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Application of Survival Quilts for prognosis prediction of gastrectomy patients based on the Surveillance,Epidemiology,and End Results database and China National cancer center gastric cancer database

Journal of the National Cancer Center

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Journal of the National cancer center 2024年第2期4卷 142-152页

作者： Lulu Zhao Penghui Niu Wanqing Wang Xue Han Xiaoyi Luan Huang Huang Yawei Zhang Dongbing Zhao Jidong Gao Yingtai Chen Department of Pancreatic and gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of cancer Prevention and Control National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Breast Surgical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeShenzhenChina

Objective:Accurate prognosis prediction is critical for individualized-therapy making of gastric cancer *** aimed to develop and test 6-month,1-,2-,3-,5-,and 10-year overall survival(OS)and cancer-specific survival(CSS)prediction models for gastric cancer patients following ***:We derived and tested Survival Quilts,a machine learning-based model,to develop 6-month,1-,2-,3-,5-,and 10-year OS and CSS prediction *** patients in the development set(n=20,583)and the internal validation set(n=5,106)were recruited from the Surveillance,Epidemiology,and End Re-sults(SEER)database,while those in the external validation set(n=6,352)were recruited from the China National cancer center gastric cancer(NCCGC)***,we selected gastrectomy patients with-out neoadjuvant therapy as a subgroup to train and test the prognostic models in order to keep the accuracy of tumor-node-metastasis(TNM)*** performances of these OS and CSS models were assessed using the Concordance Index(C-index)and area under the curve(AUC)***:The machine learning model had a consistently high accuracy in predicting 6-month,1-,2-,3-,5-,and 10-year OS in the SEER development set(C-index=0.861,0.832,0.789,0.766,0.740,and 0.709;AUC=0.784,0.828,0.840,0.849,0.869,and 0.902,respectively),SEER validation set(C-index=0.782,0.739,0.712,0.698,0.681,and 0.660;AUC=0.751,0.772,0.767,0.762,0.766,and 0.787,respectively),and NCCGC set(C-index=0.691,0.756,0.751,0.737,0.722,and 0.701;AUC=0.769,0.788,0.790,0.790,0.787,and 0.788,respectively).The model was able to predict 6-month,1-,2-,3-,5-,and 10-year CSS in the SEER development set(C-index=0.879,0.858,0.820,0.802,0.784,and 0.774;AUC=0.756,0.827,0.852,0.863,0.874,and 0.884,respectively)and SEER validation set(C-index=0.790,0.763,0.741,0.729,0.718,and 0.708;AUC=0.706,0.758,0.767,0.766,0.766,and 0.764,respectively).In multivariate analysis,the high-risk group with risk score output by 5-year OS model was p

关键词： gastric cancer Prognosis Survival Quilts Overall survival cancer specific survival

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A comparative study of totally laparoscopic distal gastrectomy versus laparoscopic-assisted distal gastrectomy in gastric cancer patients: Short-term operative outcomes at a high-volume center

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Chinese Journal of cancer Research 2018年第5期30卷 537-545页

作者： Won Ho Han Amir Ben Yehuda Deok-Hee Kim Seung Geun Yang Bang Wool Eom Hong Man Yoon Young-Woo Kim Keun Won Ryu center for gastric cancer National Cancer Center Department of Surgery Assaf Harofeh Medical Center

Objective： Laparoscopic gastrectomy has been established as a standard treatment for early gastric cancer, and its use is increasing recently. Compared with the conventional laparoscopy-assisted distal gastrectomy （LADG）, totally laparoscopic distal gastrectomy （TLDG） involves intracorporeal reconstruction, which can avoid the additional incision, resulting in pain reduction and early recovery. This study aimed to compare the short-term postoperative outcomes of TLDG vs. LADG in gastric cancer in a high-volume ***： A retrospective cohort study was conducted on 1,322 patients who underwent laparoscopic distal gastrectomy from June 2012 to June 2017 at the National cancer center, Korea. LAD G was performed in the early period before July 2015, and TLDG was applied in the later period. Postoperative short-term outcomes were compared in terms of complication and clinical course between the two groups. Pain score was measured by rating the pain intensity from 0 to 10 points on postoperative day （POD） 1 and 3. Results： A total of 667 patients underwent LADG and 655 patients underwent TLDG. Clinieopathologic characteristics were not different in both groups. Intraoperative estimated blood loss （EBL） was significantly lower in the TLDG group （P〈0.001）. Postoperative pain scores were significantly lower in the TLDG group than in the LADG group on POD 1 （5.1±1.5 vs. 4.8±1.4, P=0.015）. First flatus passage after operation was significantly earlier in the TLDG group （3.4±0.8 d vs. 3.2±0.6 d, P〈0.001）. There were no differences in postoperative complications and hospital stay between the two groups. Conclusions： Based on the reported short-term postoperative outcomes, TLDG is safe and feasible as well as LADG. Moreover, compared with LADG, TLDG can reduce intraoperative EBL and postoperative pain and enhance the bowel motility in gastric cancer surgery.

关键词： Distal gastrectomy gastric cancer intracorporeal anastomosis laparoscopic surgery

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Additional laparoscopic gastrectomy after noncurative endoscopic submucosal dissection for early gastric cancer: A single-center experience

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World Journal of Gastroenterology 2019年第29期25卷 3996-4006页

作者： Yan-Tao Tian Fu-Hai Ma Gui-Qi Wang Yue-Ming Zhang Li-Zhou Dou Yi-Bin Xie Yu-Xin Zhong Ying-Tai Chen Quan Xu Dong-Bing Zhao Department of Pancreatic and gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China Department of Endoscopy National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China

BACKGROUND The necessity of additional gastrectomy for early gastric cancer (EGC) patients who do not meet curative criteria after endoscopic submucosal dissection (ESD) is controversial. AIM To examine the clinicopathologic characteristics of patients who underwent additional laparoscopic gastrectomy after ESD and to determine the appropriate strategy for treating those after noncurative ESD. METHODS We retrospectively studied 45 patients with EGC who underwent additional laparoscopic gastrectomy after noncurative ESD from January 2013 to January 2019 at the cancer Hospital of the Chinese Academy of Medical Sciences. We analyzed the patients’ clinicopathological data and identified the predictors of residual cancer (RC) and lymph node metastasis (LNM). RESULTS Surgical specimens showed RC in ten (22.2%) patients and LNM in five (11.1%).Multivariate analysis revealed that positive horizontal margin [odds ratio (OR)=13.393, 95% confidence interval (CI): 1.435-125, P=0.023] and neural invasion (OR=14.714, 95%CI: 1.087-199, P=0.043) were independent risk factors for RC. Undifferentiated type was an independent risk factor for LNM (OR=12.000, 95%CI: 1.197-120, P=0.035). Tumors in all patients with LNM showed submucosal invasion more than 500 μm. Postoperative complications after additional laparoscopic gastrectomy occurred in five (11.1%) patients, and no deaths occurred among patients with complications. CONCLUSION Gastrectomy is necessary not only for patients who have a positive margin after ESD, but also for cases with neural invasion, undifferentiated type, and submucosal invasion more than 500 μm. Laparoscopic gastrectomy is a safe, minimally invasive, and feasible procedure for additional surgery after noncurative ESD. However, further studies are needed to apply these results to clinical practice.

关键词： Early gastric cancer Endoscopic submucosal dissection Laparoscopic gastrectomy Residual cancer Lymph node metastasis

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Comparison of totally laparoscopic total gastrectomy using an endoscopic linear stapler with laparoscopic-assisted total gastrectomy using a circular stapler in patients with gastric cancer: a single-center experience

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World Journal of Gastroenterology 2017年第48期23卷 8553-8561页

作者： Chung Sik Gong Byung Sik Kim Hee Sung Kim department of gastric surgery asan medical centeruniversity of ulsan college of medicine

AIM To evaluate the safety and efficacy of totally laparoscopic total gastrectomy(TLTG) with esophagojejunostomy using a linear stapler compared with laparoscopic-assisted total gastrectomy(LATG) using a circular stapler in gastric cancer *** We retrospectively reviewed 687 patients who underwent laparoscopic total gastrectomy for gastric cancer at a single institution from August 2008 to August 2014. The patients were divided into two groups according to the type of operation: 421 patients underwent TLTG and 266 underwent LATG. Clinicopathologic characteristics and surgical outcomes in the two groups were compared and *** The TLTG group had higher mean ages at the time of operation(57.78 ± 11.20 years and 55.69 ± 11.96 years,P = 0.020) and more histories of abdominal surgery(20.2% and 12.4%,P = 0.008) compared with the LATG group. Surgical outcomes such as intraoperative and postoperative transfusions,combined operations,pain scores and administration of analgesics,and complications were similar between the two groups. However,compared with the LATG group,the TLTG group required a shorter operation time(149 min vs 170 min,P gastric cancer.

关键词： Totally laparoscopic total gastrectomy Laparoscopic-assisted total gastrectomy gastric cancer

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Survival of patients with gastric cancer surgically treated at the National cancer center of China from 2011 to 2018 according to stage at diagnosis

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Journal of the National cancer center 2022年第3期2卷 132-138页

作者： Wenzhe Kang Hongmei Zeng Jianping Xiong Yang Li Peng Jin Xinxin Shao Haitao Hu Bingzhi Wang Yibin Xie Yantao Tian Department of Pancreatic and gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina National Central cancer Registry National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina Department of Pathology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Pancreatic and gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer HospitalChinese Academy of Medical SciencesLangfangChina

Objective:The postoperative survival rates of patients with gastric cancer at different stages treated at the National cancer center(NCC)of China have not been ***,we evaluated the survival of patients with gastric cancer who underwent surgery at the NCC from 2011 to 2018 to provide baseline information for further ***:We identified 7,301 patients with primary gastric carcinoma who underwent surgery at the NCC be-tween January 2011 and May 2018;among these,5,008 patients were enrolled in this *** up was completed on April 30,*** analyzed the 5-year survival according to the stage,sex,age,and other clini-copathological ***:Five-year survival rates of patients with pTNM stages ⅠA,ⅠB,ⅡA,ⅡB,ⅢA,ⅢB,ⅢC,and Ⅳ treated at the NCC were 94.9%,91.8%,86.5%,76.1%,61.1%,44.2%,29.7%,and 8.1%,respectively,which were similar to those reported in Japan during the same ***-year survival rates of patients with ypTNM stages I,II,III,and IV were 93.1%,63.2%,27.2%,and 0.0%,*** multivariable analysis,age,signet ring cell carcinoma,adjuvant chemotherapy,and degree of differentiation were revealed as important prognostic ***:The survival rates of patients with gastric cancer treated at the NCC have been significantly improved,reaching the levels of Japan in the same period.

关键词： gastric cancer Survival National cancer center 5-year survival rate

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Features of gastric cancer by anatomic subsite in northern China: A multi-center Health Science Report database study

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World Journal of Gastrointestinal Oncology 2022年第11期14卷 2238-2252页

作者： Rui-Ze Qu Yan-Peng Ma Xiao-Yuan Bao Li-Yuan Tao Xin Zhou Si-Yi Lu Yi Zhang Bing-Yan Wang Fei Li Lin Tuo Zhi-Peng Zhang Wei Fu Department of General Surgery Cancer CenterPeking University Third HospitalBeijing 100191China Medical Informatics center Peking University Health Science CenterBeijing 100191China Research center of Clinical Epidemiology Peking University Third HospitalBeijing 100191China Department of Hospital Management Peking University Health Science CenterBeijing 100191China

BACKGROUND The features of gastric cancer based on the anatomic site remain unknown in northern China *** To analyze gastric cancer features and associated trends based on the anatomical site in northern China *** This cross-sectional study used incident gastric cancer case data from 10 Peking University-affiliated hospitals(2014 to 2018).The clinical and prevailing local features were *** A total of 10709 patients were enrolled,including antral(42.97%),cardia(34.30%),and stomach body(18.41%)gastric cancer *** in the cardia had the highest male:female ratio,proportion of elderly patients,and patients with complications,including hypertension,diabetes,cerebrovascular,and coronary diseases(Pgastric cancer involving the antrum showed the lowest proportion of patients from rural areas and accounted for the highest hospitalization rate and cost(each Pcancer involving the cardia increased with an increase in the number of gastroesophageal reflux disease cases during the same period(Pgastric cancer based on the anatomical site differ between northern China and other regions,both globally and within the *** factors may account for these differences and should affect policy-making and clinical practice.

关键词： Feature gastric cancer Anatomical site Northern China

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Nomograms for pre-and postoperative prediction of long-term survival among proximal gastric cancer patients: A large-scale,single-center retrospective study

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World Journal of Clinical Cases 2019年第21期7卷 3419-3435页

作者： Qi-Yue Chen Zhi-Liang Hong Qing Zhong Zhi-Yu Liu Xiao-Bo Huang Si-Jin Que Ping Li Jian-Wei Xie Jia-Bin Wang Jian-Xian Lin Jun Lu Long-Long Cao Mi Lin Ru-Hong Tu Chao-Hui Zheng Chang-Ming Huang Department of gastric Surgery Fujian Medical University Union HospitalFuzhou 350001Fujian ProvinceChina Department of General Surgery Fujian Medical University Union HospitalFuzhou 350001Fujian ProvinceChina Key Laboratory of the Ministry of Education of Gastrointestinal cancer Fujian Medical UniversityFuzhou 350001Fujian ProvinceChina Fujian Key Laboratory of Tumor Microbiology Fujian Medical UniversityFuzhou 350001Fujian ProvinceChina

BACKGROUND The incidence of proximal gastric cancer(GC)is increasing,and methods for the prediction of the long-term survival of proximal GC patients have not been well *** To develop nomograms for the prediction of long-term survival among proximal GC *** Between January 2007 and June 2013,we prospectively collected and retrospectively analyzed the medical records of 746 patients with proximal GC,who were divided into a training set(n=560,75%)and a validation set(n=186,25%).A Cox regression analysis was used to identify the preoperative and postoperative risk factors for overall survival(OS).RESULTS Among the 746 patients examined,the 3-and 5-year OS rates were 66.1%and 58.4%,*** the training set,preoperative T stage(cT),N stage(cN),CA19-9,tumor size,ASA core,and 3-to 6-mo weight loss were incorporated into the preoperative nomogram to predict the *** addition to these variables,lymphatic vascular infiltration(LVI),postoperative tumor size,T stage,N stage,blood transfusions,and complications were incorporated into the postoperative *** calibration curves used to determine the OS probability fit *** the training set,the preoperative nomogram achieved a C-index of 0.751[95%confidence interval(CI):0.732-0.770]in predicting OS and accurately stratified the patients into four prognostic subgroups(5-year OS rates:86.8%,73.0%,43.72%,and 20.9%,P<0.001).The postoperative nomogram had a C-index of 0.758 in predicting OS and accurately stratified the patients into four prognostic subgroups(5-year OS rates:82.6%,74.3%,45.9%,and 18.9%,P<0.001).CONCLUSION The nomograms accurately predicted the pre-and postoperative long-term survival of proximal GC patients.

关键词： Proximal gastric cancer Preoperative Nomogram Prediction Prognosis

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gastric choriocarcinoma admixed with an α-fetoprotein-producing adenocarcinoma and separated adenocarcinoma

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World Journal of Gastroenterology 2009年第40期15卷 5106-5108页

作者： Bang Wool Eom So-Youn Jung Hongman Yoon Myeong-Cherl Kook Keun Won Ryu Jun Ho Lee Young-Woo Kim center for gastric cancer National Cancer Center

We report a case of gastric choriocarcinoma admixed with an α-fetoprotein (AFP)-producing adeno-carcinoma. A 70-year-old man was hospitalized for gastric cancer that was detected during screening by esophagogastroduodenoscopy (EGD). Initial laboratory data showed the increased serum level of AFP and EGD revealed a 5-cm ulcerofungating mass in the greater curvature of the gastric antrum. The patient underwent radical subtotal gastrectomywith D2 lymph node dissection and Billroth gastrojejunostomy. Histopathological evaluation confirmed double primary gastric cancer: gastric choriocarcinoma admixed with an AFP-producing adenocarcinoma and separated adenocarcinoma. At 2 wk postoperatively, his human chorionic gonadotropin and AFP levels had reduced and six cycles of adjuvant chemotherapy were initiated. No recurrence or distant metastasis was observed at 4 years postoperatively.

关键词： α-fetoproteins Adenocarcinoma Choriocarcinoma Stomach neoplasms

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gastric cancer in women: A regional health-center seven year retrospective study

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World Journal of Gastroenterology 2015年第25期21卷 7805-7813页

作者： Kunal Suryawala Demiana Soliman Monica Mutyala Shaheen Nageeb Moheb Boktor Abhishek Seth Avinash Aravantagi Ankur Sheth James Morris Paul Jordan Kenneth Manas Urska Cvek Marjan Trutschl Felix Becker Jonathan Alexander Department of Gastroenterology and Hepatology Louisiana State University Health Sciences Center Department of Molecular and Cellular Physiology Louisiana State University Health Sciences Center Department of Computer Science LSU Shreveport and Center for Molecular and Tumor Virology Louisiana State University Health Sciences Center Department of General and Visceral Surgery University Hospital Muenster

AIM: To investigate whether regional geography influences ethnic and gender trends for the development of gastric cancer(GC).METHODS: This retrospective analysis of the INVISION patient database at Louisiana State University Health Sciences center-Shreveport(LSUHSC-S), a southern United States regional hospital, was performed from 2005-2011. Using the international statistical classification of diseases 9(ICD-9), inpatient, day surgery outpatient, and emergency outpatient diagnosis codes entered into medical records were used to identify GC patients. For each study year, the patients were evaluated for age, ethnicity, and gender, and each patient was counted only once throughout the study. Subsequent patient encounters were counted as visits and separated by inpatient and clinic visits. Complex or severe disease may require more frequent and intensive clinical management; therefore, we evaluated annual clinic visits as "surrogate markers" of disease severity. Finally, we studied the primary diagnosis for Helicobacter pylori(H. pylori) infection(ICD-9 code 41.86) as an additional factor that might increase the risk of ***: A total of 285 patients were diagnosed with GC at LSUHSC-S between 2005 and 2011. African Americans(181 patients, 89 males and 92 females, 63.5% of total patients) had significantly higher frequencies of GC diagnosis compared with non-Hispanic whites(104 patients, 54 males and 50 females, 36.5% of total patients), at a ratio of 1.74(P = 0.002). Within each ethnic group, men and women were diagnosed at approximately equal annual rates. Our findings differed significantly from United States national trends, which found that African American females and white females had lower risks for GC than their corresponding male counterparts. The United States national trend between 2005 and 2011 showed that African Americans males had a higher incidence of GC, with an annual mean(per 100000) of 16.31 ± 0.76 compared with white males(9 ± 0.1, P < 0.001),

关键词： Gender Helicobacter pylori Ethnicity Riskfactors Health disparities

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Individual having a parent with early-onset gastric cancer may need screening at younger age

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World Journal of Gastroenterology 2015年第15期21卷 4592-4598页

作者： Hee-Won Kwak Il Ju Choi Chan Gyoo Kim Jong Yeul Lee Soo-Jeong Cho Bang Wool Eom Hong Man Yoon Jungnam Joo Keun Won Ryu Young-Woo Kim center for gastric cancer National Cancer Center Biometric Research Branch National Cancer Center

AIM: To evaluate whether individuals with gastric cancer(GC) are diagnosed earlier if they have firstdegree relatives with ***: A total of 4282 patients diagnosed with GC at National cancer center Hospital from 2002 to 2012 were enrolled in this retrospective study. We classified the patients according to presence or absence of first-degree family history of GC and compared age at diagnosis and clinicopathologic characteristics. In addition, we further classified patients according to specific family member with GC(father, mother, sibling, or offspring) and compared age at GC diagnosis among these patient groups. Baseline characteristics were obtained from a prospectively collected database. Information about the family member's age at GC diagnosis was obtained by ***: A total of 924 patients(21.6%) had a firstdegree family history of GC. The mean age at GC diagnosis in patients having paternal history of GC was 54.4 ± 10.4 years and was significantly younger than in those without a first-degree family history(58.1 ± 12.0 years, P < 0.001). However, this finding was not observed in patients who had an affected mother(57.2 ± 10.0 years) or sibling(62.2 ± 9.8 years). Among patients with family member having early-onset GC(< 50 years old), mean age at diagnosis was 47.7 ± 10.3 years for those with an affected father, 48.6 ± 10.4 years for those with an affected mother, and 57.4 ± 11.5 years for those with an affected sibling. Thus, patients with a parent diagnosed before 50 years of age developed GC 10.4 or 9.5 years earlier than individuals without a family history of GC(both P <0.001).CONCLUSION: Early-onset GC before age of 50 was associated with parental history of early-onset of GC. Individual having such family history need to start screening earlier.

关键词： gastric cancer Family history Family member Age at diagnosis Screening

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