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      Frequency and clinicopathological features of metastasis to liver, lung, bone, and brain from gastric cancer: A SEER‐based study

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          Abstract

          The hematogenous metastatic pattern of gastric cancer ( GC) was not fully explored. Here we analyzed the frequency and clinicopathological features of metastasis to liver, lung, bone, and brain from GC patients. Data queried for this analysis included GC patients from the Surveillance, Epidemiology, and End Results Program database from 2010 to 2014. All of statistical analyses were performed using the Intercooled Stata 13.0 (Stata Corporation, College Station, TX). All statistical tests were two‐sided. Totally, there were 19 022 eligible patients for analysis. At the time of diagnosis, there were 7792 patients at stage IV, including 3218 (41.30%) patients with liver metastasis, 1126 (14.45%) with lung metastasis, 966 (12.40%) with bone metastasis and 151 (1.94%) with brain metastasis. GC patients with lung or liver metastasis have a higher risk of bone and brain metastasis than those without lung nor liver metastasis. Intestinal subtype had significantly higher rate of liver and lung metastasis, while diffuse type was more likely to have bone metastasis. Proximal stomach had significantly higher risk to develop metastasis than distal stomach. African‐Americans had the highest risk of liver metastasis and Caucasian had the highest prone to develop lung and brain metastasis. The median survival for patients with liver, lung, bone, and brain metastasis was 4 months, 3 months, 4 months and 3 months, respectively. It is important to evaluate the status of bone and brain metastasis in GC patients with lung or liver metastasis. Knowledge of metastatic patterns is helpful for clinicians to design personalized pretreatment imaging evaluation for GC patients.

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          Most cited references35

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          Recurrence following curative resection for gastric carcinoma.

          The diagnosis and treatment of recurrent gastric cancer remains difficult. The aim of this study was to determine the risk factors for recurrence of gastric cancer and the prognosis for these patients. Of 2328 patients who underwent curative resection for gastric cancer from 1987 to 1995, 508 whose recurrence was confirmed by clinical examination or reoperation were studied retrospectively. The risk factors that determined the recurrence patterns and timing were investigated by univariate and multivariate analysis. The mean time to recurrence was 21.8 months and peritoneal recurrence was the most frequent (45.9 per cent). Logistic regression analysis showed that serosal invasion and lymph node metastasis were risk factors for all recurrence patterns and early recurrence (at 24 months or less). In addition, independent risk factors involved in each recurrence pattern included younger age, infiltrative or diffuse type, undifferentiated tumour and total gastrectomy for peritoneal recurrence; older age and larger tumour size for disseminated, haematogenous recurrence; and older age, larger tumour size, infiltrative or diffuse type, proximally located tumour and subtotal gastrectomy for locoregional recurrence. Other risk factors for early recurrence were infiltrative or diffuse type and total gastrectomy. Reoperation for cure was possible in only 19 patients and the mean survival time after conservative treatment or palliative operation was less than 12 months. The risk factors for each recurrence pattern and timing of gastric cancer can be predicted by the clinicopathological features of the primary tumour. Since the results of treatment remain dismal, studies of perioperative adjuvant therapy in an attempt to reduce recurrence are warranted.
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            Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry

            Background The Japanese Gastric Cancer Association (JGCA) started a new nationwide gastric cancer registration in 2008. Methods From 208 participating hospitals, 53 items including surgical procedures, pathological diagnosis, and survival outcomes of 13,626 patients with primary gastric cancer treated in 2002 were collected retrospectively. Data were entered into the JGCA database according to the JGCA classification (13th edition) and UICC TNM classification (5th edition) using an electronic data collecting system. Finally, data of 13,002 patients who underwent laparotomy were analyzed. Results The 5-year follow-up rate was 83.3 %. The direct death rate was 0.48 %. UICC 5-year survival rates (5YEARSs)/JGCA 5YEARSs were 92.2 %/92.3 % for stage IA, 85.3 %/84.7 % for stage IB, 72.1 %/70.0 % for stage II, 52.8 %/46.8 % for stage IIIA, 31.0 %/28.8 % for stage IIIB, and 14.9 %/15.3 % for stage IV, respectively. The proportion of patients more than 80 years old was 7.8 %, and their 5YEARS was 51.6 %. Postoperative outcome of the patients with primary gastric carcinoma in Japan have apparently improved in advanced cases and among the aged population when compared with the archival data. Further efforts to improve the follow-up rate are needed. Conclusions Postoperative outcome of the patients with primary gastric carcinoma in Japan have apparently improved in advanced cases and among the aged population when compared with the archival data. Further efforts to improve the follow-up rate are needed.
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              Brain metastases in adenocarcinoma of the lung: frequency, risk groups, and prognosis.

              A consecutive group of 259 patients with inoperable adenocarcinoma of the lung (ACL) were observed to define risk groups for and frequency of brain metastases together with prognosis. All patients received chemotherapy in a three-armed randomized trial. Brain metastases were diagnosed in 25 patients before protocol entry and in 37 during treatment. Brain autopsy was performed in 87 patients and was positive in 38 (44%). Eleven of these (29%) were not diagnosed clinically. Patients younger than 60 years had a somewhat higher overall frequency of brain metastases than older patients. Patients with initial performance status above 60% and patients responding to chemotherapy had higher risk for developing brain metastasis during treatment than other patients, probably because of the increasing cumulated risk for this complication with prolonged survival. Median survival after onset of brain metastases was 73 days and survival was significantly shorter for these patients than for patients without this complication at days 0, 90, 180, and 365 after protocol entry. Thus, brain metastases is a frequent complication in ACL and the frequency increases with prolonged survival. Survival after development of brain metastases is short and it is questionable whether the inclusion of this subgroup of ACL patients into experimental cytostatic treatments is justified.
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                Author and article information

                Contributors
                yangdj@sysucc.org.cn
                xurh@sysucc.org.cn
                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                09 July 2018
                August 2018
                : 7
                : 8 ( doiID: 10.1002/cam4.2018.7.issue-8 )
                : 3662-3672
                Affiliations
                [ 1 ] Department of Medical Oncology State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Sun Yat‐Sen University Cancer Center Guangzhou China
                [ 2 ] Department of Nursing State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Sun Yat‐Sen University Cancer Center Guangzhou China
                [ 3 ] Department of Experimental Research State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Sun Yat‐Sen University Cancer Center Guangzhou China
                [ 4 ] Department of Gastric Surgery State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Sun Yat‐Sen University Cancer Center Guangzhou China
                Author notes
                [*] [* ] Correspondence: Da‐Jun Yang, Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat‐Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China ( yangdj@ 123456sysucc.org.cn ). andRui‐Hua Xu, Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat‐Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China ( xurh@ 123456sysucc.org.cn ).
                Author information
                http://orcid.org/0000-0002-4774-6235
                http://orcid.org/0000-0002-5710-9096
                http://orcid.org/0000-0003-1338-1220
                http://orcid.org/0000-0001-9771-8534
                Article
                CAM41661
                10.1002/cam4.1661
                6089142
                29984918
                ed4d7444-ad51-4cd9-86cc-32b7538b9005
                © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 February 2018
                : 05 June 2018
                : 15 June 2018
                Page count
                Figures: 2, Tables: 3, Pages: 11, Words: 7181
                Funding
                Funded by: National Natural Science Foundation of China
                Award ID: 81602066
                Award ID: 81772587
                Funded by: Natural Science Foundation of Guangdong Province
                Award ID: 2014A030312015
                Funded by: Science and Technology Program of Guangdong
                Award ID: 2015B020232008
                Funded by: Fundamental Research Funds for the Central Universities
                Award ID: 16ykpy25
                Funded by: Science and Technology Program of Guangzhou
                Award ID: 15570006
                Award ID: 201508020250
                Award ID: 201604020003
                Funded by: Science and Technology Planning Project of Guangzhou, China
                Award ID: 201510161726583
                Categories
                Original Research
                Clinical Cancer Research
                Original Research
                Custom metadata
                2.0
                cam41661
                August 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.4 mode:remove_FC converted:13.08.2018

                Oncology & Radiotherapy
                gastric cancer,metastases,seer
                Oncology & Radiotherapy
                gastric cancer, metastases, seer

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