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1.
Jpn J Clin Oncol ; 51(7): 1044-1050, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33744955

RESUMO

BACKGROUND: Post-operative pneumonia is a major complication after general elective surgery in elderly patients and is often caused by aspiration associated with oesophageal reflux. The aim of this study was to identify the risk factors of post-operative pneumonia after gastrectomy in elderly patients with gastric cancer with two potential risk factors of ageing and oesophageal reflux. METHODS: We retrospectively examined the data of 251 patients ≥75 years old who underwent gastrectomy between January 2014 and December 2018 in our institution. The reconstruction methods were Billroth-I or Roux-Y after distal gastrectomy, jejunal interposition or double tract after proximal gastrectomy and Roux-Y after total gastrectomy. The severity of pneumonia was evaluated by the Clavien-Dindo classification. RESULTS: Post-operative pneumonia was identified in 15 patients (5.9%) and was significantly associated with an age ≥80 years old, poor performance status, history of smoking and cardia-non-preserving gastrectomy (total gastrectomy and proximal gastrectomy) in univariate analyses. Multivariate analyses showed that a poor performance status and cardia-non-preserving gastrectomy were independent risk factors for post-operative pneumonia. The patients who suffered post-operative pneumonia required a longer hospital stay than those without post-operative pneumonia (P = 0.002). CONCLUSION: We identified a poor performance status and cardia-non-preserving gastrectomy, which are likely to lead to oesophageal reflux, as risk factors for post-operative pneumonia in elderly patients with gastric cancer. These results warrant further prospective studies to evaluate their utility for reducing the rate of post-operative pneumonia in elderly patients through cardia-preserving gastrectomy or anti-reflux reconstruction.


Assuntos
Gastrectomia , Pneumonia/epidemiologia , Pneumonia/etiologia , Complicações Pós-Operatórias/epidemiologia , Neoplasias Gástricas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco
2.
Ann Surg Oncol ; 28(5): 2866-2876, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33393020

RESUMO

BACKGROUND: The lymph node (LN) ratio (LNR) and the log odds of positive LNs (LODDS) have been proposed as sensitive prognosticators in patients with primary gastric cancer, especially in patients with an insufficient number of harvested LNs. We investigated the association of LNR and LODDS with survival in patients with remnant gastric cancer (RGC) and explored whether these staging methods are prognostic factors in patients with an insufficient number of harvested LNs. METHODS: The present study retrospectively examined 95 patients with RGC who received gastrectomy between January 2000 and December 2018. The patients were classified according to the adjusted X-tile cutoff for LNR and LODDS. The association between survival rates and clinicopathological features was investigated. The predictive accuracy of the LNR and LODDS was compared with that of the Union for International Cancer Control pathological N factor. RESULTS: Multivariate analysis revealed that the LNR and LODDS were independent risk factors for recurrence-free survival (RFS) [hazard ratio (HR) 2.623, p = 0.020; HR 3.404, p = 0.004, respectively] and overall survival (OS) (HR 3.694, p = 0.003; HR 2.895, p = 0.022, respectively) in patients with RGC. Moreover, even in patients with 15 or fewer harvested LNs, only the LNR was a significant independent risk factor for RFS (HR 21.890, p < 0.001) and OS (HR 6.597, p = 0.002). The receiver operating characteristic curves revealed that the prognostic accuracy of the three methods was comparable (p > 0.05). CONCLUSION: LNR has significant prognostic value for patients with RGC, including those with an insufficient number of harvested LNs.


Assuntos
Neoplasias Gástricas , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
3.
In Vivo ; 35(1): 229-237, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33402469

RESUMO

BACKGROUND/AIM: Sulfite oxidase (SUOX) is an enzyme present in the mitochondria, which has been demonstrated to be correlated with various malignant tumours. MATERIALS AND METHODS: We evaluated SUOX expression in tissues of 98 cases of advanced gastric cancer and performed a clinicopathological assessment for metrics. RESULTS: Among 98 cases, 55 cases were classified into the SUOX low expression group, and 43 cases into the SUOX high expression group. There were more pStage IV cases in the low expression group. The median overall survival of the low expression group was shorter than that of the high expression group (p=0.020). In univariate and multivariate analysis, SUOX low expression level (p=0.039) and pStage (p<0.001) were independent prognostic factors. CONCLUSION: SUOX is an independent prognostic factor. Therefore, SUOX expression could also serve as a useful marker for elucidating the mechanism of gastric cancer proliferation and progression.


Assuntos
Neoplasias Gástricas , Sulfito Oxidase , Biomarcadores , Biomarcadores Tumorais/genética , Humanos , Prognóstico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/genética , Sulfito Oxidase/genética
4.
Jpn J Clin Oncol ; 51(3): 371-378, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33283236

RESUMO

BACKGROUND: A multi-institutional phase II study was conducted to evaluate the efficacy and safety of preoperative docetaxel, cisplatin and S-1 therapy in marginally resectable advanced gastric cancer. METHODS: Patients with macroscopic type 4, large macroscopic type 3 and bulky lymph node metastasis received two cycles of preoperative docetaxel, cisplatin and S-1 therapy (docetaxel 40 mg/m2 and cisplatin 60 mg/m2 on day 1, and S-1 80 mg/m2 for 14 days, every 4 weeks). The primary endpoint was the pathological response rate, with an expected value of 65%. RESULTS: Thirty-one patients were enrolled in this study. The pathological response rate was 54.8%, and it was higher than the threshold value but lower than the expected rate. The R0 resection rate was 93.5%. The frequencies of grade 3-4 toxicities during docetaxel, cisplatin and S-1 therapy were 41.9% for neutropenia, 6.5% for febrile neutropenia and 32.3% for nausea/vomiting. Grade 2 and 3 surgical morbidities occurred in 23.3 and 6.7% of the patients, respectively. CONCLUSIONS: Preoperative docetaxel, cisplatin and S-1 therapy was feasible in terms of chemotherapy-related toxicities and surgical morbidity, but the effect did not achieve the expected value. The association between the pathological response rate and survival will be evaluated in the final analysis of this clinical trial.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cisplatino/uso terapêutico , Docetaxel/uso terapêutico , Ácido Oxônico/uso terapêutico , Cuidados Pré-Operatórios , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Tegafur/uso terapêutico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Cisplatino/efeitos adversos , Docetaxel/efeitos adversos , Relação Dose-Resposta a Droga , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Ácido Oxônico/efeitos adversos , Complicações Pós-Operatórias/etiologia , Neoplasias Gástricas/cirurgia , Tegafur/efeitos adversos , Fatores de Tempo
5.
Oncotarget ; 11(30): 2906-2918, 2020 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-32774771

RESUMO

BACKGROUND: The findings of COMPASS, a randomized phase II study, suggested that the regimens and courses of neoadjuvant chemotherapy (NAC) for locally advanced gastric cancer (GC) did not affect the pathological response. However, pathological complete response was achieved in 10% patients who received four courses of either S-1/cisplatin or paclitaxel/cisplatin. We hypothesized that if relevant biomarkers could be used to predict the suitable NAC regimen before treatment initiation, further improvements could be ensured in the outcomes of locally advanced GC. MATERIALS AND METHODS: mRNA extraction, real-time polymerase chain reaction, and immunohistochemical analyses were performed using endoscopic biopsy specimens of primary tumors, collected prior to NAC, to determine the clinically relevant biomarkers. RESULTS: TIMP1, DSG2, RRM1, MUC2, EGFR, ZDHHC14, and CLDN18.2 were identified as biomarker candidates, since their expression was significantly associated with the pathological responses to each NAC regimen. Furthermore, TIMP1 and DSG2 were identified as predictive biomarkers of the pathological response to each NAC regimen. CONCLUSIONS: The effective prediction of the pathological response to NAC regimens in locally advanced GC using biomarkers identified from endoscopic biopsy specimens indicates the possibility of personalizing NAC based on biomarker analysis.

6.
Anticancer Res ; 40(7): 4067-4074, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620654

RESUMO

BACKGROUND: The aim of this study was to evaluate the impact of postoperative infectious complications on long-term outcomes after curative resection of gastric cancer. PATIENTS AND METHODS: Patients who underwent curative gastrectomy with lymphadenectomy for gastric cancer at Yokohama City University and Kanagawa Cancer Center from January 2000 to August 2015 were retrospectively selected from medical records. Clinicopathological factors between patients with and without infectious complications were compared. Prognostic factors of long-term survival were analyzed by univariate and multivariate Cox proportional hazards analyses. RESULTS: A total of 2,254 patients were eligible for inclusion in the present study. Fifty-eight patients had postoperative infectious complications (IC group); 2,196 had no postoperative infectious complications (NC group). In the IC group, the median age (p=0.031), body mass index (p=0.004), American Society of Anesthesiologists physical status (p=0.006) and percentage of male patients (p<0.001) were higher in comparison to the NC group. The operation time was longer (p<0.001) and the incidence of intestinal-type histology was higher (p=0.017) in the IC group. The 5-year overall survival rates of the IC and NC groups were 59.8% and 83.2%, respectively (p<0.001). Univariate and multivariate analyses demonstrated that postoperative infectious complications were a significant risk factor for poorer overall survival (hazard ratio=2.38; 95% confidence interval=1.47-3.85, p<0.001). CONCLUSION: Perioperative management is necessary to reduce the incidence of postoperative infectious complications and improve the survival of patients after curative resection of gastric cancer.


Assuntos
Adenocarcinoma/cirurgia , Infecções/etiologia , Complicações Pós-Operatórias , Neoplasias Gástricas/cirurgia , Adenocarcinoma/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastrectomia , Humanos , Infecções/mortalidade , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias Gástricas/mortalidade , Análise de Sobrevida , Adulto Jovem
7.
Gan To Kagaku Ryoho ; 47(1): 49-53, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-32381862

RESUMO

FOLFOX therapy has been used for gastric cancer in Japan since 2017. We retrospectively analyzed the efficacy of FOLFOX therapy compared to that of FP. Forty-seven cases were evaluated between January 2010 and December 2018. Eighteen patients received mFOLFOX6 therapy, and 29 patients received FP therapy. The median time to treatment failure was 206 days in the mFOLFOX6 group and 58 days in the FP group. The response rate was 50% in the mFOLFOX6 group and 17% in the FP group. Neutropenia(56%), thrombocytopenia(50%), and peripheral neuropathy(56%)were the common adverse events in the mFOLFOX6 group, and leukopenia(69%)and neutropenia(69%)were the common adverse effects in the FP group. Based on our results, we conclude that, unlike FP, FOLFOX is an effective therapy for of gastric cancer.


Assuntos
Neoplasias Gástricas , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Colorretais , Fluoruracila , Humanos , Japão , Leucovorina , Compostos Organoplatínicos , Estudos Retrospectivos , Resultado do Tratamento
8.
In Vivo ; 34(3): 1533-1539, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32354959

RESUMO

BACKGROUND/AIM: Lymphovascular invasion (LVI) is recognized as a prognostic predictor of recurrence in certain carcinomas. According to current Japanese guidelines, however, in gastric cancer, LVI is not clinically useful information, except for predicting the curability of endoscopic resection. We clarified the clinical significance of LVI in gastric cancer and its correlation with disease prognosis. PATIENTS AND METHODS: A total of 2,090 cases of gastric cancer undergoing radical gastrectomy were enrolled. The correlation of LVI and other histopathological factors was evaluated with regards to patient prognosis. RESULTS: LVI(+) was noted in 894 cases. A multivariate analysis showed that pT, pN, and LVI were independent risk factors for patient prognosis. In pT2-4 patients with nodal metastasis, a significant difference was revealed, and the 5-year overall survival rates in LVI(+) cases were lower than those in LVI(-) (60.9% vs. 76.7%, p=0.005). CONCLUSION: LVI in gastric cancer is an independent prognostic factor, and tends to worsen prognosis, especially in advanced cancers with lymph node metastases.


Assuntos
Neoplasias Gástricas/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/terapia , Carga Tumoral
9.
Ann Surg Oncol ; 27(11): 4235-4247, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32424582

RESUMO

BACKGROUND: Lymph node ratio (LNR), defined as the ratio of metastatic nodes to the total number of examined lymph nodes, has been proposed as a sensitive prognostic factor in patients with gastric cancer (GC). We investigate its association with survival in pathological stage (pStage) II/III GC and explore whether this is a prognostic factor in each Union for International Cancer Control pStage (7th edition). PATIENTS AND METHODS: We retrospectively examined 838 patients with pStage II/III GC who underwent curative gastrectomy between June 2000 and December 2018. Patients were classified into low-LNR (L-LNR), middle-LNR (M-LNR), and high-LNR (H-LNR) groups according to adjusted X-tile cutoff values of 0.1 and 0.25 for LNR, and their clinicopathological characteristics and survival rates were compared. RESULTS: The 5-year recurrence-free survival (RFS) and overall survival (OS) rates postsurgery showed significant differences among the groups (P < 0.001). Multivariate analysis demonstrated that LNR was a significant predictor of poor RFS [M-LNR: hazard ratio (HR) 3.128, 95% confidence interval (CI) 2.254-4.342, P < 0.001; H-LNR: HR 5.148, 95% CI 3.546-7.474, P < 0.001] and OS (M-LNR: HR 2.749, 95% CI 2.038-3.708, P < 0.001; H-LNR: HR 4.654, 95% CI 3.288-6.588, P < 0.001). On subset analysis stratified by pStage, significant differences were observed between the groups in terms of the RFS curves of pStage II and III GC (P < 0.001 and < 0.001, respectively) and OS curves of pStage II and III GC (P = 0.001 and < 0.001, respectively). CONCLUSIONS: High LNR is a predictor of worse prognosis in pStage II/III GC, including each substage.


Assuntos
Razão entre Linfonodos , Neoplasias Gástricas , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
10.
Anticancer Res ; 40(4): 2275-2281, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234926

RESUMO

BACKGROUND/AIM: To assess the prognostic effect of muscle loss after esophagectomy and before discharge. PATIENTS AND METHODS: This study retrospectively analysed 159 consecutive patients with oesophageal and gastroesophageal junction cancer who underwent esophagectomy between August 2011 and October 2015. Body composition was evaluated one week before surgery and at discharge using a bioelectrical impedance analyser. RESULTS: The median rate of muscle mass loss (RMML) was 4.38% (range=-3.3 to +18.8). Patients with increased RMML had significantly poorer outcomes of overall survival than those with decreased RMML (p=0.015). On multivariate analysis, RMML [≥4.38, hazard ratio (HR)=2.033, 95% confidence interval (CI)=1.018-5.924, p=0.044) and pathological tumour depth (≥2, HR=3.099, 95%CI=1.339-7.172, p=0.008) were selected as independent prognostic factors. CONCLUSION: RMML after esophagectomy is indicative of poor prognosis in patients with esophageal cancer.


Assuntos
Neoplasias Esofágicas/fisiopatologia , Esofagectomia/métodos , Junção Esofagogástrica/fisiopatologia , Transtornos Musculares Atróficos/fisiopatologia , Neoplasias Gástricas/fisiopatologia , Idoso , Intervalo Livre de Doença , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Junção Esofagogástrica/patologia , Junção Esofagogástrica/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Transtornos Musculares Atróficos/etiologia , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
11.
Anticancer Res ; 40(3): 1683-1690, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32132075

RESUMO

BACKGROUND: This study aimed to investigate the impact of postoperative complications (PCs) in patients with pathological stage (pStage) II or III gastric cancer (GC) who received adjuvant chemotherapy with S-1 after curative surgery. PATIENTS AND METHODS: Altogether, data for 226 patients were examined retrospectively. The relationship between PCs and clinicopathological features and survival were examined. RESULTS: Recurrence-free survival was significantly worse in the group with PCs than in the PC-negative group. On multivariate analysis, having PCs of grade 2 or more was an independent risk factor for recurrence (hazard ratio=1.721; 95% confidence intervaI=1.014-2.920; p=0.044). In addition, for each pStage analysis, having PCs of grade 2 or more was a risk factor for recurrence even in patients with pStage II GC. CONCLUSION: PC of grade 2 or more was an independent risk factor for recurrence in patients with pStage II GC who received adjuvant chemotherapy with S-1 after curative gastrectomy. Thus, for patients with PCs, even for those with pStage II GC, more effective adjuvant chemotherapy, such as S-1 plus docetaxel, may be needed.


Assuntos
Ácido Oxônico/uso terapêutico , Neoplasias Gástricas/complicações , Neoplasias Gástricas/tratamento farmacológico , Tegafur/uso terapêutico , Quimioterapia Adjuvante , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Ácido Oxônico/farmacologia , Complicações Pós-Operatórias , Prognóstico , Neoplasias Gástricas/patologia , Tegafur/farmacologia
12.
J Cancer Res Clin Oncol ; 146(1): 75-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31754833

RESUMO

PURPOSE: The enzymes gamma-glutamyl hydrolase (GGH) and folylpolyglutamate synthetase (FPGS) regulate intracellular folate concentrations needed for cell proliferation, DNA synthesis, and repair. High GGH expression affects 5-FU thymidylate synthase (TS) inhibition and is a risk factor for various malignancies. Here, the clinical significance of GGH and FPGS expression was investigated in Stage II/III gastric cancer patients undergoing postoperative adjuvant chemotherapy with S-1. METHODS: Surgical specimens of cancer tissue and adjacent normal mucosa, obtained from 253 patients with previously untreated gastric cancer, were examined. GGH and FPGS mRNA expression was measured by qPCR to evaluate their clinicopathological significance in gastric cancer patients after curative resection. RESULTS: While FPGS expression showed no significant differences between the cancerous and normal samples, GGH expression was higher in cancer tissue than in adjacent normal mucosa. High GGH expression was correlated with age, histological type, and vascular invasion. Overall survival (OS) of patients with high GGH mRNA expression was significantly poorer than of patients with low GGH expression. Multivariate analysis showed that high GGH expression was an independent prognostic factor of OS (HR: 2.58, 95% CI 1.29-5.16). Patients who received S-1 adjuvant treatment showed a significantly poor OS between high GGH/low FPGS and low GGH/high FPGS. Patients without adjuvant treatment showed no significant difference. CONCLUSION: GGH expression was significantly higher in gastric cancer tissue than in adjacent normal mucosa. High GGH and low FPGS expression is a useful independent predictor of poor outcomes in stage II/III gastric cancer patients undergoing postoperative adjuvant chemotherapy with S-1.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/biossíntese , Peptídeo Sintases/biossíntese , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/enzimologia , gama-Glutamil Hidrolase/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Quimioterapia Adjuvante , Combinação de Medicamentos , Feminino , Mucosa Gástrica/enzimologia , Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Ácido Oxônico/administração & dosagem , Peptídeo Sintases/genética , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Tegafur/administração & dosagem , gama-Glutamil Hidrolase/genética
13.
Asian J Endosc Surg ; 13(3): 415-418, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31364273

RESUMO

Gastrojejunostomy has been performed as a palliative treatment for unresectable, advanced gastric cancer patients with gastric outlet obstruction (GOO). However, its role before neoadjuvant chemotherapy (NAC) has not been established. We present the case of a 72-year-old man with distal advanced gastric cancer with GOO. Computed tomography showed para-aortic lymph node (PAN) metastasis without other distal metastasis. We performed laparoscopic stomach-partitioning gastrojejunostomy (LSPGJ), which avoided new gastrojejunostomy reconstruction when performing distal gastrectomy after NAC. His oral intake improved after surgery and NAC was successfully administered on postoperative day 14, without surgical complications. After completion of NAC, the patient underwent radical distal gastrectomy with gastrojejunostomy reused as Billroth-II reconstruction. A histological examination revealed no residual cancer cells. LSPGJ, with partitioning on the expected resection line in distal gastrectomy after NAC, can be useful for treating advanced gastric cancer with GOO when NAC followed by curative gastrectomy is planned.


Assuntos
Derivação Gástrica , Obstrução da Saída Gástrica , Laparoscopia , Neoplasias Gástricas , Idoso , Gastrectomia , Obstrução da Saída Gástrica/etiologia , Obstrução da Saída Gástrica/cirurgia , Humanos , Masculino , Terapia Neoadjuvante , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia
14.
In Vivo ; 34(1): 461-467, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31882514

RESUMO

BACKGROUND/AIM: Endothelial cell-specific molecule-1 (ESM-1) is a soluble proteoglycan which has important role in various biological events. We investigated the impact of the ESM-1 expression in cancer tissues on outcomes in stage II/III gastric cancer patients who received adjuvant S-1 chemotherapy. PATIENTS AND METHODS: The ESM-1 mRNA expression in cancerous tissues and adjacent normal mucosa from 253 patients was measured. The associations between the ESM-1 gene expression and the survival and clinicopathological features were investigated. RESULTS: A significant association was observed between high ESM-1 expression and undifferentiated adenocarcinoma. The overall survival curve was significantly lower in patients with high ESM-1 expression than in those with low expression (p=0.005). High ESM-1 expression was a significant independent prognosticator (HR=2.291, p=0.007). CONCLUSION: ESM-1 gene expression in cancerous tissues is an important prognosticator in stage II/III gastric cancer patients who received adjuvant S-1 chemotherapy.


Assuntos
Adenocarcinoma/mortalidade , Biomarcadores Tumorais/metabolismo , Proteínas de Neoplasias/metabolismo , Ácido Oxônico/uso terapêutico , Proteoglicanas/metabolismo , Neoplasias Gástricas/mortalidade , Tegafur/uso terapêutico , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/metabolismo , Adenocarcinoma/patologia , Idoso , Antimetabólitos Antineoplásicos/uso terapêutico , Quimioterapia Adjuvante , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia , Taxa de Sobrevida
15.
Gan To Kagaku Ryoho ; 47(13): 2222-2224, 2020 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-33468914

RESUMO

Here, we report a case of successful surgical resection of expansive-growth acinar cell carcinoma. A 59-year-old man was referred to a local hospital with abdominal distention. CT revealed a large abdominal tumor. Subsequently, he was referred to our hospital. Physical examination showed a large tumor on his left upper abdomen without tenderness. CT revealed an enhanced 18 cm-sized expansive-growth tumor on the left flank, suggesting a primary pancreatic tumor. EUS-FNA yielded a diagnosis of adenocarcinoma. Imaging findings were not typical for pancreatic ductal carcinoma. We performed distal pancreatectomy with splenectomy, transverse colon resection, and proximal gastrectomy. Pathological findings revealed a tumor, measuring 19.5×16.5×15.5 cm, originating from the pancreatic body, positive for trypsin, chymotrypsin, and elastase, consistent with a diagnosis of acinar cell carcinoma, pT3, N0, M0. Four courses of adjuvant chemotherapy with S-1 were provided, and the patient is currently alive without recurrence for 10 months.


Assuntos
Carcinoma de Células Acinares , Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Carcinoma de Células Acinares/tratamento farmacológico , Carcinoma de Células Acinares/cirurgia , Carcinoma Ductal Pancreático/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Pancreatectomia , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia
16.
Anticancer Res ; 39(12): 6567-6573, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810922

RESUMO

BACKGROUND/AIM: The KIAA1199 gene has been associated with cancer-cell proliferation, but its functions remain poorly studied. Here, we examined the clinical significance of the KIAA1199 mRNA levels in locally advanced gastric cancer (GC). Materials and Methods/Results: Using samples from 254 patients with stage II/III GC, we found significantly higher KIAA1199 levels in cancerous tissues compared to adjacent normal mucosa (ANM). There was no significant relationship between KIAA1199 expression and clinical features. Although overall survival rates (OSR) of patients, who underwent surgery did not correlate with KIAA1199 expression, patients who underwent adjuvant chemotherapy with S-1 and had high KIAA1199 levels displayed significantly lower OSR. KIAA1199 knock down (KIAA1199-KD) suppressed proliferation, invasiveness, and sensitivity of GC cells to 5-fluorouracil (5-FU). CONCLUSION: KIAA1199 expression appears to be a promising prognostic marker in patients with locally advanced GC, who underwent postoperative adjuvant chemotherapy with S-1. KIAA1199 may represent a novel target for GC pharmacotherapy.


Assuntos
Hialuronoglucosaminidase/genética , Ácido Oxônico/uso terapêutico , Neoplasias Gástricas/terapia , Tegafur/uso terapêutico , Regulação para Cima , Idoso , Linhagem Celular Tumoral , Proliferação de Células , Quimioterapia Adjuvante , Procedimentos Cirúrgicos do Sistema Digestório , Combinação de Medicamentos , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Prognóstico , Neoplasias Gástricas/genética , Neoplasias Gástricas/mortalidade , Análise de Sobrevida
17.
Gan To Kagaku Ryoho ; 46(8): 1307-1309, 2019 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-31501376

RESUMO

Neoadjuvant imatinib may prevent tumor rupture and the need for extended surgery by reducing the tumor size by approximately 35%, especially for large gastric gastrointestinal stromal tumors(GISTs), as shown in a previous phase Ⅱ study (Kurokawa et al. BJC 2017); however, the use ofneoadjuvant imatinib is not prevalent in clinical practice. Herein, we report a large gastric GIST that was successfully treated with neoadjuvant imatinib. A 74-year-old woman complained ofabdominal pain, and abdominal computed tomography(CT)revealed a 14 cm oval tumor in the left upper abdominal cavity. Gastric biopsy revealed that the tumor was a GIST. The patient also had a small lung tumor that was diagnosed as a primary lung carcinoma in the right upper lobe. We performed neoadjuvant imatinib for 6 months as the primary treatment. After 7 months ofimatinib administration, CT revealed that the GIST decreased in size but the lung cancer was slightly enlarged. Therefore, we performed right upper lung lobectomy and continued imatinib therapy for an additional 3 months. After a total of9 months ofneoadjuvant imatinib treatment, we performed partial gastrectomy combined with splenectomy without tumor rupture. The patient is scheduled to continue imatinib therapy for a total of 3 years.


Assuntos
Tumores do Estroma Gastrointestinal , Terapia Neoadjuvante , Neoplasias Gástricas , Idoso , Antineoplásicos , Feminino , Tumores do Estroma Gastrointestinal/terapia , Humanos , Mesilato de Imatinib , Neoplasias Gástricas/terapia
18.
J Cancer ; 10(11): 2450-2456, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31258750

RESUMO

Aims: We previously demonstrated that a loss of lean body mass loss at one month after gastrectomy was an independent risk factor for the continuation of adjuvant chemotherapy with S-1. However, it is unclear whether or not lean body mass loss after gastrectomy leads to a poor survival through poor compliance to adjuvant chemotherapy with S-1. Methods: The recurrence free survival (RFS) overall survival (OS) and were examined in 115 patients who underwent curative gastrectomy and were pathologically diagnosed with stage II or III gastric cancer and who received postoperative adjuvant chemotherapy with S-1 between May 2011 and September 2016. Results: The median follow-up period was 40.6 months. The RFS rates at 5 years after surgery were 57.8% in the lean body mass loss ≥5% group and 73.5% in the lean body mass loss <5% group. The univariate and multivariate analyses for the disease free survival (RFS) demonstrated that a lean body mass loss >5% was a significant risk factor. The OS rates at 5 years after surgery were 72.0% in the lean body mass loss ≥5% group and 77.3% in the lean body mass loss <5% group. The OS was slightly worse in the lean body mass loss ≥5% group than in the lean body mass loss <5% group (p=0.2062). Conclusions: The lean body mass loss at one month, which is closely associated with poor S-1 compliance, was an important risk factor for the RFS. A prospective cohort study is necessary to confirm whether or not the lean body mass loss affects the gastric cancer survival.

19.
J Cancer ; 10(5): 1070-1076, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30854113

RESUMO

Background: In previous our phase III study to compare perioperative standard diet with or without Eicosapentaenoic acid (EPA)-enriched oral nutritional supplement (EPA-ON), additional EPA-ON did not contribute to prevent body weight loss after total gastrectomy. This report clarified whether EPA-ON could prevent loss of lean body mass (LBM) after total gastrectomy, a key secondary endpoint, in our phase III trial. Methods: This phase III study was designed as multicenter, open-label, superiority, randomized trial to confirm the preventive effect of EPA-ON body weight loss after total gastrectomy for gastric cancer. Eligible patients were randomized to either Standard-diet group or EPA-ON group by a centralized dynamic method. Standard-diet group was given no additional nutritional supplementation perioperatively (standard diet), while EPA-ON group was given an EPA-enriched supplement (ProSure®, Abbott Japan, Tokyo, Japan) in addition to their standard diet. This supplement included 600 kcal with 2.2 g/day of EPA. For both groups, patients underwent total gastrectomy with Roux-en Y reconstruction. Results: A total of 123 patients (Group A: 60, Group B: 63) were analyzed in the study. All background factors were well balanced between the both groups. Median loss of LBM was 6.74% (range -3.91% to 20.27%) in the Standard-diet group and 6.89% (range -5.11% to 20.04%) in the EPA-ON group at 1 month after surgery and was 8.59% (range -4.40% to 20.27%) in the Standard-diet group and 7.77% (range -5.57% to 23.35%) in the EPA-ON group at 3 months after surgery, which was not significantly different at the both (p=0.794 and p=0.393, respectively). Conclusions: The perioperative EPA-ON could not be recommended to prevent loss of LBM after total gastrectomy.

20.
In Vivo ; 33(2): 587-594, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30804146

RESUMO

BACKGROUND: This study investigated the impact of postoperative C-reactive protein (CRP) level on survival in patients with esophageal cancer who received perioperative steroid therapy and enhanced recovery after surgery (ERAS) care. PATIENTS AND METHODS: Overall, 115 patients were retrospectively reviewed. The patients were classified into those with a high CRP level (≥4.0 mg/dl) on postoperative day 4 and those with low CRP level (<4.0 mg/dl). The risk factors for overall survival (OS) and recurrence-free survival (RFS) were identified. RESULTS: The OS and RFS rates at 5 years after surgery were significantly low in patients with high CRP level on postoperative day 4. The multivariate analysis demonstrated that high CRP level on postoperative day 4 was a significant independent risk factor for OS and RFS. CONCLUSION: The present results suggest that the postoperative CRP level can be a prognosticator in patients with esophageal cancer who have received perioperative steroid therapy and ERAS care.


Assuntos
Proteína C-Reativa/metabolismo , Neoplasias Esofágicas/sangue , Neoplasias Esofágicas/tratamento farmacológico , Esteroides/administração & dosagem , Idoso , Cefazolina/administração & dosagem , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assistência Perioperatória , Período Pós-Operatório , Prognóstico
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