center, Seventh Affiliated Hospital, Sun Yat-Sen University, 628 Zhenyuan Road, Shenzhen, 518107, China
| | - Zhewei Wei
- Gastrointestinal Surgery Center, First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, China
| | - Sijun Meng
- Digestive Disease Center, Seventh Affiliated Hospital, Sun Yat-Sen University, 628 Zhenyuan Road, Shenzhen, 518107, China
| | - Chuangqi Chen
- Gastrointestinal Surgery Center, First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, China
| | - Changhua Zhang
- Digestive Disease Center, Seventh Affiliated Hospital, Sun Yat-Sen University, 628 Zhenyuan Road, Shenzhen, 518107, China.
| | - Yulong He
- Digestive Disease Center, Seventh Affiliated Hospital, Sun Yat-Sen University, 628 Zhenyuan Road, Shenzhen, 518107, China. .,Gastrointestinal Surgery Center, First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan 2nd Road, Guangzhou, 510080, China.
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Ciesielski M, Kruszewski WJ, Szajewski M, Walczak J, Spychalska N, Szefel J, Zieliński J. Extremely High Mortality Rate after a Successful Gastrectomy for Cancer in Older Adults. J Gastric Cancer 2019; 19:202-211. [PMID: 31245165 PMCID: PMC6589425 DOI: 10.5230/jgc.2019.19.e16] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/27/2019] [Accepted: 04/19/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Poor physiological reserve for withstanding major cancer surgery in older adults is an important concern in the selection of patients for oncologic gastrectomy. The present study aimed to analyze mortality patterns among patients who underwent gastrectomy for cancer according to age groups. The primary outcomes of this study were early- and middle-term results: 30-day and 3-, 6-, 12-, and 36-month mortality rates. MATERIALS AND METHODS A retrospective review of 288 patients who underwent surgical resection for gastric cancer in two centers was carried out. Patients were stratified into four groups according to age: 29-50 years (group I, n=27), 51-65 years (group II, n=117), 66-75 years (group III, n=81), and 76-92 years (group IV, n=58). Statistical calculations focused on the differences in the survival rates between groups I and II as well as between groups II and IV. RESULTS The middle-aged patients (group II) had significantly better 3-year survival than either the youngest (group I) or the oldest patients (group IV). The 6-month mortality rates were 16.9% in group III and 29.3% in group IV. Two-thirds of the patients from groups III and IV who died between 2 and 6 months after surgery had an uneventful postoperative course. CONCLUSIONS Age is an important prognostic factor of middle-term survival after gastrectomy for cancer. Geriatric assessment and better patient selection for major surgery for cancer are required to improve the outcome of gastrectomy for cancer in patients aged over 75 years.
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Affiliation(s)
- Maciej Ciesielski
- Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals, Gdynia, Poland
- Division of Propedeutics of Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Wiesław Janusz Kruszewski
- Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals, Gdynia, Poland
- Division of Propedeutics of Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Mariusz Szajewski
- Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals, Gdynia, Poland
- Division of Propedeutics of Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Jakub Walczak
- Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals, Gdynia, Poland
| | - Natalia Spychalska
- Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals, Gdynia, Poland
| | - Jarosław Szefel
- Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals, Gdynia, Poland
- Division of Propedeutics of Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Jacek Zieliński
- Department of Oncological Surgery, Medical University of Gdańsk, Gdańsk, Poland
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Clinicopathological features and prognosis of young gastric cancer patients following radical gastrectomy: a propensity score matching analysis. Sci Rep 2019; 9:5943. [PMID: 30976037 PMCID: PMC6459851 DOI: 10.1038/s41598-019-42406-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/01/2019] [Indexed: 02/07/2023] Open
Abstract
The aim of the this retrospective study was to investigate the clinicopathological features of gastric cancer (GC) in young patients and the potential impact of age on the prognosis of patients undergoing radical gastrectomy for GC. From November 2010 to November 2016, 317 young (≤45 years) and 1344 older patients (>45 years) who underwent radical gastrectomy for stage I-III GC were enrolled. The association between age and prognosis was estimated by univariate and multivariate analyses after propensity score matching (PSM). Compared with older patients, the proportion of females, poorly differentiated tumors, good nutritional status, and who received neo-adjuvant and/or adjuvant chemotherapy was significant higher in younger patients, but were less likely to suffer from comorbidities or post-operative complications (all P < 0.05). PSM analysis created 310 pairs of patients. After matching, the long-term survival in younger patients was significantly longer than in older patients at stage I, but similar at stages II and III. However, a young age was not identified as a significant prognostic factor. In conclusion, the prognosis of young GC patients is comparable with and even better than that in older patients after radical gastrectomy when matched for baseline characteristics. Early detection could improve the prognosis of young GC patients.
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Li J, Perez Perez GI. Is There a Role for the Non- Helicobacter pylori Bacteria in the Risk of Developing Gastric Cancer? Int J Mol Sci 2018; 19:E1353. [PMID: 29751550 PMCID: PMC5983810 DOI: 10.3390/ijms19051353] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori is the most abundant bacterium in the gastric epithelium, and its presence has been associated with the risk of developing gastric cancer. As of 15 years ago, no other bacteria were associated with gastric epithelial colonization; but thanks to new methodologies, many other non-H. pylori bacteria have been identified. It is possible that non-H. pylori may have a significant role in the development of gastric cancer. Here, we discuss the specific role of H. pylori as a potential trigger for events that may be conducive to gastric cancer, and consider whether or not the rest of the gastric microbiota represent an additional risk in the development of this disease.
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Affiliation(s)
- Jackie Li
- Department of Medicine, New York University School of Medicine, New York, NY 10016, USA.
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