scholarly journals D2 lymphadenectomy can disseminate tumor cells into peritoneal cavity in patients with advanced gastric cancer

Neoplasma ◽  
2012 ◽  
Vol 60 (02) ◽  
pp. 174-181 ◽  
Author(s):  
X. F. YU ◽  
Z. G. REN ◽  
Y. W. XUE ◽  
H. T. SONG ◽  
Y. Z. WEI ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Tumor Cells ◽  
Peritoneal Cavity ◽  
D2 Lymphadenectomy

Laparoscopic D2 gastrectomy with complete mesogastrium excision (D2+CME) to reduce cancer leak from mesogastrium in patients with advanced gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 18-18
Author(s):  
Daxing Xie ◽  
Jianping Gong
Keyword(s):  
Gastric Cancer ◽  
Cancer Cells ◽  
Advanced Gastric Cancer ◽  
Peritoneal Cavity ◽  
Mrna Level ◽  
Tumor Resection ◽  
D2 Lymphadenectomy ◽  
Curative Surgery ◽  
Peritoneal Washing ◽  
Cea Mrna

18 Background: The mechanism underlying tumor recurrence following curative surgery remains unclear. It is believed that intraperitoneal free cancer cells leaked into peritoneal cavity during curative surgery play an important role. In gastric cancer, new strategies should be established towards preventing leakage of cancer cells from the primary tumor involved tissues. Our previous research demonstrated the existence of disseminated cancer cells in the mesogastrium, and we proposed laparoscopic D2 lymphadenectomy plus complete mesogastrium excision (D2+CME) as an optimized surgical procedure for advanced gastric cancer (AGC). By dissecting along the surgical planes and embryonic boundary of mesogastrium, D2+CME is repeatable with less blood lost and improved short-term surgical outcomes. In this study, we further evaluated the oncological effect of D2+CME based on the detection of “cancer leak”. Methods: The peritoneal washings were collected prior to and after tumor resection from 45 patients who underwent D2+CME (D2+CME group) and 46 patients who underwent conventional D2 lymphadenectomy (D2 group). RT-PCR was used to determine the presence of cancer cells. Positive samples are defined as those with CEA mRNA level over threshold (cutoff value). Results: Of 91 peritoneal washing samples obtained before gastrectomy, 84 (41 in D2+CME; 43 in D2 alone) showed no presence of cancer cell. After gastrectomy, CEA positive was detected in 17 of 43 (39.5%) samples with D2 group, however, only 5 of 41 (12.2%) samples in D2+CME group detected positive CEA. The average level of CEA expression in D2+CME group was also significant lower than that in D2 group after gastrectomy (p < 0.05). Presence of “cancer leak” was closely associated with pT stage and surgical procedures. The DFS of patients with CEA positive after gastrectomy was significantly poorer than that of patients with CEA negative (p < 0.05). Conclusions: LaparoscopicD2+CME could reduce the leakage of free cancer cells from the envelop of mesogastrium into the peritoneal cavity during radical gastrectomy, and thus, it might potentially increase the prognosis of AGC patients. Clinical trial information: NCT01978444.

scholarly journals Totally Laparoscopic Total Gastrectomy with D2 Lymphadenectomy for Advanced Gastric Cancer

2015 ◽  
Vol 06 (06) ◽  
pp. 247-254
Author(s):  
Hironobu Takano ◽  
Yuma Ebihara ◽  
Yo Kurashima ◽  
Soichi Murakami ◽  
Toshiaki Shichinohe ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Total Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Totally Laparoscopic Total Gastrectomy ◽  
Totally Laparoscopic

scholarly journals Clinical significance of phenotyping and karyotyping of circulating tumor cells in patients with advanced gastric cancer

Oncotarget ◽  
2014 ◽  
Vol 5 (16) ◽  
pp. 6594-6602 ◽  
Author(s):  
Yilin Li ◽  
Xiaotian Zhang ◽  
Sai Ge ◽  
Jing Gao ◽  
Jifang Gong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Clinical Significance

Long-Term Outcomes of Laparoscopic Distal Gastrectomy for Locally Advanced Gastric Cancer: The KLASS-02-RCT Randomized Clinical Trial

2020 ◽  
Vol 38 (28) ◽  
pp. 3304-3313 ◽  
Author(s):  
Woo Jin Hyung ◽  
Han-Kwang Yang ◽  
Young-Kyu Park ◽  
Hyuk-Joon Lee ◽  
Ji Yeong An ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Open Surgery ◽  
Distal Gastrectomy ◽  
Locally Advanced ◽  
Laparoscopic Distal Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Locally Advanced Gastric Cancer

PURPOSE It is unclear whether laparoscopic distal gastrectomy for locally advanced gastric cancer is oncologically equivalent to open distal gastrectomy. The noninferiority of laparoscopic subtotal gastrectomy with D2 lymphadenectomy for locally advanced gastric cancer compared with open surgery in terms of 3-year relapse-free survival rate was evaluated. PATIENTS AND METHODS A phase III, open-label, randomized controlled trial was conducted for patients with histologically proven locally advanced gastric adenocarcinoma suitable for distal subtotal gastrectomy. The primary end point was the 3-year relapse-free survival rate; the upper limit of the hazard ratio (HR) for noninferiority was 1.43 between the laparoscopic and open distal gastrectomy groups. RESULTS From November 2011 to April 2015, 1,050 patients were randomly assigned to laparoscopy (n = 524) or open surgery (n = 526). After exclusions, 492 patients underwent laparoscopic surgery and 482 underwent open surgery and were included in the analysis. The laparoscopy group, compared with the open surgery group, suffered fewer early complications (15.7% v 23.4%, respectively; P = .0027) and late complications (4.7% v 9.5%, respectively; P = .0038), particularly intestinal obstruction (2.0% v 4.4%, respectively; P = .0447). The 3-year relapse-free survival rate was 80.3% (95% CI, 76.0% to 85.0%) for the laparoscopy group and 81.3% (95% CI, 77.0% to 85.0%; log-rank P = .726) for the open group. Cox regression analysis after stratification by the surgeon revealed an HR of 1.035 (95% CI, 0.762 to 1.406; log-rank P = .827; P for noninferiority = .039). When stratified by pathologic stage, the HR was 1.020 (95% CI, 0.751 to 1.385; log-rank P = .900; P for noninferiority = .030). CONCLUSION Laparoscopic distal gastrectomy with D2 lymphadenectomy was comparable to open surgery in terms of relapse-free survival for patients with locally advanced gastric cancer. Laparoscopic distal gastrectomy with D2 lymphadenectomy could be a potential standard treatment option for locally advanced gastric cancer.

scholarly journals Detection and HER2 Expression of Circulating Tumor Cells in Advanced Gastric Cancer Patients

2012 ◽  
Vol 23 ◽  
pp. xi118
Author(s):  
S. Matsusaka ◽  
K. Chin ◽  
M. Ogur ◽  
E. Shinozaki ◽  
M. Suenaga ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Her2 Expression ◽  
Gastric Cancer Patients

scholarly journals Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer

1999 ◽  
Vol 2 (4) ◽  
pp. 230-234 ◽  
Author(s):  
Ichiro Uyama ◽  
Atsushi Sugioka ◽  
Junko Fujita ◽  
Akitake Hasumi ◽  
Yoshiyuki Komori ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Total Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Distal Pancreatosplenectomy

scholarly journals Prognostic Significance of Preoperative Serum Uric Acid to Lymphocyte Ratio in Advanced Gastric Cancer A Propensity Score-Matched Analysis

2021 ◽  
Author(s):  
Li Heng Liu ◽  
Shan Shan Hu ◽  
Cheng Lei Liao ◽  
ziwei wang
Keyword(s):  
Gastric Cancer ◽  
Uric Acid ◽  
Propensity Score ◽  
Advanced Gastric Cancer ◽  
Prognostic Significance ◽  
D2 Lymphadenectomy ◽  
Entire Cohort ◽  
Lymphocyte Ratio ◽  
Incidence And Mortality ◽  
High Level

Abstract Purpose: Gastric cancer ranks sixth and second in incidence and mortality among all cancer. The purpose of our research was to evaluate the prognostic value of uric acid to lymphocyte ratio (ULR) for advanced gastric cancer (AGC) patients after gastrectomy with D2 lymphadenectomy.Methods: In this research, we included 287 AGC patients underwent gastrectomy with D2 lymphadenectomy. These patients were followed up for 5 years, and their clinicopathological data were collected. All patients were divided into two groups based on the preoperative ULR level. Then we established the propensity score matching (PSM) cohort to confirm our results. Finally, The clinical characteristics and survival indexes of the two groups in the PSM cohort and the entire cohort were compared. Results：We found that age and gender were significantly correlated with the ULR level. Multivariate analysis for the entire cohort and PSM cohort showed that high levels of ULR, poor differentiation, postoperative pathology of T4 stage, and regional lymph node metastasis were independent prediction factors for poor outcomes of overall survival (OS) and Disease-free survival (DFS) in patients with AGC after gastrectomy with D2 lymphadenectomy. Survival analysis showed that the OS and DFS in the high level ULR group were significantly shorter than in the low level ULR group (log-rank P < 0.001). Conclusion: High level ULR is a poor predictive factor for patients with AGC underwent gastrectomy with D2 lymphadenectomy, and high levels of ULR predict shorter OS and DFS.

scholarly journals Application of Circulating Tumor Cells and Circulating Free DNA from Peripheral Blood in the Prognosis of Advanced Gastric Cancer

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Pengjie Yu ◽  
Shengmao Zhu ◽  
Yushuang Luo ◽  
Ganggang Li ◽  
Yongqiang Pu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Neoadjuvant Therapy ◽  
Advanced Gastric Cancer ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Peripheral Blood ◽  
Circulating Free Dna ◽  
Free Dna ◽  
N Stage

Objective. To explore the application value of circulating tumor cells (CTCs) and circulating free DNA (cfDNA) from peripheral blood in the prognosis of advanced gastric cancer (AGC). Here, we measured CTCs and cfDNA quantity for predicting the outcome of patients. Patients and Methods. Forty-five patients with advanced gastric cancer who underwent neoadjuvant chemotherapy and surgical treatment were enrolled in this study. All patients received neoadjuvant chemotherapy with paclitaxel + S-1 + oxaliplatin (PSOX) regimen, and CTCs and cfDNA of the peripheral blood were detected before and after neoadjuvant therapy. Relationships between the number/type of CTC or cfDNA and the efficacy of neoadjuvant chemotherapy were analyzed. Results. Among 45 patients, 43 (95.6%) were positive, and the positive rate of mesenchymal CTC was increased with the increase in the T stage. The proportion of mesenchymal CTC was positively correlated with the N stage ( P < 0.05 ), and the larger N stage will have the higher proportion of mesenchymal CTC. Patients with a small number of mesenchymal CTC before neoadjuvant chemotherapy were more likely to achieve partial response (PR) with neoadjuvant therapy. Patients with positive CA-199 were more likely to achieve PR with neoadjuvant therapy ( P < 0.05 ). Patients in the PR group were more likely to have decreased/unchanged cfDNA concentration after neoadjuvant therapy ( P = 0.119 ). After neoadjuvant therapy (before surgery), the cfDNA concentration was higher and the efficacy of neoadjuvant therapy (SD or PD) was lower ( P = 0.045 ). Conclusions. Peripheral blood CTC, especially interstitial CTC and cfDNA, has a certain value in predicting the efficacy and prognosis of neoadjuvant chemotherapy in advanced gastric cancer.

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