Lymph node ratio is a critical prognostic predictor in gastric cancer treated with S-1 chemotherapy
Background S-1 is an oral anticancer drug widely used in postoperative adjuvant therapy for patients in Japan with stage II/III gastric cancer. Candidates for more intense adjuvant treatments need to be identified, particularly among patients with stage III cancer. Methods Univariate and multivariat...
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| Veröffentlicht in: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2014, Vol.17 (1), p.67-75 |
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| creator | Ema, Akira Yamashita, Keishi Sakuramoto, Shinich Wang, Guoqin Mieno, Hiroaki Nemoto, Masayuki Shibata, Tomotaka Katada, Natsuya Kikuchi, Shiro Watanabe, Masahiko |
| description | Background
S-1 is an oral anticancer drug widely used in postoperative adjuvant therapy for patients in Japan with stage II/III gastric cancer. Candidates for more intense adjuvant treatments need to be identified, particularly among patients with stage III cancer.
Methods
Univariate and multivariate analyses were conducted for patients with stage II/III gastric cancer who underwent surgery and received S-1 postoperatively between 2000 and 2010.
Results
Factors indicating poor prognosis identified by univariate analysis include male sex (
P
= 0.022), age ≥67 years (
P
= 0.021), intestinal-type histology (
P
= 0.049), lymph node ratio ≥16.7 % (
P
|
| doi_str_mv | 10.1007/s10120-013-0253-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1469979823</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3162594711</sourcerecordid><originalsourceid>FETCH-LOGICAL-c396t-58d802fe97d5ddaf4b55c5d14bd03656503c107fff5c631a65c3ff3df97e2e3e3</originalsourceid><addsrcrecordid>eNp1kM1PwyAYxonRuDn9A7wYEs8olNKWo1n8SpZ4UM-EwcvaZW0nsJj-97J0M148vR88z_OSH0LXjN4xSsv7wCjLKKGME5oJToYTNGU5LwjnVJwe-0yyCboIYU0pE5IV52iS8SqZeDlFZjG02xp3vQXsdWx63ASssfFNbIze4K3vV10f0pBasI2JvcdNh1c6RJ-WRncGPI4edASLv5tY43fCsKmh7WMNXm-HS3Tm9CbA1aHO0OfT48f8hSzenl_nDwtiuCwiEZWtaOZAllZYq12-FMIIy_KlpbwQhaDcMFo654QpONOFMNw5bp0sIQMOfIZux9z06a8dhKjW_c536aRieSFlKauMJxUbVcb3IXhwauubVvtBMar2WNWIVSVCao9VDclzc0jeLVuwv44jxyTIRkFIT90K_J_T_6b-ALMYg9M</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1469979823</pqid></control><display><type>article</type><title>Lymph node ratio is a critical prognostic predictor in gastric cancer treated with S-1 chemotherapy</title><source>MEDLINE</source><source>Springer Journals</source><source>EZB Electronic Journals Library</source><creator>Ema, Akira ; Yamashita, Keishi ; Sakuramoto, Shinich ; Wang, Guoqin ; Mieno, Hiroaki ; Nemoto, Masayuki ; Shibata, Tomotaka ; Katada, Natsuya ; Kikuchi, Shiro ; Watanabe, Masahiko</creator><creatorcontrib>Ema, Akira ; Yamashita, Keishi ; Sakuramoto, Shinich ; Wang, Guoqin ; Mieno, Hiroaki ; Nemoto, Masayuki ; Shibata, Tomotaka ; Katada, Natsuya ; Kikuchi, Shiro ; Watanabe, Masahiko</creatorcontrib><description>Background
S-1 is an oral anticancer drug widely used in postoperative adjuvant therapy for patients in Japan with stage II/III gastric cancer. Candidates for more intense adjuvant treatments need to be identified, particularly among patients with stage III cancer.
Methods
Univariate and multivariate analyses were conducted for patients with stage II/III gastric cancer who underwent surgery and received S-1 postoperatively between 2000 and 2010.
Results
Factors indicating poor prognosis identified by univariate analysis include male sex (
P
= 0.022), age ≥67 years (
P
= 0.021), intestinal-type histology (
P
= 0.049), lymph node ratio ≥16.7 % (
P
< 0.0001), open surgery (
P
= 0.039), as well as the 13th JGCA stage (
P
< 0.0001) and the 14th JGCA/7th International Union Against Cancer (UICC) stage (
P
< 0.0001). Multivariate analysis revealed that lymph node ratio ≥16.7 % and intestinal-type histology were significant as predictors of prognosis, independent from the pathological stages. Based on these and other findings, stage IIIC cancer on the 14th JGCA/7th UICC stage system in combination with the lymph node ratio could identify patients with extremely high risk for recurrence
Conclusions
Our current findings suggest that lymph node ratio ≥16.7 % in combination with the new staging system could be a useful prognostic indicator in advanced gastric cancer. Because these high-risk patients cannot be identified preoperatively by any diagnostic tool, further improvement in postoperative adjuvant therapy is warranted.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-013-0253-y</identifier><identifier>PMID: 23801337</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Abdominal Surgery ; Adenocarcinoma - drug therapy ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Aged ; Cancer Research ; Chemotherapy, Adjuvant ; Drug Combinations ; Female ; Gastric cancer ; Gastroenterology ; Humans ; Japan ; Lymph Node Excision ; Lymph Nodes - pathology ; Lymphatic Metastasis - pathology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Oncology ; Original Article ; Oxonic Acid - therapeutic use ; Prognosis ; Stomach Neoplasms - drug therapy ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgical Oncology ; Tegafur - therapeutic use ; Treatment Outcome</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2014, Vol.17 (1), p.67-75</ispartof><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2013</rights><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-58d802fe97d5ddaf4b55c5d14bd03656503c107fff5c631a65c3ff3df97e2e3e3</citedby><cites>FETCH-LOGICAL-c396t-58d802fe97d5ddaf4b55c5d14bd03656503c107fff5c631a65c3ff3df97e2e3e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-013-0253-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-013-0253-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23801337$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ema, Akira</creatorcontrib><creatorcontrib>Yamashita, Keishi</creatorcontrib><creatorcontrib>Sakuramoto, Shinich</creatorcontrib><creatorcontrib>Wang, Guoqin</creatorcontrib><creatorcontrib>Mieno, Hiroaki</creatorcontrib><creatorcontrib>Nemoto, Masayuki</creatorcontrib><creatorcontrib>Shibata, Tomotaka</creatorcontrib><creatorcontrib>Katada, Natsuya</creatorcontrib><creatorcontrib>Kikuchi, Shiro</creatorcontrib><creatorcontrib>Watanabe, Masahiko</creatorcontrib><title>Lymph node ratio is a critical prognostic predictor in gastric cancer treated with S-1 chemotherapy</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><description>Background
S-1 is an oral anticancer drug widely used in postoperative adjuvant therapy for patients in Japan with stage II/III gastric cancer. Candidates for more intense adjuvant treatments need to be identified, particularly among patients with stage III cancer.
Methods
Univariate and multivariate analyses were conducted for patients with stage II/III gastric cancer who underwent surgery and received S-1 postoperatively between 2000 and 2010.
Results
Factors indicating poor prognosis identified by univariate analysis include male sex (
P
= 0.022), age ≥67 years (
P
= 0.021), intestinal-type histology (
P
= 0.049), lymph node ratio ≥16.7 % (
P
< 0.0001), open surgery (
P
= 0.039), as well as the 13th JGCA stage (
P
< 0.0001) and the 14th JGCA/7th International Union Against Cancer (UICC) stage (
P
< 0.0001). Multivariate analysis revealed that lymph node ratio ≥16.7 % and intestinal-type histology were significant as predictors of prognosis, independent from the pathological stages. Based on these and other findings, stage IIIC cancer on the 14th JGCA/7th UICC stage system in combination with the lymph node ratio could identify patients with extremely high risk for recurrence
Conclusions
Our current findings suggest that lymph node ratio ≥16.7 % in combination with the new staging system could be a useful prognostic indicator in advanced gastric cancer. Because these high-risk patients cannot be identified preoperatively by any diagnostic tool, further improvement in postoperative adjuvant therapy is warranted.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Aged</subject><subject>Cancer Research</subject><subject>Chemotherapy, Adjuvant</subject><subject>Drug Combinations</subject><subject>Female</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Japan</subject><subject>Lymph Node Excision</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Oxonic Acid - therapeutic use</subject><subject>Prognosis</subject><subject>Stomach Neoplasms - drug therapy</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgical Oncology</subject><subject>Tegafur - therapeutic use</subject><subject>Treatment Outcome</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kM1PwyAYxonRuDn9A7wYEs8olNKWo1n8SpZ4UM-EwcvaZW0nsJj-97J0M148vR88z_OSH0LXjN4xSsv7wCjLKKGME5oJToYTNGU5LwjnVJwe-0yyCboIYU0pE5IV52iS8SqZeDlFZjG02xp3vQXsdWx63ASssfFNbIze4K3vV10f0pBasI2JvcdNh1c6RJ-WRncGPI4edASLv5tY43fCsKmh7WMNXm-HS3Tm9CbA1aHO0OfT48f8hSzenl_nDwtiuCwiEZWtaOZAllZYq12-FMIIy_KlpbwQhaDcMFo654QpONOFMNw5bp0sIQMOfIZux9z06a8dhKjW_c536aRieSFlKauMJxUbVcb3IXhwauubVvtBMar2WNWIVSVCao9VDclzc0jeLVuwv44jxyTIRkFIT90K_J_T_6b-ALMYg9M</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Ema, Akira</creator><creator>Yamashita, Keishi</creator><creator>Sakuramoto, Shinich</creator><creator>Wang, Guoqin</creator><creator>Mieno, Hiroaki</creator><creator>Nemoto, Masayuki</creator><creator>Shibata, Tomotaka</creator><creator>Katada, Natsuya</creator><creator>Kikuchi, Shiro</creator><creator>Watanabe, Masahiko</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope></search><sort><creationdate>2014</creationdate><title>Lymph node ratio is a critical prognostic predictor in gastric cancer treated with S-1 chemotherapy</title><author>Ema, Akira ; Yamashita, Keishi ; Sakuramoto, Shinich ; Wang, Guoqin ; Mieno, Hiroaki ; Nemoto, Masayuki ; Shibata, Tomotaka ; Katada, Natsuya ; Kikuchi, Shiro ; Watanabe, Masahiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-58d802fe97d5ddaf4b55c5d14bd03656503c107fff5c631a65c3ff3df97e2e3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma - drug therapy</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Aged</topic><topic>Cancer Research</topic><topic>Chemotherapy, Adjuvant</topic><topic>Drug Combinations</topic><topic>Female</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Japan</topic><topic>Lymph Node Excision</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Oxonic Acid - therapeutic use</topic><topic>Prognosis</topic><topic>Stomach Neoplasms - drug therapy</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgical Oncology</topic><topic>Tegafur - therapeutic use</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ema, Akira</creatorcontrib><creatorcontrib>Yamashita, Keishi</creatorcontrib><creatorcontrib>Sakuramoto, Shinich</creatorcontrib><creatorcontrib>Wang, Guoqin</creatorcontrib><creatorcontrib>Mieno, Hiroaki</creatorcontrib><creatorcontrib>Nemoto, Masayuki</creatorcontrib><creatorcontrib>Shibata, Tomotaka</creatorcontrib><creatorcontrib>Katada, Natsuya</creatorcontrib><creatorcontrib>Kikuchi, Shiro</creatorcontrib><creatorcontrib>Watanabe, Masahiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ema, Akira</au><au>Yamashita, Keishi</au><au>Sakuramoto, Shinich</au><au>Wang, Guoqin</au><au>Mieno, Hiroaki</au><au>Nemoto, Masayuki</au><au>Shibata, Tomotaka</au><au>Katada, Natsuya</au><au>Kikuchi, Shiro</au><au>Watanabe, Masahiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lymph node ratio is a critical prognostic predictor in gastric cancer treated with S-1 chemotherapy</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><addtitle>Gastric Cancer</addtitle><date>2014</date><risdate>2014</risdate><volume>17</volume><issue>1</issue><spage>67</spage><epage>75</epage><pages>67-75</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>Background
S-1 is an oral anticancer drug widely used in postoperative adjuvant therapy for patients in Japan with stage II/III gastric cancer. Candidates for more intense adjuvant treatments need to be identified, particularly among patients with stage III cancer.
Methods
Univariate and multivariate analyses were conducted for patients with stage II/III gastric cancer who underwent surgery and received S-1 postoperatively between 2000 and 2010.
Results
Factors indicating poor prognosis identified by univariate analysis include male sex (
P
= 0.022), age ≥67 years (
P
= 0.021), intestinal-type histology (
P
= 0.049), lymph node ratio ≥16.7 % (
P
< 0.0001), open surgery (
P
= 0.039), as well as the 13th JGCA stage (
P
< 0.0001) and the 14th JGCA/7th International Union Against Cancer (UICC) stage (
P
< 0.0001). Multivariate analysis revealed that lymph node ratio ≥16.7 % and intestinal-type histology were significant as predictors of prognosis, independent from the pathological stages. Based on these and other findings, stage IIIC cancer on the 14th JGCA/7th UICC stage system in combination with the lymph node ratio could identify patients with extremely high risk for recurrence
Conclusions
Our current findings suggest that lymph node ratio ≥16.7 % in combination with the new staging system could be a useful prognostic indicator in advanced gastric cancer. Because these high-risk patients cannot be identified preoperatively by any diagnostic tool, further improvement in postoperative adjuvant therapy is warranted.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>23801337</pmid><doi>10.1007/s10120-013-0253-y</doi><tpages>9</tpages></addata></record> |
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| identifier | ISSN: 1436-3291 |
| ispartof | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2014, Vol.17 (1), p.67-75 |
| issn | 1436-3291 1436-3305 |
| language | eng |
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| subjects | Abdominal Surgery Adenocarcinoma - drug therapy Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Aged Cancer Research Chemotherapy, Adjuvant Drug Combinations Female Gastric cancer Gastroenterology Humans Japan Lymph Node Excision Lymph Nodes - pathology Lymphatic Metastasis - pathology Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Neoplasm Staging Oncology Original Article Oxonic Acid - therapeutic use Prognosis Stomach Neoplasms - drug therapy Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgical Oncology Tegafur - therapeutic use Treatment Outcome |
| title | Lymph node ratio is a critical prognostic predictor in gastric cancer treated with S-1 chemotherapy |
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