Tumor recurrence and survival prognosis in patients with advanced gastric cancer after radical resection with radiotherapy and chemotherapy.

BACKGROUND: Advanced gastric cancer is a common malignancy that is often diagnosed at an advanced stage and is still at risk of recurrence after radical surgical treatment. Chemoradiotherapy, as one of the important treatment methods for gastric cancer, is of great significance for improving the survival rate of patients. However, the tumor recurrence and survival prognosis of gastric cancer patients after radiotherapy and chemotherapy are still uncertain. AIM: To analyze the tumor recurrence after radical radiotherapy and chemotherapy for advanced gastric cancer and provide more in-depth guidance for clinicians. METHODS: A retrospective analysis was performed on 171 patients with gastric cancer who received postoperative adjuvant radiotherapy and chemotherapy in our hospital from 2021 to 2023. The Kaplan-Meier method was used to calculate the recurrence rate and survival rate; the log-rank method was used to analyze the single-factor prognosis; and the Cox model was used to analyze the prognosis associated with multiple factors. RESULTS: The median follow-up time of the whole group was 63 months, and the follow-up rate was 93.6%. Stage II and III patients accounted for 31.0% and 66.7%, respectively. The incidences of Grade 3 and above acute gastrointestinal reactions and hematological adverse reactions were 8.8% and 9.9%, respectively. A total of 166 patients completed the entire chemoradiotherapy regimen, during which no adverse reaction-related deaths occurred. In terms of the recurrence pattern, 17 patients had local recurrence, 29 patients had distant metastasis, and 12 patients had peritoneal implantation metastasis. The 1-year, 3-year, and 5-year overall survival (OS) rates were 83.7%, 66.3%, and 60.0%, respectively. The 1-year, 3-year, and 5-year disease-free survival rates were 75.5%, 62.7%, and 56.5%, respectively. Multivariate analysis revealed that T stage, peripheral nerve invasion, and the lymph node metastasis rate (LNR) were independent prognostic factors for OS. CONCLUSION: Postoperative intensity-modulated radiotherapy combined with chemotherapy for gastric cancer treatment is well tolerated and has acceptable adverse effects, which is beneficial for local tumor control and can improve the long-term survival of patients. The LNR was an independent prognostic factor for OS. For patients with a high risk of local recurrence, postoperative adjuvant chemoradiation should be considered.

Clinicopathologic and prognostic implications of Golgi Phosphoprotein 3 in colorectal cancer: A meta-analysis.

BACKGROUND: Golgi Phosphoprotein 3 (GOLPH3) has been implicated in the development of colorectal cancer (CRC). Nevertheless, the clinicopathological and prognostic roles of GOLPH3 in CRC remain undefined. We thus did a meta-analysis to assess GOLPH3 association with the clinicopathological characteristics of patients and evaluate the prognostic significance of GOLPH3 in CRC. METHODS: An electronic search for relevant articles was conducted in the PubMed, Cochrane Library, Web of Science, Medline, Embase, CNKI, and WanFang databases. Two independent reviewers searched all the literature and finished the data extraction and quality assessment. Odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) were used to assess estimates. Stata software (version12.0) was employed to analyze the data. RESULTS: A total of 8 published studies were eligible (N = 723 participants). Meta-analysis revealed that GOLPH3 was found to be highly expressed in tumor tissues compared to that of adjacent colorectal tissues (OR, 2.63), and overexpression of GOLPH3 had significant relationship with advanced clinical stage (OR, 3.42). GOLPH3 expression was not correlated with gender (OR, 0.89), age (OR, 0.95), positive lymphatic metastasis (OR, 1.27), tumor size (OR, 1.12), poor differentiation of tumor (OR, 0.56) or T stage (OR, 0.70). Moreover, GOLPH3 overexpression was not associated with worse overall survival (OS) (HR = 1.14, 95% CI: 0.42-1.86, P>0.05) and disease-free survival (DFS) (HR = 0.80, 95% CI:-0.26-1.86, P>0.05). CONCLUSIONS: GOLPH3 overexpression is correlated with tumor stage, which is an adverse clinicopathological characteristic of CRC. But, GOLPH3 can not serve as a useful biomarker in evaluating the progression of CRC.

Risk factors of gastroparesis syndrome after abdominal non-gastroduodenal operation and its prevention.

OBJECTIVE: To investigate risk factors of gastroparesis syndrome (PGS) after abdominal non-gastroduodenal operation and its prevention. METHODS: Clinical data of 22 patients with PGS after abdominal non-gastroduodenal operation was analyzed retrospectively, and compared with the patients of non-PGS after abdominal non-gastroduodenal operation during the same time. The possible influencing factors of PGS were analyzed by single factor analysis and logistic regression analysis. RESULTS: All 13 selected factors related with PGS, including age, disease category (benign and malignant), operation time, intraoperative blood loss, postoperative analgesic pump, postoperative enteral nutrition time, postoperative parenteral nutrition time, perioperative blood glucose level, perioperative nutrition status (anaemia or lower proteinemia), pylorus obstruction before surgery, intra-abdominal infection after surgery, and spiritual factor were related with PGS. The statistical analysis showed that the difference was statistical significant (P<0.05), and gender had no correlation with PGS (P>0.05); non-conditional multivariate analysis showed that malignant tumor, perioperative nutrition status, pylorus obstruction, operation time, blood loss, intra-abdominal infection after surgery, and mental factor were significant related with PGS as dependent variable and related risk factors in single factor analysis as independent variables (P <0.05). CONCLUSIONS: PGS is a result of multiple factors, and among these factors, malignant tumor, poor nutrition status, pylorus obstruction before surgery, longer operation-time, more blood loss, intra-abdominal infection after surgery, and mental factor are major risk factors of PGS.