Comparison of Therapeutic Efficacy between Gastrectomy with Transarterial Chemoembolization Plus Systemic Chemotherapy and Systemic Chemotherapy Alone in Gastric Cancer with Synchronous Liver Metastasis.

BACKGROUND: Systemic chemotherapy (SC) is the recommended treatment for gastric cancer with liver metastasis. However, the improvement in survival has been disappointing. The aim of this study was to compare the therapeutic efficacy of gastrectomy with transarterial chemoembolization plus SC (GTC) and SC alone for gastric cancer with synchronous liver metastasis. METHODS: From January 2008 to December 2013, 107 gastric cancer patients with synchronous liver metastasis attending the four participating centers were enrolled in this multicenter, ambispective, controlled cohort study. Patients who underwent GTC (n = 32) were compared with controls who were received SC alone (n = 75). The primary endpoints of the study were overall survival (OS) and progression-free survival (PFS). The secondary endpoints were response rate to treatment and treatment-related adverse effects. RESULTS: The median OS was 14.0 months (95% confidence interval [CI ]: 13.1-14.9 months) in the GTC treatment group and 8.0 months (95% CI : 6.6-9.4 months) in SC group, this difference being statistically significant (P < 0.001). The median PFS was significantly longer in the GTC than in the SC group (5 months, 95% CI : 2.2-7.8 months vs. 3 months, 95% CI : 2.3-3.4 months, respectively) (P < 0.001). The rate of response to treatment was significantly better in the GTC than the SC group (59.4% vs. 37.4%, respectively) (P = 0.035). According to multivariate analysis, OS in patients receiving combination treatment was significantly correlated with the size (P = 0.037) and extent of liver metastases (P < 0.001). PFS was also correlated with the extent of liver metastases (P = 0.003). CONCLUSIONS: GTC is more effective than SC alone in patients with gastric cancer with synchronous liver metastasis. GTC therapy prolongs the survival of selected gastric cancer patients with synchronous liver metastasis.

[Expressions of CXCL16/CXCR6 and CXCL12/CXCR4 in first-trimester human trophoblast cells].

OBJECTIVE: To investigate the transcription and protein expressions of chemokines CXCL16, CXCL12 and their receptors CXCR6, CXCR4 in first-trimester human cytotrophoblast cells and human choriocarcinoma cell line JAR. METHODS: Transcriptions of CXCR6, CXCL16, CXCR4, CXCL12 in purified first-trimester human trophoblast cells and JAR line were assessed by semi-quantitative RT-PCR, and protein expressions of CXCR6, CXCL16, CXCR4, CXCL12 were analyzed in primary cultured villous cytotrophoblasts (VCT), extravillous cytotrophoblasts (EVCT), JAR line and placentas by immunostaining. RESULTS: CXCR6 and CXCR4 were highly transcribed in primary cultured trophoblast cells with mRNA relative level of 1.12 +/- 0.25 and 1.08 +/- 0.11 respectively, and their ligands CXCL16 and CXCL12 were transcribed moderately with mRNA relative level of 0.89 +/- 0.11 and 0.78 +/- 0.10 respectively. It was demonstrated that CXCL16, CXCL12, CXCR6 and CXCR4 were expressed in primary cultured VCT, EVCT, JAR line and placentas by immunostaining. CONCLUSION: The co-expression of CXCL16/CXCR6 and CXCL12/CXCR4 in trophoblast cells may play a role in the proliferation and differentiation of first-trimester trophoblast cells in a manner of autocrine.