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Clinical practice guidelines for esophagogastric junction cancer: Upper GI Oncology Summit 2023. 食管胃交界癌临床实践指南:2023 年上消化道肿瘤学峰会。
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-22 DOI: 10.1007/s10120-023-01457-3
Yuko Kitagawa, Satoru Matsuda, Takuji Gotoda, Ken Kato, Bas Wijnhoven, Florian Lordick, Pradeep Bhandari, Hirofumi Kawakubo, Yasuhiro Kodera, Masanori Terashima, Kei Muro, Hiroya Takeuchi, Paul F Mansfield, Yukinori Kurokawa, Jimmy So, Stefan Paul Mönig, Kohei Shitara, Sun Young Rha, Yelena Janjigian, Daisuke Takahari, Ian Chau, Prateek Sharma, Jiafu Ji, Giovanni de Manzoni, Magnus Nilsson, Paulo Kassab, Wayne L Hofstetter, Elizabeth Catherine Smyth, Sylvie Lorenzen, Yuichiro Doki, Simon Law, Do-Youn Oh, Khek Yu Ho, Tomoyuki Koike, Lin Shen, Richard van Hillegersberg, Hisato Kawakami, Rui-Hua Xu, Zev Wainberg, Naohisa Yahagi, Yeong Yeh Lee, Rajvinder Singh, Min-Hee Ryu, Ryu Ishihara, Zili Xiao, Chika Kusano, Heike Irmgard Grabsch, Hiroki Hara, Ken-Ichi Mukaisho, Tomoki Makino, Mitsuro Kanda, Eisuke Booka, Sho Suzuki, Waku Hatta, Motohiko Kato, Akira Maekawa, Akihito Kawazoe, Shun Yamamoto, Izuma Nakayama, Yukiya Narita, Han-Kwang Yang, Masahiro Yoshida, Takeshi Sano
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引用次数: 0
Dietary intake of vitamin C and gastric cancer: a pooled analysis within the Stomach cancer Pooling (StoP) Project. 膳食中维生素 C 的摄入量与胃癌:胃癌汇总(StoP)项目的汇总分析。
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-01 Epub Date: 2024-03-04 DOI: 10.1007/s10120-024-01476-8
Michele Sassano, Monireh Sadat Seyyedsalehi, Giulia Collatuzzo, Claudio Pelucchi, Rossella Bonzi, Monica Ferraroni, Domenico Palli, Guo-Pei Yu, Zuo-Feng Zhang, Lizbeth López-Carrillo, Nuno Lunet, Samantha Morais, David Zaridze, Dmitry Maximovich, Vicente Martín, Gemma Castano-Vinyals, Jesús Vioque, Sandra González-Palacios, Mary H Ward, Reza Malekzadeh, Mohammadreza Pakseresht, Raul Ulises Hernández-Ramirez, Malaquias López-Cervantes, Eva Negri, Federica Turati, Charles S Rabkin, Shoichiro Tsugane, Akihisa Hidaka, Areti Lagiou, Pagona Lagiou, M Constanza Camargo, Maria Paula Curado, Stefania Boccia, Carlo La Vecchia, Paolo Boffetta

Background: Previous studies suggest that dietary vitamin C is inversely associated with gastric cancer (GC), but most of them did not consider intake of fruit and vegetables. Thus, we aimed to evaluate this association within the Stomach cancer Pooling (StoP) Project, a consortium of epidemiological studies on GC.

Methods: Fourteen case-control studies were included in the analysis (5362 cases, 11,497 controls). We estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the association between dietary intake of vitamin C and GC, adjusted for relevant confounders and for intake of fruit and vegetables. The dose-response relationship was evaluated using mixed-effects logistic models with second-order fractional polynomials.

Results: Individuals in the highest quartile of dietary vitamin C intake had reduced odds of GC compared with those in the lowest quartile (OR: 0.64; 95% CI: 0.58, 0.72). Additional adjustment for fruit and vegetables intake led to an OR of 0.85 (95% CI: 0.73, 0.98). A significant inverse association was observed for noncardia GC, as well as for both intestinal and diffuse types of the disease. The results of the dose-response analysis showed decreasing ORs of GC up to 150-200 mg/day of vitamin C (OR: 0.54; 95% CI: 0.41, 0.71), whereas ORs for higher intakes were close to 1.0.

Conclusions: The findings of our pooled study suggest that vitamin C is inversely associated with GC, with a potentially beneficial effect also for intakes above the currently recommended daily intake (90 mg for men and 75 mg for women).

背景:以往的研究表明,膳食中的维生素 C 与胃癌(GC)呈反向关系,但大多数研究并未考虑水果和蔬菜的摄入量。因此,我们旨在胃癌汇集(StoP)项目(胃癌流行病学研究联盟)中评估这种相关性:分析包括 14 项病例对照研究(5362 例病例,11497 例对照)。我们估算了膳食中维生素 C 摄入量与 GC 之间关系的几率比(ORs)和相应的 95% 置信区间(CIs),并对相关混杂因素以及水果和蔬菜的摄入量进行了调整。剂量-反应关系采用二阶分数多项式混合效应逻辑模型进行评估:结果:膳食维生素 C 摄入量最高四分位数的人与最低四分位数的人相比,患 GC 的几率有所降低(OR:0.64;95% CI:0.58,0.72)。对水果和蔬菜摄入量进行额外调整后,OR 值为 0.85(95% CI:0.73,0.98)。在非心绞痛性 GC 以及肠道型和弥漫型 GC 中均观察到了明显的负相关。剂量反应分析的结果显示,维生素 C 摄入量达到 150-200 毫克/天时,GC 的 ORs 下降(OR:0.54;95% CI:0.41,0.71),而维生素 C 摄入量越高,ORs 越接近 1.0:我们的汇总研究结果表明,维生素 C 与 GC 呈反向关系,摄入量超过目前推荐的每日摄入量(男性 90 毫克,女性 75 毫克)也可能产生有益影响。
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引用次数: 0
Impact of preoperative prealbumin levels on long-term prognosis in patients with gastric cancer after gastrectomy: a retrospective cohort study. 胃切除术后胃癌患者术前白蛋白水平对长期预后的影响:一项回顾性队列研究。
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-24 DOI: 10.1007/s10120-024-01472-y
Ryota Matsui, Satoshi Ida, Motonari Ri, Rie Makuuchi, Masaru Hayami, Koshi Kumagai, Manabu Ohashi, Takeshi Sano, Souya Nunobe

Background: The relationship between preoperative prealbumin levels and long-term prognoses in patients with gastric cancer after gastrectomy has not been fully investigated. This study clarified the effect of preoperative prealbumin levels on the long-term prognosis of patients with gastric cancer after gastrectomy.

Methods: This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStage I-III gastric cancer and whose preoperative prealbumin levels were measured between May 2006 and March 2017. Participants were categorized according to their preoperative prealbumin levels into high (≥22 mg/dL), moderate (15-22 mg/dL), and low (<15 mg/dL) groups. The overall survival (OS) in the three groups was compared using the log-rank test, and prognostic factors were identified using Cox proportional hazards regression analysis.

Results: The median follow-up duration was 66 months. Of 4732 patients, 3649 (77.2%) were classified as high, 925 (19.6%) as moderate, and 158 (3.3%) as low. Lower prealbumin levels were associated with poorer prognoses (P < 0.001). Multivariate analysis showed that prealbumin levels of 15-22 mg/dL [hazard ratio (HR): 1.576, 95% confidence interval (CI): 1.353-1.835, P < 0.001] and <15 mg/dL (HR: 1.769, 95% CI: 1.376-2.276, P < 0.001) were independent poor prognostic factors for OS. When analyzed according to the cause of death, prealbumin levels were associated with other-cause survival, but not cancer-specific survival.

Conclusions: Preoperative prealbumin levels correlated with OS in patients with gastric cancer after gastrectomy; the lower the prealbumin level, the worse is the prognosis. Prealbumin levels may be associated with other-cause survival.

背景:胃切除术后胃癌患者术前白蛋白水平与长期预后之间的关系尚未得到充分研究。本研究阐明了术前白蛋白水平对胃切除术后胃癌患者长期预后的影响:这项回顾性队列研究纳入了2006年5月至2017年3月间因原发性I-III期胃癌接受根治性胃切除术的连续患者,并对其术前白蛋白水平进行了测量。根据术前白蛋白水平将参与者分为高(≥22 mg/dL)、中(15-22 mg/dL)和低(结果:中位随访时间为 66 个月。在 4732 名患者中,有 3649 人(77.2%)被归类为高,925 人(19.6%)被归类为中,158 人(3.3%)被归类为低。较低的术前白蛋白水平与较差的预后有关(P 结论:术前白蛋白水平越低,预后越差:术前白蛋白水平与胃切除术后胃癌患者的预后相关;术前白蛋白水平越低,预后越差。术前白蛋白水平可能与其他原因导致的生存率有关。
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引用次数: 0
Diagnostic performance of deep-learning-based virtual chromoendoscopy in gastric neoplasms. 基于深度学习的虚拟色内镜在胃肿瘤中的诊断性能。
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-05-01 Epub Date: 2024-01-19 DOI: 10.1007/s10120-024-01469-7
Sho Suzuki, Yusuke Monno, Ryo Arai, Masaki Miyaoka, Yosuke Toya, Mitsuru Esaki, Takuya Wada, Waku Hatta, Ayaka Takasu, Shigeaki Nagao, Fumiaki Ishibashi, Yohei Minato, Kenichi Konda, Takahiro Dohmen, Kenji Miki, Masatoshi Okutomi

Backgrounds: Cycle-consistent generative adversarial network (CycleGAN) is a deep neural network model that performs image-to-image translations. We generated virtual indigo carmine (IC) chromoendoscopy images of gastric neoplasms using CycleGAN and compared their diagnostic performance with that of white light endoscopy (WLE).

Methods: WLE and IC images of 176 patients with gastric neoplasms who underwent endoscopic resection were obtained. We used 1,633 images (911 WLE and 722 IC) of 146 cases in the training dataset to develop virtual IC images using CycleGAN. The remaining 30 WLE images were translated into 30 virtual IC images using the trained CycleGAN and used for validation. The lesion borders were evaluated by 118 endoscopists from 22 institutions using the 60 paired virtual IC and WLE images. The lesion area concordance rate and successful whole-lesion diagnosis were compared.

Results: The lesion area concordance rate based on the pathological diagnosis in virtual IC was lower than in WLE (44.1% vs. 48.5%, p < 0.01). The successful whole-lesion diagnosis was higher in the virtual IC than in WLE images; however, the difference was insignificant (28.2% vs. 26.4%, p = 0.11). Conversely, subgroup analyses revealed a significantly higher diagnosis in virtual IC than in WLE for depressed morphology (41.9% vs. 36.9%, p = 0.02), differentiated histology (27.6% vs. 24.8%, p = 0.02), smaller lesion size (42.3% vs. 38.3%, p = 0.01), and assessed by expert endoscopists (27.3% vs. 23.6%, p = 0.03).

Conclusions: The diagnostic ability of virtual IC was higher for some lesions, but not completely superior to that of WLE. Adjustments are required to improve the imaging system's performance.

背景:循环一致性生成对抗网络(CycleGAN)是一种深度神经网络模型,可进行图像到图像的转换。我们利用 CycleGAN 生成了虚拟的靛蓝胭脂红(IC)胃肿瘤色内镜图像,并将其诊断性能与白光内镜(WLE)进行了比较:方法: 我们获得了 176 名接受内镜切除术的胃肿瘤患者的 WLE 和 IC 图像。我们使用训练数据集中 146 个病例的 1,633 张图像(911 张 WLE 和 722 张 IC),利用 CycleGAN 开发了虚拟 IC 图像。剩下的 30 张 WLE 图像则使用训练好的 CycleGAN 转换成 30 张虚拟 IC 图像,并用于验证。来自 22 个机构的 118 名内镜医师使用 60 张配对的虚拟 IC 和 WLE 图像对病灶边界进行了评估。比较了病变区域吻合率和全病变诊断成功率:结果:根据病理诊断,虚拟 IC 的病灶面积吻合率低于 WLE(44.1% 对 48.5%,P 结论:虚拟 IC 的病灶面积吻合率低于 WLE(44.1% 对 48.5%,P 结论):虚拟 IC 对某些病变的诊断能力较高,但并不完全优于 WLE。需要进行调整以提高成像系统的性能。
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引用次数: 0
Genome-wide 5-hydroxymethylcytosines in circulating cell-free DNA as noninvasive diagnostic markers for gastric cancer 循环细胞游离 DNA 中的全基因组 5-羟甲基胞嘧啶是胃癌的非侵入性诊断标记物
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-04-07 DOI: 10.1007/s10120-024-01493-7
Yingli Fu, Jing Jiang, Yanhua Wu, Donghui Cao, Zhifang Jia, Yangyu Zhang, Dongming Li, Yingnan Cui, Yuzheng Zhang, Xueyuan Cao

Background

5-Hydroxymethylcytosine-enriched gene profiles and regions show tissue-specific and tumor specific. There is a potential value to explore cell-free DNA 5-hydroxymethylcytosine feature biomarkers for early gastric cancer detection.

Methods

A matched case‒control study design with 50 gastric cancer patients and 50 controls was performed to sequence the different 5-hydroxymethylcytosine modification features of cell free DNA. Significantly differential 5-hydroxymethylcytosine modification genes were identified to construct a gastric cancer diagnostic model. Data set from GEO was used as an external testing set to test the robustness of the diagnostic model.

Results

Accounting for more than 90% of 5-hydroxymethylcytosine peaks were distributed in the gene body in both the gastric cancer and control groups. The diagnostic model was developed based on five different 5-hydroxymethylcytosine modification genes, FBXL7, PDE3A, TPO, SNTG2 and STXBP5. The model could effectively distinguish gastric cancer patients from controls in the training (AUC = 0.95, sensitivity = 88.6%, specificity = 94.3%), validation (AUC = 0.87, sensitivity = 73.3%, specificity = 93.3%) and testing (AUC = 0.90, sensitivity = 81.9%, specificity = 90.2%) sets. The risk scores of the controls from the model were significantly lower than those of gastric cancer patients in both our own data (P < 0.001) and GEO external testing data (P < 0.001), and no significant difference between different TNM stage patients (P = 0.09 and 0.66). Furthermore, there was no significant difference between the healthy control and benign gastric disease patients in the testing set from GEO (P = 0.10).

Conclusions

The characteristics of 5-hydroxymethylcytosine in cell free DNA are specific to gastric cancer patients, and the diagnostic model constructed by five genes’ 5-hydroxymethylcytosine features could effectively identify gastric cancer patients.

背景5-羟甲基胞嘧啶富集的基因图谱和区域具有组织特异性和肿瘤特异性。方法采用匹配的病例对照研究设计,以50名胃癌患者和50名对照组为研究对象,对细胞游离DNA的不同5-羟甲基胞嘧啶修饰特征进行测序。确定了具有显著差异的 5-羟甲基胞嘧啶修饰基因,从而构建了胃癌诊断模型。结果90%以上的5-羟甲基胞嘧啶峰分布在胃癌组和对照组的基因体内。根据五个不同的5-羟甲基胞嘧啶修饰基因FBXL7、PDE3A、TPO、SNTG2和STXBP5建立了诊断模型。在训练集(AUC = 0.95,灵敏度 = 88.6%,特异度 = 94.3%)、验证集(AUC = 0.87,灵敏度 = 73.3%,特异度 = 93.3%)和测试集(AUC = 0.90,灵敏度 = 81.9%,特异度 = 90.2%)中,该模型能有效区分胃癌患者和对照组。在我们自己的数据(P <0.001)和 GEO 外部检测数据(P <0.001)中,模型中对照组的风险评分明显低于胃癌患者,不同 TNM 分期患者之间也无明显差异(P = 0.09 和 0.66)。结论 细胞游离 DNA 中 5- 羟甲基胞嘧啶的特征对胃癌患者具有特异性,由 5 个基因的 5- 羟甲基胞嘧啶特征构建的诊断模型可有效识别胃癌患者。
{"title":"Genome-wide 5-hydroxymethylcytosines in circulating cell-free DNA as noninvasive diagnostic markers for gastric cancer","authors":"Yingli Fu, Jing Jiang, Yanhua Wu, Donghui Cao, Zhifang Jia, Yangyu Zhang, Dongming Li, Yingnan Cui, Yuzheng Zhang, Xueyuan Cao","doi":"10.1007/s10120-024-01493-7","DOIUrl":"https://doi.org/10.1007/s10120-024-01493-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>5-Hydroxymethylcytosine-enriched gene profiles and regions show tissue-specific and tumor specific. There is a potential value to explore cell-free DNA 5-hydroxymethylcytosine feature biomarkers for early gastric cancer detection.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A matched case‒control study design with 50 gastric cancer patients and 50 controls was performed to sequence the different 5-hydroxymethylcytosine modification features of cell free DNA. Significantly differential 5-hydroxymethylcytosine modification genes were identified to construct a gastric cancer diagnostic model. Data set from GEO was used as an external testing set to test the robustness of the diagnostic model.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Accounting for more than 90% of 5-hydroxymethylcytosine peaks were distributed in the gene body in both the gastric cancer and control groups. The diagnostic model was developed based on five different 5-hydroxymethylcytosine modification genes, <i>FBXL7, PDE3A, TPO, SNTG2 and STXBP5.</i> The model could effectively distinguish gastric cancer patients from controls in the training (AUC = 0.95, sensitivity = 88.6%, specificity = 94.3%), validation (AUC = 0.87, sensitivity = 73.3%, specificity = 93.3%) and testing (AUC = 0.90, sensitivity = 81.9%, specificity = 90.2%) sets. The risk scores of the controls from the model were significantly lower than those of gastric cancer patients in both our own data (<i>P</i> &lt; 0.001) and GEO external testing data (<i>P</i> &lt; 0.001), and no significant difference between different TNM stage patients (<i>P</i> = 0.09 and 0.66). Furthermore, there was no significant difference between the healthy control and benign gastric disease patients in the testing set from GEO (<i>P</i> = 0.10).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The characteristics of 5-hydroxymethylcytosine in cell free DNA are specific to gastric cancer patients, and the diagnostic model constructed by five genes’ 5-hydroxymethylcytosine features could effectively identify gastric cancer patients.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":"32 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140577823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Precise highlighting of the pancreas by semantic segmentation during robot-assisted gastrectomy: visual assistance with artificial intelligence for surgeons 在机器人辅助胃切除术中通过语义分割精确标出胰腺:利用人工智能为外科医生提供视觉辅助
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-04-04 DOI: 10.1007/s10120-024-01495-5
Tatsuro Nakamura, Nao Kobayashi, Yuta Kumazu, Kyohei Fukata, Motoki Murakami, Shugo Kohno, Yudai Hojo, Eiichiro Nakao, Yasunori Kurahashi, Yoshinori Ishida, Hisashi Shinohara

Background

A postoperative pancreatic fistula (POPF) is a critical complication of radical gastrectomy for gastric cancer, mainly because surgeons occasionally misrecognize the pancreas and fat during lymphadenectomy. Therefore, this study aimed to develop an artificial intelligence (AI) system capable of identifying and highlighting the pancreas during robot-assisted gastrectomy.

Methods

A pancreas recognition algorithm was developed using HRNet, with 926 training images and 232 validation images extracted from 62 scenes of robot-assisted gastrectomy videos. During quantitative evaluation, the precision, recall, intersection over union (IoU), and Dice coefficients were calculated based on the surgeons’ ground truth and the AI-inferred image from 80 test images. During the qualitative evaluation, 10 surgeons answered two questions related to sensitivity and similarity for assessing clinical usefulness.

Results

The precision, recall, IoU, and Dice coefficients were 0.70, 0.59, 0.46, and 0.61, respectively. Regarding sensitivity, the average score for pancreas recognition by AI was 4.18 out of 5 points (1 = lowest recognition [less than 50%]; 5 = highest recognition [more than 90%]). Regarding similarity, only 54% of the AI-inferred images were correctly differentiated from the ground truth.

Conclusions

Our surgical AI system precisely highlighted the pancreas during robot-assisted gastrectomy at a level that was convincing to surgeons. This technology may prevent misrecognition of the pancreas by surgeons, thus leading to fewer POPFs.

背景术后胰瘘(POPF)是胃癌根治性胃切除术的一种严重并发症,主要原因是外科医生在淋巴腺切除术中偶尔会误识胰腺和脂肪。因此,本研究旨在开发一种人工智能(AI)系统,该系统能够在机器人辅助胃切除术过程中识别并突出显示胰腺。方法使用 HRNet 开发了一种胰腺识别算法,从机器人辅助胃切除术视频的 62 个场景中提取了 926 幅训练图像和 232 幅验证图像。在定量评估中,根据外科医生的基本事实和人工智能从80张测试图像中推断出的图像,计算了精确度、召回率、交集大于联合(IoU)和骰子系数。在定性评估中,10 名外科医生回答了与灵敏度和相似度有关的两个问题,以评估临床实用性。结果精确度、召回率、IoU 和 Dice 系数分别为 0.70、0.59、0.46 和 0.61。在灵敏度方面,人工智能识别胰腺的平均得分为 4.18 分(满分 5 分,1 分=识别率最低[低于 50%];5 分=识别率最高[高于 90%])。结论我们的手术人工智能系统在机器人辅助胃切除术中精确地突出了胰腺,令外科医生信服。这项技术可以防止外科医生错误识别胰腺,从而减少 POPF。
{"title":"Precise highlighting of the pancreas by semantic segmentation during robot-assisted gastrectomy: visual assistance with artificial intelligence for surgeons","authors":"Tatsuro Nakamura, Nao Kobayashi, Yuta Kumazu, Kyohei Fukata, Motoki Murakami, Shugo Kohno, Yudai Hojo, Eiichiro Nakao, Yasunori Kurahashi, Yoshinori Ishida, Hisashi Shinohara","doi":"10.1007/s10120-024-01495-5","DOIUrl":"https://doi.org/10.1007/s10120-024-01495-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>A postoperative pancreatic fistula (POPF) is a critical complication of radical gastrectomy for gastric cancer, mainly because surgeons occasionally misrecognize the pancreas and fat during lymphadenectomy. Therefore, this study aimed to develop an artificial intelligence (AI) system capable of identifying and highlighting the pancreas during robot-assisted gastrectomy.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A pancreas recognition algorithm was developed using HRNet, with 926 training images and 232 validation images extracted from 62 scenes of robot-assisted gastrectomy videos. During quantitative evaluation, the precision, recall, intersection over union (IoU), and Dice coefficients were calculated based on the surgeons’ ground truth and the AI-inferred image from 80 test images. During the qualitative evaluation, 10 surgeons answered two questions related to sensitivity and similarity for assessing clinical usefulness.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The precision, recall, IoU, and Dice coefficients were 0.70, 0.59, 0.46, and 0.61, respectively. Regarding sensitivity, the average score for pancreas recognition by AI was 4.18 out of 5 points (1 = lowest recognition [less than 50%]; 5 = highest recognition [more than 90%]). Regarding similarity, only 54% of the AI-inferred images were correctly differentiated from the ground truth.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Our surgical AI system precisely highlighted the pancreas during robot-assisted gastrectomy at a level that was convincing to surgeons. This technology may prevent misrecognition of the pancreas by surgeons, thus leading to fewer POPFs.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":"31 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140577833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global burden of young-onset gastric cancer: a systematic trend analysis of the global burden of disease study 2019 年轻胃癌的全球负担:2019 年全球疾病负担研究的系统趋势分析
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-04-03 DOI: 10.1007/s10120-024-01494-6
Yunhao Li, Anne I. Hahn, Monika Laszkowska, Fang Jiang, Ann G. Zauber, Wai K. Leung

Background

While gastric cancer is generally declining globally, the temporal trend of young-onset (< 40 years) gastric cancer remains uncertain. We performed this analysis to determine the temporal trends of young-onset gastric cancer compared to late-onset cancer (≥ 40 years).

Methods

We extracted cross-sectional data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The burden of gastric cancer from 1990 to 2019 was assessed through indicators including incidence and mortality rates, which were classified at global, national, and regional levels, and according to socio-demographic indexes (SDI) and age or sex groups. Joinpoint regression analysis was used to identify specific years with significant changes. The correlation between AAPC with countries' average SDI was tested by Pearson’s Test.

Results

The global incidence rate of young-onset gastric cancer decreased from 2.20 (per 100,000) in 1990 to 1.65 in 2019 (AAPC: − 0.95; 95% confidence interval [CI] − 1.25 to − 0.65; P < 0.001). Late-onset cancer incidence also decreased from 59.53 (per 100,000) in 1990 to 41.26 in 2019 (AAPC: − 1.23; 95% CI − 1.39 to − 1.06, P < 0.001). Despite an overall decreasing trend, the incidence rate of young-onset cancer demonstrated a significant increase from 2015 to 2019 (annual percentage change [APC]: 1.39; 95% CI 0.06 to 2.74; P = 0.041), whereas no upward trend was observed in late-onset cancer. Mortality rates of young- and late-onset cancer both exhibited a significant decline during this period (AAPC: − 1.82; 95% CI − 2.15 to − 1.56; P < 0.001 and AAPC: − 1.69, 95% CI − 1.79 to − 1.59; P < 0.001). The male-to-female rate ratio for incidence and mortality in both age groups have been increasing since 1990. While countries with high SDI have had a greater decline in the incidence of late-onset gastric cancer (slope of AAPC change: − 0.20, P = 0.004), it was not observed in young-onset cancer (slope of AAPC change: − 0.11, P = 0.13).

Conclusions

The global incidence and mortality rates of both young- and late-onset gastric cancer have decreased since 1990. However, the incidence rate of young-onset cancer has demonstrated a small but significant upward trend since 2015. There was disparity in the decline in young-onset gastric cancer among male and high SDI countries. These findings could help to inform future strategies in preventing gastric cancer in younger individuals.

背景虽然胃癌在全球范围内普遍呈下降趋势,但年轻发病者(40 岁以下)胃癌的时间趋势仍不确定。方法我们从《2019 年全球疾病、伤害和风险因素负担研究》(GBD)中提取了横断面数据。通过包括发病率和死亡率在内的指标评估了1990年至2019年的胃癌负担,这些指标按照社会人口指数(SDI)和年龄或性别组进行了全球、国家和地区层面的分类。连接点回归分析用于确定有显著变化的具体年份。结果全球年轻胃癌发病率从 1990 年的 2.20(每 10 万人)下降到 2019 年的 1.65(AAPC:- 0.95;95% 置信区间 [CI] - 1.25 至 - 0.65;P < 0.001)。晚期癌症发病率也从 1990 年的 59.53(每 10 万人)下降到 2019 年的 41.26(美国癌症协会:- 1.23;95% 置信区间 [CI] - 1.39 至 - 1.06;P <;0.001)。尽管总体呈下降趋势,但从 2015 年到 2019 年,年轻发病癌症的发病率显著上升(年度百分比变化 [APC]:1.39;95% CI 0.06 至 2.74;P = 0.041),而晚期发病癌症的发病率没有观察到上升趋势。在此期间,年轻癌症患者和晚期癌症患者的死亡率均出现了显著下降(AAPC:1.82;95% CI:0.06 至 2.74;P = 0.041):- 1.82; 95% CI - 2.15 to - 1.56; P < 0.001 和 AAPC:- 1.69,95% CI - 1.79 至 - 1.59;P <0.001)。自 1990 年以来,这两个年龄组的发病率和死亡率的男女比例一直在上升。虽然 SDI 高的国家晚发胃癌的发病率下降幅度更大(AAPC 变化斜率:- 0.20,P = 0.004),但在年轻发病者中却没有观察到这种情况(AAPC 变化斜率:- 0.11,P = 0.13)。然而,自 2015 年以来,年轻胃癌的发病率出现了小幅但显著的上升趋势。在男性和高SDI国家中,年轻胃癌发病率的下降存在差异。这些发现有助于为今后预防年轻人患胃癌的战略提供参考。
{"title":"Global burden of young-onset gastric cancer: a systematic trend analysis of the global burden of disease study 2019","authors":"Yunhao Li, Anne I. Hahn, Monika Laszkowska, Fang Jiang, Ann G. Zauber, Wai K. Leung","doi":"10.1007/s10120-024-01494-6","DOIUrl":"https://doi.org/10.1007/s10120-024-01494-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>While gastric cancer is generally declining globally, the temporal trend of young-onset (&lt; 40 years) gastric cancer remains uncertain. We performed this analysis to determine the temporal trends of young-onset gastric cancer compared to late-onset cancer (≥ 40 years).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We extracted cross-sectional data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The burden of gastric cancer from 1990 to 2019 was assessed through indicators including incidence and mortality rates, which were classified at global, national, and regional levels, and according to socio-demographic indexes (SDI) and age or sex groups. Joinpoint regression analysis was used to identify specific years with significant changes. The correlation between AAPC with countries' average SDI was tested by Pearson’s Test.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The global incidence rate of young-onset gastric cancer decreased from 2.20 (per 100,000) in 1990 to 1.65 in 2019 (AAPC: − 0.95; 95% confidence interval [CI] − 1.25 to − 0.65; <i>P</i> &lt; 0.001). Late-onset cancer incidence also decreased from 59.53 (per 100,000) in 1990 to 41.26 in 2019 (AAPC: − 1.23; 95% CI − 1.39 to − 1.06, <i>P</i> &lt; 0.001). Despite an overall decreasing trend, the incidence rate of young-onset cancer demonstrated a significant increase from 2015 to 2019 (annual percentage change [APC]: 1.39; 95% CI 0.06 to 2.74; <i>P</i> = 0.041), whereas no upward trend was observed in late-onset cancer. Mortality rates of young- and late-onset cancer both exhibited a significant decline during this period (AAPC: − 1.82; 95% CI − 2.15 to − 1.56; <i>P</i> &lt; 0.001 and AAPC: − 1.69, 95% CI − 1.79 to − 1.59; P &lt; 0.001). The male-to-female rate ratio for incidence and mortality in both age groups have been increasing since 1990. While countries with high SDI have had a greater decline in the incidence of late-onset gastric cancer (slope of AAPC change: − 0.20, P = 0.004), it was not observed in young-onset cancer (slope of AAPC change: − 0.11, P = 0.13).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The global incidence and mortality rates of both young- and late-onset gastric cancer have decreased since 1990. However, the incidence rate of young-onset cancer has demonstrated a small but significant upward trend since 2015. There was disparity in the decline in young-onset gastric cancer among male and high SDI countries. These findings could help to inform future strategies in preventing gastric cancer in younger individuals.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":"264 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140578104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Superior lymph node harvest by fluorescent lymphography during minimally invasive gastrectomy for gastric cancer patients with high body mass index 在对体重指数较高的胃癌患者进行微创胃切除术时,通过荧光淋巴造影术采集优质淋巴结
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-19 DOI: 10.1007/s10120-024-01482-w
Ki-Yoon Kim, Jawon Hwang, Sung Hyun Park, Minah Cho, Yoo Min Kim, Hyoung-Il Kim, Woo Jin Hyung

Background

Fluorescent lymphography (FL) using indocyanine green (ICG) allows for the visualization of all draining lymph nodes (LNs), thereby increasing LN retrieval. However, no studies have assessed the efficacy of FL in high body mass index (BMI) gastric cancer patients, even as LN yield decreases with increasing BMI in gastrectomy. This study aimed to investigate the influence of FL on LN retrieval in high BMI gastric cancer patients.

Methods

Gastric cancer patients who underwent laparoscopic or robotic gastrectomies from 2013 to 2021 were included. Patients were classified into two groups, with FL (FL group) or without FL (non-FL group). The effect of FL on LN retrieval was assessed by BMI. Inverse probability of treatment weighting (IPTW) was used to ensure comparability between groups.

Results

Retrieved LN number decreased as BMI increased regardless of FL application (P < 0.001). According to the IPTW analysis, the mean retrieved LN number was significantly higher in the FL group (48.4 ± 18.5) than in the non-FL group (39.8 ± 16.3, P < 0.001), irrespective of BMI. The FL group exhibited a significantly higher proportion of patients with 16 or more LNs (99.5%) than the non-FL group (98.1%, P < 0.001). The FL group also had a significantly higher proportion of patients with 30 or more LNs (86.6%) than the non-FL group (72.2%, P < 0.001). In both the normal and high-BMI patients, the FL group had a significantly larger percentage of patients with a higher nodal classification than the non-FL group.

Conclusion

FL resulted in more LN retrieval, even in high BMI patients. FL ensures accurate staging by maintaining the appropriate retrieved LN number in high BMI gastric cancer patients.

背景使用吲哚菁绿(ICG)进行荧光淋巴造影(FL)可显示所有引流淋巴结(LN),从而提高 LN 检出率。然而,还没有研究评估过荧光淋巴造影对高体重指数(BMI)胃癌患者的疗效,即使在胃切除术中随着体重指数(BMI)的增加,淋巴结检出率也会降低。本研究旨在探讨FL对高体重指数胃癌患者LN取材率的影响。方法纳入2013年至2021年期间接受腹腔镜或机器人胃切除术的胃癌患者。患者被分为两组,有FL(FL组)和无FL(非FL组)。通过BMI评估FL对LN取材的影响。结果无论是否应用 FL,随着 BMI 的增加,检索到的 LN 数量减少(P <0.001)。根据 IPTW 分析,FL 组(48.4 ± 18.5)明显高于非 FL 组(39.8 ± 16.3,P < 0.001),与 BMI 无关。FL 组患者中有 16 个或更多 LN 的比例(99.5%)明显高于非 FL 组(98.1%,P < 0.001)。FL 组患者中 LNs 达到或超过 30 个的比例(86.6%)也明显高于非 FL 组(72.2%,P < 0.001)。在正常和高 BMI 患者中,FL 组结节分类较高的患者比例明显高于非FL 组。FL通过保持高BMI胃癌患者适当的LN检索数目,确保了准确的分期。
{"title":"Superior lymph node harvest by fluorescent lymphography during minimally invasive gastrectomy for gastric cancer patients with high body mass index","authors":"Ki-Yoon Kim, Jawon Hwang, Sung Hyun Park, Minah Cho, Yoo Min Kim, Hyoung-Il Kim, Woo Jin Hyung","doi":"10.1007/s10120-024-01482-w","DOIUrl":"https://doi.org/10.1007/s10120-024-01482-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Fluorescent lymphography (FL) using indocyanine green (ICG) allows for the visualization of all draining lymph nodes (LNs), thereby increasing LN retrieval. However, no studies have assessed the efficacy of FL in high body mass index (BMI) gastric cancer patients, even as LN yield decreases with increasing BMI in gastrectomy. This study aimed to investigate the influence of FL on LN retrieval in high BMI gastric cancer patients.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Gastric cancer patients who underwent laparoscopic or robotic gastrectomies from 2013 to 2021 were included. Patients were classified into two groups, with FL (FL group) or without FL (non-FL group). The effect of FL on LN retrieval was assessed by BMI. Inverse probability of treatment weighting (IPTW) was used to ensure comparability between groups.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Retrieved LN number decreased as BMI increased regardless of FL application (P &lt; 0.001). According to the IPTW analysis, the mean retrieved LN number was significantly higher in the FL group (48.4 ± 18.5) than in the non-FL group (39.8 ± 16.3, P &lt; 0.001), irrespective of BMI. The FL group exhibited a significantly higher proportion of patients with 16 or more LNs (99.5%) than the non-FL group (98.1%, P &lt; 0.001). The FL group also had a significantly higher proportion of patients with 30 or more LNs (86.6%) than the non-FL group (72.2%, P &lt; 0.001). In both the normal and high-BMI patients, the FL group had a significantly larger percentage of patients with a higher nodal classification than the non-FL group.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>FL resulted in more LN retrieval, even in high BMI patients. FL ensures accurate staging by maintaining the appropriate retrieved LN number in high BMI gastric cancer patients.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":"23 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140167015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704). 多西他赛、奥沙利铂和 S-1 术前化疗治疗广泛淋巴结转移的胃癌的短期疗效(JCOG1704)。
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-05 DOI: 10.1007/s10120-023-01453-7
Yukinori Kurokawa, Yuichiro Doki, Ryo Kitabayashi, Takaki Yoshikawa, Takashi Nomura, Kunihiro Tsuji, Masahiro Goto, Haruhiko Cho, Jun Hihara, Naoki Hiki, Souya Nunobe, Junki Mizusawa, Narikazu Boku, Masanori Terashima

Background: The prognosis for marginally resectable gastric cancer with extensive lymph node metastasis (ELM) remains unfavorable, even after R0 resection. To assess the safety and efficacy of preoperative docetaxel, oxaliplatin, and S-1 (DOS), we conducted a multicenter phase II trial.

Methods: Eligibility criteria included histologically proven HER2-negative gastric adenocarcinoma with bulky nodal (bulky N) involvement around major branched arteries or para-aortic node (PAN) metastases. Patients received three cycles of docetaxel (40 mg/m2, day 1), oxaliplatin (100 mg/m2, day 1), and S-1 (80-120 mg/body, days 1-14), followed by gastrectomy with D2 plus PAN dissection. Subsequently, patients underwent postoperative chemotherapy with S-1 for 1 year. The primary endpoint was major (grade ≥ 2a) pathological response rate (pRR) according to the Japanese Classification of Gastric Carcinoma criteria.

Results: Between October 2018 and March 2022, 47 patients (bulky N, 20; PAN, 17; both, 10) were enrolled in the trial. One patient was ineligible. Another declined any protocol treatments before initiation. Among the 45 eligible patients who initiated DOS chemotherapy, 44 (98%) completed 3 cycles and 42 (93%) underwent R0 resection. Major pRR and pathological complete response rates among the 46 eligible patients, including the patient who declined treatment, were 57% (26/46) and 24% (11/46), respectively. Common grade 3 or 4 toxicities were neutropenia (24%), anorexia (16%), febrile neutropenia (9%), and diarrhea (9%). No treatment-related deaths occurred.

Conclusions: Preoperative chemotherapy with DOS yielded favorable pathological responses with an acceptable toxicity profile. This multimodal approach is highly promising for treating gastric cancer with ELM.

背景:即使进行了R0切除,伴有广泛淋巴结转移(ELM)的可微切除胃癌的预后仍然不佳。为了评估术前多西他赛、奥沙利铂和 S-1(DOS)的安全性和有效性,我们开展了一项多中心 II 期试验:入选标准包括经组织学证实的HER2阴性胃腺癌,且主要分支动脉周围或主动脉旁结节(PAN)转移累及大结节(bulky N)。患者接受三个周期的多西他赛(40 毫克/平方米,第 1 天)、奥沙利铂(100 毫克/平方米,第 1 天)和 S-1(80-120 毫克/体,第 1-14 天)治疗,然后进行 D2 加 PAN 切开的胃切除术。随后,患者接受为期一年的S-1术后化疗。根据日本胃癌分类标准,主要终点为主要(≥2a级)病理反应率(pRR):2018年10月至2022年3月期间,47名患者(大块N型20人;PAN型17人;两者均为10人)入组试验。一名患者不符合条件。另一名患者在开始治疗前拒绝接受任何方案治疗。在 45 名符合条件并开始 DOS 化疗的患者中,44 人(98%)完成了 3 个周期的治疗,42 人(93%)接受了 R0 切除术。包括一名拒绝治疗的患者在内,46名符合条件的患者的主要pRR和病理完全反应率分别为57%(26/46)和24%(11/46)。常见的3级或4级毒性反应为中性粒细胞减少(24%)、厌食(16%)、发热性中性粒细胞减少(9%)和腹泻(9%)。没有发生与治疗相关的死亡病例:使用DOS进行术前化疗可获得良好的病理反应,且毒性可接受。这种多模式方法在治疗ELM胃癌方面前景广阔。
{"title":"Short-term outcomes of preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis (JCOG1704).","authors":"Yukinori Kurokawa, Yuichiro Doki, Ryo Kitabayashi, Takaki Yoshikawa, Takashi Nomura, Kunihiro Tsuji, Masahiro Goto, Haruhiko Cho, Jun Hihara, Naoki Hiki, Souya Nunobe, Junki Mizusawa, Narikazu Boku, Masanori Terashima","doi":"10.1007/s10120-023-01453-7","DOIUrl":"10.1007/s10120-023-01453-7","url":null,"abstract":"<p><strong>Background: </strong>The prognosis for marginally resectable gastric cancer with extensive lymph node metastasis (ELM) remains unfavorable, even after R0 resection. To assess the safety and efficacy of preoperative docetaxel, oxaliplatin, and S-1 (DOS), we conducted a multicenter phase II trial.</p><p><strong>Methods: </strong>Eligibility criteria included histologically proven HER2-negative gastric adenocarcinoma with bulky nodal (bulky N) involvement around major branched arteries or para-aortic node (PAN) metastases. Patients received three cycles of docetaxel (40 mg/m<sup>2</sup>, day 1), oxaliplatin (100 mg/m<sup>2</sup>, day 1), and S-1 (80-120 mg/body, days 1-14), followed by gastrectomy with D2 plus PAN dissection. Subsequently, patients underwent postoperative chemotherapy with S-1 for 1 year. The primary endpoint was major (grade ≥ 2a) pathological response rate (pRR) according to the Japanese Classification of Gastric Carcinoma criteria.</p><p><strong>Results: </strong>Between October 2018 and March 2022, 47 patients (bulky N, 20; PAN, 17; both, 10) were enrolled in the trial. One patient was ineligible. Another declined any protocol treatments before initiation. Among the 45 eligible patients who initiated DOS chemotherapy, 44 (98%) completed 3 cycles and 42 (93%) underwent R0 resection. Major pRR and pathological complete response rates among the 46 eligible patients, including the patient who declined treatment, were 57% (26/46) and 24% (11/46), respectively. Common grade 3 or 4 toxicities were neutropenia (24%), anorexia (16%), febrile neutropenia (9%), and diarrhea (9%). No treatment-related deaths occurred.</p><p><strong>Conclusions: </strong>Preoperative chemotherapy with DOS yielded favorable pathological responses with an acceptable toxicity profile. This multimodal approach is highly promising for treating gastric cancer with ELM.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"366-374"},"PeriodicalIF":7.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of contour maps on estimating the risk of gastrointestinal stromal tumor recurrence: indications for adjuvant therapy: an analysis of the Kinki GIST registry. 轮廓图对估计胃肠道间质瘤复发风险的影响:辅助治疗的适应症:近畿 GIST 登记分析。
IF 7.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-01 Epub Date: 2023-12-25 DOI: 10.1007/s10120-023-01444-8
Ryugo Teranishi, Tsuyoshi Takahashi, Shinsuke Sato, Katsunobu Sakurai, Kentaro Kishi, Hisahiro Hosogi, Takuya Nakai, Yukinori Kurokawa, Junya Fujita, Toshirou Nishida, Seiichi Hirota, Toshimasa Tsujinaka

Introduction: Contour maps enable risk classification of GIST recurrence in individual patients within 10 postoperative years. Although contour maps have been referred to in Japanese guidelines, their usefulness and role in determining indications for adjuvant therapy is still unclear in Japanese patients. The aims of this study are to investigate the validity of contour maps in Japanese patients with GIST and explore the new strategy for adjuvant therapy.

Materials and methods: A total of 1426 Japanese GIST patients who were registered to the registry by the Kinki GIST Study Group between 2003 and 2012 were analyzed. Patients who had R0 surgery without perioperative therapy were included in this study. The accuracy of contour maps was validated.

Results: Overall, 994 patients have concluded this study. Using contour maps, we validated the patients. The 5-year recurrence-free survival rates of patients within the GIST classification groups of 0-10%, 10-20%, 20-40%, 40-60%, 60-80%, 80-90%, and 90-100% were 98.1%, 96.6%, 92.3%, 48.0%, 37.3%, 41.0% and 42.4%, respectively. We confirmed that this classification by contour maps was well reflected recurrence prediction. Further, in the high-risk group stratified by the modified National Institutes of Health consensus criteria (m-NIHC), the 10-year RFS rate was remarkably changed at a cutoff of 40% (0-40% group vs. 40-100% group: 88.7% vs. 50.3%, p < 0.001).

Conclusion: Contour maps are effective in predicting individual recurrence rates. And it may be useful for the decision of individual strategy for high-risk patients combined with m-NIHC.

简介:等高线图可对个别 GIST 患者术后 10 年内的复发进行风险分类:等高线图可对个别患者术后 10 年内的 GIST 复发风险进行分类。虽然日本指南中提到了等高线图,但在日本患者中,等高线图在确定辅助治疗适应症方面的作用和用途仍不明确。本研究旨在调查等高线图在日本 GIST 患者中的有效性,并探索辅助治疗的新策略:分析了近畿 GIST 研究小组在 2003 年至 2012 年间登记在册的 1426 例日本 GIST 患者。本研究纳入了接受 R0 手术且未进行围手术期治疗的患者。结果:共有994名患者完成了这项研究。我们利用等高线图对患者进行了验证。GIST分类为0-10%、10-20%、20-40%、40-60%、60-80%、80-90%和90-100%的患者的5年无复发生存率分别为98.1%、96.6%、92.3%、48.0%、37.3%、41.0%和42.4%。我们证实,通过等高线图进行的分类能很好地反映复发预测。此外,在按美国国立卫生研究院共识标准(m-NIHC)分层的高危组中,以 40% 为分界点的 10 年 RFS 率有显著变化(0-40% 组 vs. 40-100% 组,88.7% vs. 50.4%):88.7% vs. 50.3%, p 结论:等高线图能有效预测个体复发率。它可能有助于高危患者联合 m-NIHC 制定个体化策略。
{"title":"The impact of contour maps on estimating the risk of gastrointestinal stromal tumor recurrence: indications for adjuvant therapy: an analysis of the Kinki GIST registry.","authors":"Ryugo Teranishi, Tsuyoshi Takahashi, Shinsuke Sato, Katsunobu Sakurai, Kentaro Kishi, Hisahiro Hosogi, Takuya Nakai, Yukinori Kurokawa, Junya Fujita, Toshirou Nishida, Seiichi Hirota, Toshimasa Tsujinaka","doi":"10.1007/s10120-023-01444-8","DOIUrl":"10.1007/s10120-023-01444-8","url":null,"abstract":"<p><strong>Introduction: </strong>Contour maps enable risk classification of GIST recurrence in individual patients within 10 postoperative years. Although contour maps have been referred to in Japanese guidelines, their usefulness and role in determining indications for adjuvant therapy is still unclear in Japanese patients. The aims of this study are to investigate the validity of contour maps in Japanese patients with GIST and explore the new strategy for adjuvant therapy.</p><p><strong>Materials and methods: </strong>A total of 1426 Japanese GIST patients who were registered to the registry by the Kinki GIST Study Group between 2003 and 2012 were analyzed. Patients who had R0 surgery without perioperative therapy were included in this study. The accuracy of contour maps was validated.</p><p><strong>Results: </strong>Overall, 994 patients have concluded this study. Using contour maps, we validated the patients. The 5-year recurrence-free survival rates of patients within the GIST classification groups of 0-10%, 10-20%, 20-40%, 40-60%, 60-80%, 80-90%, and 90-100% were 98.1%, 96.6%, 92.3%, 48.0%, 37.3%, 41.0% and 42.4%, respectively. We confirmed that this classification by contour maps was well reflected recurrence prediction. Further, in the high-risk group stratified by the modified National Institutes of Health consensus criteria (m-NIHC), the 10-year RFS rate was remarkably changed at a cutoff of 40% (0-40% group vs. 40-100% group: 88.7% vs. 50.3%, p < 0.001).</p><p><strong>Conclusion: </strong>Contour maps are effective in predicting individual recurrence rates. And it may be useful for the decision of individual strategy for high-risk patients combined with m-NIHC.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"355-365"},"PeriodicalIF":7.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139037581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Gastric Cancer
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