https://jgc-online.org Several large-randomized trials have indicated that adjuvant chemotherapy after curative resection with D2 lymph node dissection has a significant survival benefit in Asian patients with resectable gastric cancer. Adjuvant chemotherapy in Asian patients with resectable gastric cancer is primarily supported by the results of 2 large, randomized phase 3 trials: the Adjuvant Chemotherapy Trial of TS-1 for Gastric Cancer (ACTS-GC) and the Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer (CLASSIC) [1,2]. Based on the results of these trials, both chemotherapy regimens (S-1 for 1 year or capecitabine plus oxaliplatin for 6 months) are currently accepted in East Asia as standard adjuvant chemotherapy regimens for pathological stage II or III gastric cancer after D2 gastrectomy [3,4]. However, as S-1 monotherapy has limited survival benefits in patients with stage III gastric cancer, oral fluoropyrimidine-based doublet regimens (capecitabine plus oxaliplatin [XELOX], S-1 plus oxaliplatin [SOX], or S-1 plus docetaxel) are recommended as adjuvant chemotherapy for these patients [2-6] (Fig. 1A).
{"title":"Optimal Duration of Adjuvant Chemotherapy for Gastric Cancer: Might Less Be More?","authors":"Hye Sook Han","doi":"10.5230/jgc.2022.22.e13","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e13","url":null,"abstract":"https://jgc-online.org Several large-randomized trials have indicated that adjuvant chemotherapy after curative resection with D2 lymph node dissection has a significant survival benefit in Asian patients with resectable gastric cancer. Adjuvant chemotherapy in Asian patients with resectable gastric cancer is primarily supported by the results of 2 large, randomized phase 3 trials: the Adjuvant Chemotherapy Trial of TS-1 for Gastric Cancer (ACTS-GC) and the Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer (CLASSIC) [1,2]. Based on the results of these trials, both chemotherapy regimens (S-1 for 1 year or capecitabine plus oxaliplatin for 6 months) are currently accepted in East Asia as standard adjuvant chemotherapy regimens for pathological stage II or III gastric cancer after D2 gastrectomy [3,4]. However, as S-1 monotherapy has limited survival benefits in patients with stage III gastric cancer, oral fluoropyrimidine-based doublet regimens (capecitabine plus oxaliplatin [XELOX], S-1 plus oxaliplatin [SOX], or S-1 plus docetaxel) are recommended as adjuvant chemotherapy for these patients [2-6] (Fig. 1A).","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72421500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khalid Alzahrani, Ji-Hyeon Park, H. Lee, S. Park, Jong-Ho Choi, Chaojie Wang, Fadhel Alzahrani, Y. Suh, S. Kong, D. Park, Han-Kwang Yang
Purpose This study aimed to compare the surgical and oncological outcomes between totally laparoscopic pylorus-preserving gastrectomy (TLPPG) with intracorporeal anastomosis and laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) with extracorporeal anastomosis. Materials and Methods A retrospective analysis was performed in 258 patients with cT1N0 gastric cancer who underwent laparoscopic pylorus-preserving gastrectomy using two different anastomosis methods: TLPPG with intracorporeal anastomosis (n=88) and LAPPG with extracorporeal anastomosis (n=170). The following variables were compared between the two groups to assess the postoperative surgical and oncological outcomes: proximal and distal margins, number of resected lymph nodes (LNs) in total and in LN station 6, operation time, postoperative hospital stay, and postoperative morbidity including delayed gastric emptying (DGE). Results The average length of the proximal margin was similar between the TLPPG and LAPPG groups (2.35 vs. 2.73 cm, P=0.070). Although the distal margin was significantly shorter in the TLPPG group than in the LAPPG group (3.15 vs. 4.08 cm, P=0.001), no proximal or distal resection margin-positive cases were reported in either group. The average number of resected LN was similar in both groups (36.0 vs. 33.98, P=0.229; LN station 6, 5.72 vs. 5.33, P=0.399). The operation time was shorter in the TLPPG group than in the LAPPG (200.17 vs. 220.80 minutes, P=0.001). No significant differences were observed between the two groups in terms of postoperative hospital stay (9.38 vs. 10.10 days, P=0.426) and surgical complication rate (19.3% vs. 22.9%), including DGE (8.0% vs. 11.8%, P=0.343). Conclusions The oncological safety and postoperative complications of TLPPG with intracorporeal anastomosis are similar to those of LAPPG with extracorporeal anastomosis.
目的比较全腹腔镜保幽门胃切除术(TLPPG)与腹腔镜辅助保幽门胃切除术(LAPPG)联合体外吻合的手术及肿瘤预后。材料与方法回顾性分析258例cT1N0型胃癌行腹腔镜保幽门胃切除术的患者，采用TLPPG +体内吻合(n=88)和LAPPG +体外吻合(n=170)两种不同的吻合方式。比较两组之间的以下变量以评估术后手术和肿瘤预后:近端和远端边缘、总淋巴结和淋巴结6站切除淋巴结(LNs)数量、手术时间、术后住院时间和术后发病率，包括胃排空延迟(DGE)。结果TLPPG组和LAPPG组近端切缘平均长度相近(2.35 vs. 2.73 cm, P=0.070)。虽然TLPPG组远端切缘明显短于LAPPG组(3.15 cm vs 4.08 cm, P=0.001)，但两组均未报告近端或远端切缘阳性病例。两组平均LN切除数相似(36.0 vs. 33.98, P=0.229;LN站6 (5.72 vs. 5.33, P=0.399)。TLPPG组手术时间短于LAPPG组(200.17 vs. 220.80 min, P=0.001)。两组患者术后住院时间(9.38天vs. 10.10天，P=0.426)、手术并发症发生率(19.3% vs. 22.9%)，其中DGE发生率(8.0% vs. 11.8%， P=0.343)差异无统计学意义。结论TLPPG联合体外吻合与TLPPG联合体外吻合的肿瘤安全性及术后并发症相似。
{"title":"Short-term Outcomes of Pylorus-Preserving Gastrectomy for Early Gastric Cancer: Comparison Between Extracorporeal and Intracorporeal Gastrogastrostomy","authors":"Khalid Alzahrani, Ji-Hyeon Park, H. Lee, S. Park, Jong-Ho Choi, Chaojie Wang, Fadhel Alzahrani, Y. Suh, S. Kong, D. Park, Han-Kwang Yang","doi":"10.5230/jgc.2022.22.e16","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e16","url":null,"abstract":"Purpose This study aimed to compare the surgical and oncological outcomes between totally laparoscopic pylorus-preserving gastrectomy (TLPPG) with intracorporeal anastomosis and laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) with extracorporeal anastomosis. Materials and Methods A retrospective analysis was performed in 258 patients with cT1N0 gastric cancer who underwent laparoscopic pylorus-preserving gastrectomy using two different anastomosis methods: TLPPG with intracorporeal anastomosis (n=88) and LAPPG with extracorporeal anastomosis (n=170). The following variables were compared between the two groups to assess the postoperative surgical and oncological outcomes: proximal and distal margins, number of resected lymph nodes (LNs) in total and in LN station 6, operation time, postoperative hospital stay, and postoperative morbidity including delayed gastric emptying (DGE). Results The average length of the proximal margin was similar between the TLPPG and LAPPG groups (2.35 vs. 2.73 cm, P=0.070). Although the distal margin was significantly shorter in the TLPPG group than in the LAPPG group (3.15 vs. 4.08 cm, P=0.001), no proximal or distal resection margin-positive cases were reported in either group. The average number of resected LN was similar in both groups (36.0 vs. 33.98, P=0.229; LN station 6, 5.72 vs. 5.33, P=0.399). The operation time was shorter in the TLPPG group than in the LAPPG (200.17 vs. 220.80 minutes, P=0.001). No significant differences were observed between the two groups in terms of postoperative hospital stay (9.38 vs. 10.10 days, P=0.426) and surgical complication rate (19.3% vs. 22.9%), including DGE (8.0% vs. 11.8%, P=0.343). Conclusions The oncological safety and postoperative complications of TLPPG with intracorporeal anastomosis are similar to those of LAPPG with extracorporeal anastomosis.","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87923341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jae-Seok Min, Rock Bum Kim, Kyung Won Seo, Sang-Ho Jeong
Background: To analyze the short- and long-term clinical outcomes of 2 reconstruction methods after distal gastrectomy for gastric cancer.
Methods: Three keywords, "gastric neoplasm," "distal gastrectomy," and "reconstruction," were used to search PubMed. We selected only randomized controlled trial that compared the anastomosis methods. A total of 11 papers and 8 studies were included in this meta-analysis. All statistical analyses were performed using the R software.
Results: Among short-term clinical outcomes, a shorter operation time, reduced morbidity, and shorter hospital stay were found for Billroth type I (B-I) than for Roux-en-Y (RNY) reconstruction in the meta-analysis (P<0.001, P=0.048, P<0.001, respectively). When comparing Billroth type II (B-II) to RNY, the operation time was shorter for B-II than for RNY (P<0.019), but there were no differences in morbidity or length of hospital stay (P=0.500, P=0.259, respectively). Regarding long-term clinical outcomes related to reflux, there were significantly fewer incidents of reflux esophagitis, reflux gastritis, and bile reflux (P=0.035, P<0.001, P=0.019, respectively) for RNY than for B-I in the meta-analysis, but there was no difference between the 2 methods in residual food (P=0.545). When comparing B-II to RNY, there were significantly fewer incidents of reflux gastritis (P<0.001) for RNY than for B-II, but the amount of residual food and patient weight gain showed no difference.
Conclusion: B-I had the most favorable short-term outcomes, but RNY was more advantageous for long-term outcomes than for other methods. Surgeons should be aware of the advantages and disadvantages of each type of anastomosis and select the appropriate method.
{"title":"Comparison of the Clinical Outcomes of Reconstruction Methods After Distal Gastrectomy: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials.","authors":"Jae-Seok Min, Rock Bum Kim, Kyung Won Seo, Sang-Ho Jeong","doi":"10.5230/jgc.2022.22.e9","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e9","url":null,"abstract":"<p><strong>Background: </strong>To analyze the short- and long-term clinical outcomes of 2 reconstruction methods after distal gastrectomy for gastric cancer.</p><p><strong>Methods: </strong>Three keywords, \"gastric neoplasm,\" \"distal gastrectomy,\" and \"reconstruction,\" were used to search PubMed. We selected only randomized controlled trial that compared the anastomosis methods. A total of 11 papers and 8 studies were included in this meta-analysis. All statistical analyses were performed using the R software.</p><p><strong>Results: </strong>Among short-term clinical outcomes, a shorter operation time, reduced morbidity, and shorter hospital stay were found for Billroth type I (B-I) than for Roux-en-Y (RNY) reconstruction in the meta-analysis (P<0.001, P=0.048, P<0.001, respectively). When comparing Billroth type II (B-II) to RNY, the operation time was shorter for B-II than for RNY (P<0.019), but there were no differences in morbidity or length of hospital stay (P=0.500, P=0.259, respectively). Regarding long-term clinical outcomes related to reflux, there were significantly fewer incidents of reflux esophagitis, reflux gastritis, and bile reflux (P=0.035, P<0.001, P=0.019, respectively) for RNY than for B-I in the meta-analysis, but there was no difference between the 2 methods in residual food (P=0.545). When comparing B-II to RNY, there were significantly fewer incidents of reflux gastritis (P<0.001) for RNY than for B-II, but the amount of residual food and patient weight gain showed no difference.</p><p><strong>Conclusion: </strong>B-I had the most favorable short-term outcomes, but RNY was more advantageous for long-term outcomes than for other methods. Surgeons should be aware of the advantages and disadvantages of each type of anastomosis and select the appropriate method.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/25/jgc-22-83.PMC9091459.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10249360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuanyuan Yu, Zicheng Zhang, Qianhao Meng, Ke Wang, Qingwei Li, Yue Ma, Yuanfei Yao, Jie Sun, Guangyu Wang
Purpose We aimed to explore whether the prognosis of patients treated with capecitabine and oxaliplatin (XELOX) or S-1 and oxaliplatin (SOX) regimens who received fewer cycles of chemotherapy after D2 radical resection for gastric cancer (GC) would be non-inferior to that of patients who received the standard number of cycles of chemotherapy. Materials and Methods Data on patients who received XELOX or SOX chemotherapy after undergoing D2 radical resection at Harbin Medical University Cancer Hospital between January 2011 and May 2016 were collected. Results In patients who received 4, 6, and 8 cycles of chemotherapy, the 5-year overall survival (OS) rates were 59.4%, 64.8%, and 62.7%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (hazard ratio [HR], 0.882; 95% confidence interval [CI], 0.599–1.299; P=0.52) or 8 cycles (HR, 0.882; 95% CI, 0.533–1.458; P=0.62) of chemotherapy did not exhibit significantly prolonged OS. The 3-year disease-free survival (DFS) rate of patients who received 4, 6, and 8 cycles of chemotherapy was 62.1%, 67.2%, and 60.8%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (HR, 0.835; 95% CI, 0.572–1.221; P=0.35) or 8 cycles (HR, 0.972; 95% CI, 0.606–1.558; P=0.91) of chemotherapy did not show significantly prolonged DFS. However, the 3-year DFS and 5-year OS rates of patients who received 6 cycles of chemotherapy appeared to be superior to those of patients who received 4 and 8 cycles of chemotherapy. Conclusions For patients with stage III GC, 4 to 6 cycles of XELOX or SOX chemotherapy may be a favorable option. This study provides a rationale for further randomized clinical trials.
{"title":"Efficacy of Different Number of XELOX or SOX Chemotherapy Cycles After D2 Resection for Stage III Gastric Cancer","authors":"Yuanyuan Yu, Zicheng Zhang, Qianhao Meng, Ke Wang, Qingwei Li, Yue Ma, Yuanfei Yao, Jie Sun, Guangyu Wang","doi":"10.5230/jgc.2022.22.e11","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e11","url":null,"abstract":"Purpose We aimed to explore whether the prognosis of patients treated with capecitabine and oxaliplatin (XELOX) or S-1 and oxaliplatin (SOX) regimens who received fewer cycles of chemotherapy after D2 radical resection for gastric cancer (GC) would be non-inferior to that of patients who received the standard number of cycles of chemotherapy. Materials and Methods Data on patients who received XELOX or SOX chemotherapy after undergoing D2 radical resection at Harbin Medical University Cancer Hospital between January 2011 and May 2016 were collected. Results In patients who received 4, 6, and 8 cycles of chemotherapy, the 5-year overall survival (OS) rates were 59.4%, 64.8%, and 62.7%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (hazard ratio [HR], 0.882; 95% confidence interval [CI], 0.599–1.299; P=0.52) or 8 cycles (HR, 0.882; 95% CI, 0.533–1.458; P=0.62) of chemotherapy did not exhibit significantly prolonged OS. The 3-year disease-free survival (DFS) rate of patients who received 4, 6, and 8 cycles of chemotherapy was 62.1%, 67.2%, and 60.8%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (HR, 0.835; 95% CI, 0.572–1.221; P=0.35) or 8 cycles (HR, 0.972; 95% CI, 0.606–1.558; P=0.91) of chemotherapy did not show significantly prolonged DFS. However, the 3-year DFS and 5-year OS rates of patients who received 6 cycles of chemotherapy appeared to be superior to those of patients who received 4 and 8 cycles of chemotherapy. Conclusions For patients with stage III GC, 4 to 6 cycles of XELOX or SOX chemotherapy may be a favorable option. This study provides a rationale for further randomized clinical trials.","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86930649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peng Zhou, Zi-Han Zheng, Tao Wan, Jie Wu, Chuanwen Liao, Xue Sun
This corrects the article on p. 439 in vol. 21, PMID: 35079445.
这更正了第21卷第439页的文章，PMID: 35079445。
{"title":"Erratum: Vitexin Inhibits Gastric Cancer Growth and Metastasis through HMGB1-mediated Inactivation of the PI3K/AKT/mTOR/HIF-1α Signaling Pathway","authors":"Peng Zhou, Zi-Han Zheng, Tao Wan, Jie Wu, Chuanwen Liao, Xue Sun","doi":"10.5230/jgc.2022.22.e14","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e14","url":null,"abstract":"This corrects the article on p. 439 in vol. 21, PMID: 35079445.","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76695500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kim, Jung-Bok Lee, Y. Ko, Taeyong Park, Hyeon U Jo, Jin Kyoo Jang, K. Lee, K. Kim, Inseob Lee
Purpose Weight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy. Materials and Methods In total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data. Results A larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03). Conclusions Larger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.
{"title":"Larger Remaining Stomach Volume Is Associated With Better Nutrition and Muscle Preservation in Patients With Gastric Cancer Receiving Distal Gastrectomy With Gastroduodenostomy","authors":"A. Kim, Jung-Bok Lee, Y. Ko, Taeyong Park, Hyeon U Jo, Jin Kyoo Jang, K. Lee, K. Kim, Inseob Lee","doi":"10.5230/jgc.2022.22.e15","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e15","url":null,"abstract":"Purpose Weight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy. Materials and Methods In total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data. Results A larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03). Conclusions Larger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86115853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cheng Zhang, Minmin Xie, Yi Zhang, Xiaopeng Zhang, Chong Feng, Zhijun Wu, Ying Feng, Yahui Yang, Hui Xu, Tai Ma
Purpose This study aimed to identify prognostic factors for patients with distant lymph node-involved gastric cancer (GC) using a machine learning algorithm, a method that offers considerable advantages and new prospects for high-dimensional biomedical data exploration. Materials and Methods This study employed 79 features of clinical pathology, laboratory tests, and therapeutic details from 289 GC patients whose distant lymphadenopathy was presented as the first episode of recurrence or metastasis. Outcomes were measured as any-cause death events and survival months after distant lymph node metastasis. A prediction model was built based on possible outcome predictors using a random survival forest algorithm and confirmed by 5×5 nested cross-validation. The effects of single variables were interpreted using partial dependence plots. A contour plot was used to visually represent survival prediction based on 2 predictive features. Results The median survival time of patients with GC with distant nodal metastasis was 9.2 months. The optimal model incorporated the prealbumin level and the prothrombin time (PT), and yielded a prediction error of 0.353. The inclusion of other variables resulted in poorer model performance. Patients with higher serum prealbumin levels or shorter PTs had a significantly better prognosis. The predicted one-year survival rate was stratified and illustrated as a contour plot based on the combined effect the prealbumin level and the PT. Conclusions Machine learning is useful for identifying the important determinants of cancer survival using high-dimensional datasets. The prealbumin level and the PT on distant lymph node metastasis are the 2 most crucial factors in predicting the subsequent survival time of advanced GC. Trial Registration ChiCTR Identifier: ChiCTR1800019978
{"title":"Determination of Survival of Gastric Cancer Patients With Distant Lymph Node Metastasis Using Prealbumin Level and Prothrombin Time: Contour Plots Based on Random Survival Forest Algorithm on High-Dimensionality Clinical and Laboratory Datasets","authors":"Cheng Zhang, Minmin Xie, Yi Zhang, Xiaopeng Zhang, Chong Feng, Zhijun Wu, Ying Feng, Yahui Yang, Hui Xu, Tai Ma","doi":"10.5230/jgc.2022.22.e12","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e12","url":null,"abstract":"Purpose This study aimed to identify prognostic factors for patients with distant lymph node-involved gastric cancer (GC) using a machine learning algorithm, a method that offers considerable advantages and new prospects for high-dimensional biomedical data exploration. Materials and Methods This study employed 79 features of clinical pathology, laboratory tests, and therapeutic details from 289 GC patients whose distant lymphadenopathy was presented as the first episode of recurrence or metastasis. Outcomes were measured as any-cause death events and survival months after distant lymph node metastasis. A prediction model was built based on possible outcome predictors using a random survival forest algorithm and confirmed by 5×5 nested cross-validation. The effects of single variables were interpreted using partial dependence plots. A contour plot was used to visually represent survival prediction based on 2 predictive features. Results The median survival time of patients with GC with distant nodal metastasis was 9.2 months. The optimal model incorporated the prealbumin level and the prothrombin time (PT), and yielded a prediction error of 0.353. The inclusion of other variables resulted in poorer model performance. Patients with higher serum prealbumin levels or shorter PTs had a significantly better prognosis. The predicted one-year survival rate was stratified and illustrated as a contour plot based on the combined effect the prealbumin level and the PT. Conclusions Machine learning is useful for identifying the important determinants of cancer survival using high-dimensional datasets. The prealbumin level and the PT on distant lymph node metastasis are the 2 most crucial factors in predicting the subsequent survival time of advanced GC. Trial Registration ChiCTR Identifier: ChiCTR1800019978","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86218968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sun-Hwi Hwang, D. Park, Hyung-Ho Kim, W. Hyung, H. Hur, Han-Kwang Yang, Hyuk-Joon Lee, Hyoung-il Kim, S. Kong, Young Woo Kim, H. Lee, B. Kim, Young-Kyu Park, Young-Joon Lee, Sang-Hoon Ahn, Inseob Lee, Y. Suh, Ji-Ho Park, Soyeon Ahn, Sang-Uk Han
Purpose Laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DTR) is a function-preserving procedure performed for treating upper early gastric cancer (EGC). However, few studies have compared the outcomes of LPG-DTR with those of laparoscopic total gastrectomy (LTG). This study aimed at comparing the short-term outcomes of LPG-DTR between LTG and upper EGC. Materials and Methods For upper-third EGC, a multicenter, prospective, randomized trial was performed to compare those who underwent LPG-DTR with those who underwent LTG. Short-term outcomes, including clinicopathologic results, morbidity, mortality, and postoperative courses, were evaluated using a full analysis set based on the intention-to-treat principle and the per-protocol set. Results Of the patients, 138 who fulfilled the criteria were randomized to each group. One patient in the LPG-DTR group withdrew consent. Sixty-eight patients underwent LPG-DTR and 69 underwent LTG. The operative time (LPG-DTR=219.4 minutes; LTG=201.8 minutes; P=0.085), estimated blood loss (LPG-DTR=76.0 mL; LTG=66.1 mL; P=0.413), and the morbidity rate (LPG-DTR=23.5%; LTG=17.4%; P=0.373) between the groups were not significantly different. No mortality occurred in either of the study groups. Two weeks post operation, the Visick scores for postprandial symptoms, including reflux symptoms, were not significantly different between the groups (P=0.749). Laboratory findings on postoperative day 5 were not significantly different between the groups. Conclusions The short-term outcomes of LPG-DTR for upper EGC were comparable to those of LTG. Trial Registration ClinicalTrials.gov Identifier: NCT02892643
{"title":"Short-Term Outcomes of Laparoscopic Proximal Gastrectomy With Double-Tract Reconstruction Versus Laparoscopic Total Gastrectomy for Upper Early Gastric Cancer: A KLASS 05 Randomized Clinical Trial","authors":"Sun-Hwi Hwang, D. Park, Hyung-Ho Kim, W. Hyung, H. Hur, Han-Kwang Yang, Hyuk-Joon Lee, Hyoung-il Kim, S. Kong, Young Woo Kim, H. Lee, B. Kim, Young-Kyu Park, Young-Joon Lee, Sang-Hoon Ahn, Inseob Lee, Y. Suh, Ji-Ho Park, Soyeon Ahn, Sang-Uk Han","doi":"10.5230/jgc.2022.22.e8","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e8","url":null,"abstract":"Purpose Laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DTR) is a function-preserving procedure performed for treating upper early gastric cancer (EGC). However, few studies have compared the outcomes of LPG-DTR with those of laparoscopic total gastrectomy (LTG). This study aimed at comparing the short-term outcomes of LPG-DTR between LTG and upper EGC. Materials and Methods For upper-third EGC, a multicenter, prospective, randomized trial was performed to compare those who underwent LPG-DTR with those who underwent LTG. Short-term outcomes, including clinicopathologic results, morbidity, mortality, and postoperative courses, were evaluated using a full analysis set based on the intention-to-treat principle and the per-protocol set. Results Of the patients, 138 who fulfilled the criteria were randomized to each group. One patient in the LPG-DTR group withdrew consent. Sixty-eight patients underwent LPG-DTR and 69 underwent LTG. The operative time (LPG-DTR=219.4 minutes; LTG=201.8 minutes; P=0.085), estimated blood loss (LPG-DTR=76.0 mL; LTG=66.1 mL; P=0.413), and the morbidity rate (LPG-DTR=23.5%; LTG=17.4%; P=0.373) between the groups were not significantly different. No mortality occurred in either of the study groups. Two weeks post operation, the Visick scores for postprandial symptoms, including reflux symptoms, were not significantly different between the groups (P=0.749). Laboratory findings on postoperative day 5 were not significantly different between the groups. Conclusions The short-term outcomes of LPG-DTR for upper EGC were comparable to those of LTG. Trial Registration ClinicalTrials.gov Identifier: NCT02892643","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79926901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sang Soo Eom, Wonyoung Choi, B. Eom, Sin Hye Park, S. Kim, Young Il Kim, H. Yoon, J. Lee, C. Kim, H. Kim, M. Kook, I. Choi, Young-Woo Kim, Young-iee Park, K. Ryu
Countries differ in their treatment expertise and research results regarding gastric cancer; hence, treatment guidelines are diverse based on evidence and medical situations. A comprehensive and comparative review of each country’s guidelines is imperative to understand the similarities and differences among countries. We reviewed and compared five gastric cancer treatment guidelines in terms of endoscopic, surgical, perioperative, and palliative systemic treatment based on evidence levels and recommendation grades, as well as the postoperative follow-up strategies for each guideline. The Korean, Chinese, and European guidelines provided evidence and grading of the recommendations. The United States guidelines suggested categories for evidence and consensus. The Japanese guidelines suggested evidence and recommendations only for systemic treatment. The Korean and Japanese guidelines described endoscopic treatment, surgery, and lymphadenectomy in detail. The Chinese, United States, and European guidelines more intensively considered perioperative chemotherapy. In particular, the indications for chemotherapy and the regimens recommended by each guideline differed slightly. Considering their medical situations, each guideline had some diversity in terms of adopting evidence, which resulted in heterogeneous recommendations. This review will help medical personnel to comprehensively understand the diversity in gastric cancer treatment guidelines for each country in terms of evidence and recommendations.
{"title":"A Comprehensive and Comparative Review of Global Gastric Cancer Treatment Guidelines","authors":"Sang Soo Eom, Wonyoung Choi, B. Eom, Sin Hye Park, S. Kim, Young Il Kim, H. Yoon, J. Lee, C. Kim, H. Kim, M. Kook, I. Choi, Young-Woo Kim, Young-iee Park, K. Ryu","doi":"10.5230/jgc.2022.22.e10","DOIUrl":"https://doi.org/10.5230/jgc.2022.22.e10","url":null,"abstract":"Countries differ in their treatment expertise and research results regarding gastric cancer; hence, treatment guidelines are diverse based on evidence and medical situations. A comprehensive and comparative review of each country’s guidelines is imperative to understand the similarities and differences among countries. We reviewed and compared five gastric cancer treatment guidelines in terms of endoscopic, surgical, perioperative, and palliative systemic treatment based on evidence levels and recommendation grades, as well as the postoperative follow-up strategies for each guideline. The Korean, Chinese, and European guidelines provided evidence and grading of the recommendations. The United States guidelines suggested categories for evidence and consensus. The Japanese guidelines suggested evidence and recommendations only for systemic treatment. The Korean and Japanese guidelines described endoscopic treatment, surgery, and lymphadenectomy in detail. The Chinese, United States, and European guidelines more intensively considered perioperative chemotherapy. In particular, the indications for chemotherapy and the regimens recommended by each guideline differed slightly. Considering their medical situations, each guideline had some diversity in terms of adopting evidence, which resulted in heterogeneous recommendations. This review will help medical personnel to comprehensively understand the diversity in gastric cancer treatment guidelines for each country in terms of evidence and recommendations.","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76356809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01Epub Date: 2022-03-22DOI: 10.5230/jgc.2022.22.e7
Jie-Hyun Kim
{"title":"Predicting the Bleeding Risk for Patients on Anticoagulant Therapy Prior to Gastric Endoscopic Submucosal Dissection.","authors":"Jie-Hyun Kim","doi":"10.5230/jgc.2022.22.e7","DOIUrl":"10.5230/jgc.2022.22.e7","url":null,"abstract":"","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74330677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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