Abstract:
BACKGROUND:Neoadjuvant chemotherapy has been applied worldwide to improve the survival of patients with gastric adenocarcinoma (GAC). The evaluation of histological regression in primary tumors is valuable for predicting prognosis. However, the prognostic effect of regression change in lymph nodes (LNs) remains unclear. AIM:To confirm whether the evaluation of regression change in LNs could predict the prognosis of GAC patients who received neoadjuvant chemotherapy followed by surgery. METHODS:In this study, we evaluated the histological regression of resected LNs from 192 GAC patients (including those with esophagogastric junction adenocarcinoma) treated with neoadjuvant chemotherapy. We classified regression change and residual tumor in LNs into four groups: (A) true negative LNs with no evidence of a preoperative therapy effect, (B) no residual metastasis but the presence of regression change in LNs, (C) residual metastasis with regression change in LNs, and (D) metastasis with minimal or no regression change in LNs. Correlations between regression change and residual tumor groups in LNs and regression change in the primary tumor, as well as correlations between regression change in LNs and clinicopathological characteristics, were analyzed. The prognostic effect of regression change and residual tumor groups in LNs was also analyzed. RESULTS:We found that regression change and residual tumor groups in LNs were significantly correlated with regression change in the primary tumor, tumor differentiation, ypT stage, ypN stage, ypTNM stage, lymph-vascular invasion, perineural invasion and R0 resection status. Regression change and residual tumor groups in LNs were statistically significant using univariate Cox proportional hazards analysis, but were not independent predictors. For patients who had no residual tumor in LNs, the 5-year overall survival (OS) rates were 67.5% in Group A and 67.4% in Group B. For the patients who had residual tumors in LNs, the 5-year OS rates were 28.2% in Group C and 39.5% in Group D. The patients in Groups A+B had a significantly better outcome than the patients in Groups C+D (P < 0.01). No significant differences in survival were found between Groups A and B, or between Groups C and D. CONCLUSION:The existence of residual tumor in LNs, rather than regression change in LNs, is useful for predicting the prognosis after neoadjuvant chemotherapy in GAC patients. In practice, it may not be necessary to report regression change in LNs.
journal_name
World J Gastrointest Oncoljournal_title
World journal of gastrointestinal oncologyauthors
Zhu YL,Sun YK,Xue XM,Yue JY,Yang L,Xue LYdoi
10.4251/wjgo.v11.i1.48subject
Has Abstractpub_date
2019-01-15 00:00:00pages
48-58issue
1issn
1948-5204journal_volume
11pub_type
杂志文章abstract::While the incidence and mortality of gastric cancer (GC) have declined due to public health programs, it remains the third deadliest cancer worldwide. For patients with early disease, innovative endoscopic and complex surgical techniques have improved survival. However, for patients with advanced disease, there are li...
journal_title:World journal of gastrointestinal oncology
pub_type: 杂志文章,评审
doi:10.4251/wjgo.v11.i7.509
更新日期:2019-07-15 00:00:00
abstract:BACKGROUND:Breast metastases from colorectal cancer (CRC) are very uncommon. There is no unanimous consensus regarding the best treatment for this rare condition, and management is, especially in elderly patients, limited to diagnosis and palliative care. Capecitabine, an oral fluoropyrimidine derivative, might be help...
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journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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abstract:AIM:To correct the misclassification in registered gastric cancer incidence across Iranian provinces in cancer registry data. METHODS:Gastric cancer data is extracted from Iranian annual of national cancer registration report 2008. A Bayesian method with beta prior is implemented to estimate the rate of misclassificat...
journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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更新日期:2012-04-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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更新日期:2017-12-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
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更新日期:2010-05-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
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更新日期:2019-10-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
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更新日期:2015-05-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
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更新日期:2020-10-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
pub_type: 杂志文章,评审
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更新日期:2016-02-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
pub_type: 杂志文章
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更新日期:2017-09-15 00:00:00
abstract:BACKGROUND:Pathological manifestations of hepatic tumours are often associated with prognosis. Although surgical specimens (SS) can provide more information, currently, pre-treatment needle core biopsy (NCB) is increasingly showing important value in understanding the nature of liver tumors and even in diagnosis and tr...
journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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journal_title:World journal of gastrointestinal oncology
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更新日期:2010-10-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
pub_type: 杂志文章
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更新日期:2009-10-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
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更新日期:2015-07-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
pub_type: 临床试验
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更新日期:2020-06-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
pub_type: 杂志文章
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更新日期:2019-06-15 00:00:00
abstract::Primary non-Hodgkin lymphomas in the esophagus are rare. Tracheoesophageal fistulas mainly arise from solid esophageal carcinoma or mediastinal malignancies. Our patient presented with cough, dysphagia and weight loss, and upon initial computed tomography imaging and esophagogastroduodenoscopy, a malignant mass in the...
journal_title:World journal of gastrointestinal oncology
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更新日期:2017-10-15 00:00:00
abstract::5-flurouracil (5-FU)-based chemotherapy is the main pharmacological therapy for advanced colorectal cancer (CRC). Despite significant progress in the treatment of CRC during the last decades, 5-FU drug resistance remains the most important cause of failure in CRC therapy. Resistance to 5-FU is a complex and multistep ...
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更新日期:2020-09-15 00:00:00
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journal_title:World journal of gastrointestinal oncology
pub_type: 杂志文章,评审
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更新日期:2018-12-15 00:00:00
abstract:AIM:To examine survival outcomes of perihilar cholangiocarcinoma (PCCA) resection including mortality, morbidity and prognostic factors. METHODS:Multivariate analyses were carried out based on the survival data of all patients with histologically confirmed PCCA who underwent curative resection at Srinagarind Hospital ...
journal_title:World journal of gastrointestinal oncology
pub_type: 杂志文章
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更新日期:2015-12-15 00:00:00
abstract:AIM:To investigate p16 gene methylation and its expression in 30 patients with sporadic colorectal adenocarcinoma in a North Indian population. METHODS:Methylation specific polymerase chain reaction was used to detect p16 gene methylation and immunohistochemistry was used to study the p16 expression in 30 sporadic col...
journal_title:World journal of gastrointestinal oncology
pub_type: 杂志文章
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更新日期:2010-07-15 00:00:00