Population-Based Outcome of Stage IA-IIA Resected Gastric Adenocarcinoma: Who Should Get Adjuvant Treatment?
Background The benefit of adjuvant treatment in gastric adenocarcinoma was demonstrated by randomized, controlled trials of patients with locally advanced tumors. Thus, its role for stage IIB-IIIC disease is widely accepted. We aimed to identify patients with stage IA-IIA gastric adenocarcinoma who...
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| Veröffentlicht in: | Annals of surgical oncology 2013-07, Vol.20 (7), p.2304-2310 |
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| container_title | Annals of surgical oncology |
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| creator | Gold, Jason S. Al Natour, Riad H. Saund, Mandeep S. Yoon, Charles Sharma, Ashish M. Huang, Qin Boosalis, Valia A. Whang, Edward E. |
| description | Background
The benefit of adjuvant treatment in gastric adenocarcinoma was demonstrated by randomized, controlled trials of patients with locally advanced tumors. Thus, its role for stage IIB-IIIC disease is widely accepted. We aimed to identify patients with stage IA-IIA gastric adenocarcinoma who have a poor prognosis and thus may benefit from adjuvant treatment.
Methods
Patients with gastric adenocarcinoma who underwent surgical resection with pathological evaluation of ≥15 lymph nodes and had available disease-specific survival (DSS) data were identified from the Surveillance Epidemiology and End Results Registry. Survival differences were evaluated with the log-rank test and Cox multivariate analysis.
Results
Stage and TN grouping strongly predicted DSS (
P
|
| doi_str_mv | 10.1245/s10434-012-2852-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1365989427</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1365989427</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-e4dd1189208407ce9f61126b2314d5c21a458b6cb63da12e6961d59965a216c3</originalsourceid><addsrcrecordid>eNp1kd9rFDEQx4Motlb_AF8k4Isv0czkx-36Itei9aBQsQc-hlx2rt1jd3MmWeH-e1Ovigg-zTDzme8M82XsJci3gNq8yyC10kICCmwMisMjdgqmVrRt4HHNpW1Ei9acsGc576SEhZLmKTtBpbQ2jTxlw5e4nwdf-jiJc5-p49dzCXEkHrf8pvhb4qulWK2W_CtlCqUClz6X1Ae-7GiKwafQT3H07_m3u8hv7uI8VIRKbe_mH34qfJ3Il5Gm8uE5e7L1Q6YXD_GMrT99XF98FlfXl6uL5ZUIaoFFkO46gKZF2Wi5CNRuLQDaDSrQnQkIvt6-sWFjVecBybYWOtO21ngEG9QZe3OU3af4faZc3NjnQMPgJ4pzdqCsaZtW46Kir_9Bd3FOUz3uF2UVINpKwZEKKeacaOv2qR99OjiQ7t4Jd3TCVSfcvRPuUGdePSjPm5G6PxO_X18BPAK5tqZbSn-t_q_qT76-keY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1365631226</pqid></control><display><type>article</type><title>Population-Based Outcome of Stage IA-IIA Resected Gastric Adenocarcinoma: Who Should Get Adjuvant Treatment?</title><source>MEDLINE</source><source>Springer Online Journals</source><creator>Gold, Jason S. ; Al Natour, Riad H. ; Saund, Mandeep S. ; Yoon, Charles ; Sharma, Ashish M. ; Huang, Qin ; Boosalis, Valia A. ; Whang, Edward E.</creator><creatorcontrib>Gold, Jason S. ; Al Natour, Riad H. ; Saund, Mandeep S. ; Yoon, Charles ; Sharma, Ashish M. ; Huang, Qin ; Boosalis, Valia A. ; Whang, Edward E.</creatorcontrib><description><![CDATA[Background
The benefit of adjuvant treatment in gastric adenocarcinoma was demonstrated by randomized, controlled trials of patients with locally advanced tumors. Thus, its role for stage IIB-IIIC disease is widely accepted. We aimed to identify patients with stage IA-IIA gastric adenocarcinoma who have a poor prognosis and thus may benefit from adjuvant treatment.
Methods
Patients with gastric adenocarcinoma who underwent surgical resection with pathological evaluation of ≥15 lymph nodes and had available disease-specific survival (DSS) data were identified from the Surveillance Epidemiology and End Results Registry. Survival differences were evaluated with the log-rank test and Cox multivariate analysis.
Results
Stage and TN grouping strongly predicted DSS (
P
< 0.001,
P
< 0.001). Stage IA tumors had an excellent outcome: 91 ± 1.2 % 5-year DSS. The TN groupings of stages IB and IIA had the next best outcomes with 5-year DSS from 66 ± 4.6 % to 81 ± 2.3 %. Older age (
P
< 0.001), higher grade (
P
= 0.004), larger tumor size (
P
< 0.001), and proximal tumor location (
P
< 0.001) were independent predictors of worse DSS in stage IB-IIA tumors. We devised a risk stratification scheme for stage IB-IIA tumors where 1 point was assigned for age >60 years, tumor size >5 cm, proximal tumor location, and grade other than well-differentiated. Five-year DSS was 100 % for patients with 0 points; 86 ± 4.3 %, 1 point; 76 ± 3 %, 2 points; 72 ± 2.8 %, 3 points; and 48 ± 4.9 %, 4 points (
P
< 0.001).
Conclusions
Patients with stage IB-IIA gastric adenocarcinoma and ≥2 adverse features (age >60 years, tumor size >5 cm, proximal location, and high-grade) have 5-year DSS ≤76 %. Adjuvant therapy may be warranted for these patients.]]></description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-012-2852-y</identifier><identifier>PMID: 23344580</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adenocarcinoma - pathology ; Adenocarcinoma - therapy ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Gastrectomy ; Gastrointestinal Oncology ; Humans ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Oncology ; Proportional Hazards Models ; Risk Assessment ; SEER Program ; Stomach Neoplasms - pathology ; Stomach Neoplasms - therapy ; Surgery ; Surgical Oncology ; Survival Rate ; Tumor Burden ; Young Adult</subject><ispartof>Annals of surgical oncology, 2013-07, Vol.20 (7), p.2304-2310</ispartof><rights>Society of Surgical Oncology 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-e4dd1189208407ce9f61126b2314d5c21a458b6cb63da12e6961d59965a216c3</citedby><cites>FETCH-LOGICAL-c372t-e4dd1189208407ce9f61126b2314d5c21a458b6cb63da12e6961d59965a216c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-012-2852-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-012-2852-y$$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/23344580$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gold, Jason S.</creatorcontrib><creatorcontrib>Al Natour, Riad H.</creatorcontrib><creatorcontrib>Saund, Mandeep S.</creatorcontrib><creatorcontrib>Yoon, Charles</creatorcontrib><creatorcontrib>Sharma, Ashish M.</creatorcontrib><creatorcontrib>Huang, Qin</creatorcontrib><creatorcontrib>Boosalis, Valia A.</creatorcontrib><creatorcontrib>Whang, Edward E.</creatorcontrib><title>Population-Based Outcome of Stage IA-IIA Resected Gastric Adenocarcinoma: Who Should Get Adjuvant Treatment?</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description><![CDATA[Background
The benefit of adjuvant treatment in gastric adenocarcinoma was demonstrated by randomized, controlled trials of patients with locally advanced tumors. Thus, its role for stage IIB-IIIC disease is widely accepted. We aimed to identify patients with stage IA-IIA gastric adenocarcinoma who have a poor prognosis and thus may benefit from adjuvant treatment.
Methods
Patients with gastric adenocarcinoma who underwent surgical resection with pathological evaluation of ≥15 lymph nodes and had available disease-specific survival (DSS) data were identified from the Surveillance Epidemiology and End Results Registry. Survival differences were evaluated with the log-rank test and Cox multivariate analysis.
Results
Stage and TN grouping strongly predicted DSS (
P
< 0.001,
P
< 0.001). Stage IA tumors had an excellent outcome: 91 ± 1.2 % 5-year DSS. The TN groupings of stages IB and IIA had the next best outcomes with 5-year DSS from 66 ± 4.6 % to 81 ± 2.3 %. Older age (
P
< 0.001), higher grade (
P
= 0.004), larger tumor size (
P
< 0.001), and proximal tumor location (
P
< 0.001) were independent predictors of worse DSS in stage IB-IIA tumors. We devised a risk stratification scheme for stage IB-IIA tumors where 1 point was assigned for age >60 years, tumor size >5 cm, proximal tumor location, and grade other than well-differentiated. Five-year DSS was 100 % for patients with 0 points; 86 ± 4.3 %, 1 point; 76 ± 3 %, 2 points; 72 ± 2.8 %, 3 points; and 48 ± 4.9 %, 4 points (
P
< 0.001).
Conclusions
Patients with stage IB-IIA gastric adenocarcinoma and ≥2 adverse features (age >60 years, tumor size >5 cm, proximal location, and high-grade) have 5-year DSS ≤76 %. Adjuvant therapy may be warranted for these patients.]]></description><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - therapy</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastrointestinal Oncology</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Proportional Hazards Models</subject><subject>Risk Assessment</subject><subject>SEER Program</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - therapy</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Tumor Burden</subject><subject>Young Adult</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kd9rFDEQx4Motlb_AF8k4Isv0czkx-36Itei9aBQsQc-hlx2rt1jd3MmWeH-e1Ovigg-zTDzme8M82XsJci3gNq8yyC10kICCmwMisMjdgqmVrRt4HHNpW1Ei9acsGc576SEhZLmKTtBpbQ2jTxlw5e4nwdf-jiJc5-p49dzCXEkHrf8pvhb4qulWK2W_CtlCqUClz6X1Ae-7GiKwafQT3H07_m3u8hv7uI8VIRKbe_mH34qfJ3Il5Gm8uE5e7L1Q6YXD_GMrT99XF98FlfXl6uL5ZUIaoFFkO46gKZF2Wi5CNRuLQDaDSrQnQkIvt6-sWFjVecBybYWOtO21ngEG9QZe3OU3af4faZc3NjnQMPgJ4pzdqCsaZtW46Kir_9Bd3FOUz3uF2UVINpKwZEKKeacaOv2qR99OjiQ7t4Jd3TCVSfcvRPuUGdePSjPm5G6PxO_X18BPAK5tqZbSn-t_q_qT76-keY</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Gold, Jason S.</creator><creator>Al Natour, Riad H.</creator><creator>Saund, Mandeep S.</creator><creator>Yoon, Charles</creator><creator>Sharma, Ashish M.</creator><creator>Huang, Qin</creator><creator>Boosalis, Valia A.</creator><creator>Whang, Edward E.</creator><general>Springer-Verlag</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>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</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><scope>7X8</scope></search><sort><creationdate>20130701</creationdate><title>Population-Based Outcome of Stage IA-IIA Resected Gastric Adenocarcinoma: Who Should Get Adjuvant Treatment?</title><author>Gold, Jason S. ; Al Natour, Riad H. ; Saund, Mandeep S. ; Yoon, Charles ; Sharma, Ashish M. ; Huang, Qin ; Boosalis, Valia A. ; Whang, Edward E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-e4dd1189208407ce9f61126b2314d5c21a458b6cb63da12e6961d59965a216c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - therapy</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastrointestinal Oncology</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Proportional Hazards Models</topic><topic>Risk Assessment</topic><topic>SEER Program</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - therapy</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Tumor Burden</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gold, Jason S.</creatorcontrib><creatorcontrib>Al Natour, Riad H.</creatorcontrib><creatorcontrib>Saund, Mandeep S.</creatorcontrib><creatorcontrib>Yoon, Charles</creatorcontrib><creatorcontrib>Sharma, Ashish M.</creatorcontrib><creatorcontrib>Huang, Qin</creatorcontrib><creatorcontrib>Boosalis, Valia A.</creatorcontrib><creatorcontrib>Whang, Edward E.</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>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</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 UK/Ireland</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><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gold, Jason S.</au><au>Al Natour, Riad H.</au><au>Saund, Mandeep S.</au><au>Yoon, Charles</au><au>Sharma, Ashish M.</au><au>Huang, Qin</au><au>Boosalis, Valia A.</au><au>Whang, Edward E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Population-Based Outcome of Stage IA-IIA Resected Gastric Adenocarcinoma: Who Should Get Adjuvant Treatment?</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>20</volume><issue>7</issue><spage>2304</spage><epage>2310</epage><pages>2304-2310</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract><![CDATA[Background
The benefit of adjuvant treatment in gastric adenocarcinoma was demonstrated by randomized, controlled trials of patients with locally advanced tumors. Thus, its role for stage IIB-IIIC disease is widely accepted. We aimed to identify patients with stage IA-IIA gastric adenocarcinoma who have a poor prognosis and thus may benefit from adjuvant treatment.
Methods
Patients with gastric adenocarcinoma who underwent surgical resection with pathological evaluation of ≥15 lymph nodes and had available disease-specific survival (DSS) data were identified from the Surveillance Epidemiology and End Results Registry. Survival differences were evaluated with the log-rank test and Cox multivariate analysis.
Results
Stage and TN grouping strongly predicted DSS (
P
< 0.001,
P
< 0.001). Stage IA tumors had an excellent outcome: 91 ± 1.2 % 5-year DSS. The TN groupings of stages IB and IIA had the next best outcomes with 5-year DSS from 66 ± 4.6 % to 81 ± 2.3 %. Older age (
P
< 0.001), higher grade (
P
= 0.004), larger tumor size (
P
< 0.001), and proximal tumor location (
P
< 0.001) were independent predictors of worse DSS in stage IB-IIA tumors. We devised a risk stratification scheme for stage IB-IIA tumors where 1 point was assigned for age >60 years, tumor size >5 cm, proximal tumor location, and grade other than well-differentiated. Five-year DSS was 100 % for patients with 0 points; 86 ± 4.3 %, 1 point; 76 ± 3 %, 2 points; 72 ± 2.8 %, 3 points; and 48 ± 4.9 %, 4 points (
P
< 0.001).
Conclusions
Patients with stage IB-IIA gastric adenocarcinoma and ≥2 adverse features (age >60 years, tumor size >5 cm, proximal location, and high-grade) have 5-year DSS ≤76 %. Adjuvant therapy may be warranted for these patients.]]></abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>23344580</pmid><doi>10.1245/s10434-012-2852-y</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2013-07, Vol.20 (7), p.2304-2310 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1365989427 |
| source | MEDLINE; Springer Online Journals |
| subjects | Adenocarcinoma - pathology Adenocarcinoma - therapy Adolescent Adult Age Factors Aged Aged, 80 and over Combined Modality Therapy Female Gastrectomy Gastrointestinal Oncology Humans Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Neoplasm Grading Neoplasm Staging Oncology Proportional Hazards Models Risk Assessment SEER Program Stomach Neoplasms - pathology Stomach Neoplasms - therapy Surgery Surgical Oncology Survival Rate Tumor Burden Young Adult |
| title | Population-Based Outcome of Stage IA-IIA Resected Gastric Adenocarcinoma: Who Should Get Adjuvant Treatment? |
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