Dataset Information

Chronological improvement of survival in patients with advanced gastric cancer over 15 years.

ABSTRACT:

Background

Recent trials have reported a median overall survival (OS) of 11-17 months in patients with advanced gastric cancer (AGC). However, it is unclear how recently approved drugs contribute to patient prognosis.

Objectives

We aimed to evaluate the characteristics and survival in patients with AGC over the past 15 years.

Design

Retrospective study.

Methods

We evaluated data of 1355 patients with AGC who received first-line chemotherapy between January 2005 and March 2019 at a single institution. We compared the characteristics and survival rates across four periods: January 2005-December 2007 (period A), January 2008-February 2011 (period B), March 2011-May 2015 (period C), and June 2015-March 2019 (period D). The median follow-up duration was 13.1 months, with 312, 333, 393, and 317 patients in periods A, B, C, and D, respectively.

Results

There were no significant differences in patient characteristics between the four periods, except for the proportion of patients who underwent prior gastrectomy and human epidermal growth factor receptor 2 (HER2) testing. Patients in period D had significantly longer OS than those in period A [median: 15.7 versus 12.4 months; adjusted hazard ratio (aHR): 0.79; p = 0.02]. The mean OS in patients with liver metastasis (LM) in period D was remarkably longer than that in patients in period A (median: 19.3 versus 12.4 months; aHR: 0.61; p < 0.01), while that in patients with peritoneal metastasis showed limited improvement.

Conclusion

Clinical strategy changes, including gastrectomy, HER2 testing, and approval of new drugs, may be associated with improved OS in patients with AGC. In the last 4 years, a remarkable improvement has been observed in patients with LM.

SUBMITTER: Ogata T

PROVIDER: S-EPMC10858657 | biostudies-literature | 2024

REPOSITORIES: biostudies-literature

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Publications

Chronological improvement of survival in patients with advanced gastric cancer over 15 years.

Ogata Takatsugu T Narita Yukiya Y Oze Isao I Kumanishi Ryosuke R Nakazawa Taiko T Matsubara Yuki Y Kodama Hiroyuki H Nakata Akinobu A Honda Kazunori K Masuishi Toshiki T Bando Hideaki H Taniguchi Hiroya H Kadowaki Shigenori S Ando Masashi M Ito Seiji S Tajika Masahiro M Muro Kei K

Therapeutic advances in medical oncology 20240209

<h4>Background</h4>Recent trials have reported a median overall survival (OS) of 11-17 months in patients with advanced gastric cancer (AGC). However, it is unclear how recently approved drugs contribute to patient prognosis.<h4>Objectives</h4>We aimed to evaluate the characteristics and survival in patients with AGC over the past 15 years.<h4>Design</h4>Retrospective study.<h4>Methods</h4>We evaluated data of 1355 patients with AGC who received first-line chemotherapy between January 2005 and M ...[more]

PMID: 38344409

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Project description:BackgroundSerum tumor markers including AFU, AFP, CEA, CA199, CA125 and CA724, are of great importance in the diagnosis, prognostic prediction and recurrence monitoring of gastrointestinal malignancies. However, their significance in gastric cancer (GC) patients with neoadjuvant therapy (NCT) is still uncertain. The aim of this study was to evaluate the predictive value of these six tumor markers in locally advanced GC patients who underwent NCT and curative surgery.MethodsIn total, 290 locally advanced GC patients who underwent NCT and D2 radical gastrectomy were retrospectively analyzed. Data on their tumor markers before (pre-) and after (post-) NCT and pathological characteristics were extracted from the database of our hospital. The optimal cutoff values of the six tumor markers were calculated by the ROC curve and Youden index. Their predictive significance was analyzed and survival curves for overall survival (OS) were obtained by the Kaplan-Meier method. Associations between categorical variables were explored by the chi-square test or Fisher's exact test. Multivariate analyses were performed by the Cox regression model.ResultsPre- and post-CA199, -CA125 and -CA724 could predict overall survival (all P < 0.05), but only the change (diff-) of CA199 was related to prognosis (P = 0.05). In the multivariable analysis, pre- (P = 0.014) and post-CA724 (P = 0.036) remained significant, though diff-CA724 was not an independent prognostic factor (P = 0.581). In addition, pre- and post-CA199, -CA125 and -CA724 were associated with lymph node metastasis (N- vs N+) and pathological stage (I-II vs III) (all P < 0.05). Moreover, post-CA724 was related to the vascular or lymphatic invasion (P = 0.019), while pre-CA724 was not (P = 0.082). However, AFU, AFP and CEA showed no association with survival (P > 0.05).ConclusionsCA724 is an independent factor for prognosis and could be used to predict ypN and ypTNM stage in locally advanced GC patients undergoing NCT and curative resection.

Dataset Information

Chronological improvement of survival in patients with advanced gastric cancer over 15 years.

Background

Objectives

Design

Methods

Results

Conclusion

Publications

Chronological improvement of survival in patients with advanced gastric cancer over 15 years.

Similar Datasets

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