Incidence Of Early Cancer Research Articles

Abstract 689: A randomized phase III study assessing the efficacy of liquid biopsy in early diagnosis of recurrence and second malignancies in lung cancer survivors

Abstract We designed a 6,000-patient prospective, multi-institutional randomized clinical trial to assess the efficacy of liquid biopsy in early diagnosis of recurrence and second malignancies in lung cancer survivors. To ensure over 25% of participants are of disadvantaged or minority status, we have recruited multiple community hospitals (Jamaica, Flushing, Wyckoff, and Staten Island/Bronx satellites of Northwell hospitals) to the study in partnership with Memorial Sloan Kettering Cancer Center. Patients included in this study are survivors of non-metastatic non-small cell lung cancer, status-post definitive treatment (surgery or radiation) with no evidence of disease for at least one year. These patients may be on maintenance therapy for their prior lung cancer but may not have any other active malignancy at the time of enrollment. Participants will be randomized 1:1 to standard surveillance at the discretion of the treating physician or standard surveillance plus six-monthly methylation-based liquid biopsy tests over a two-year study period, and strict guidelines on follow-up of positive liquid biopsy testing will be provided to reduce harms from false positives or overdiagnosis. The primary endpoint of this study is the incidence of late stage cancer (distant recurrence or new primary cancer of stage III/IV). Secondary endpoints include incidence of early cancers (locoregional recurrence or new primary cancer of stage I/II), metastasis-free survival, and utilization of liquid biopsy versus standard of care scans. We will stratify our results by minority and socioeconomic status to specifically ascertain the effect of this intervention on populations of need. This is the first randomized controlled trial of liquid biopsy in a survivor population and the first trial utilizing liquid biopsy in a large minority population. We will have preliminary experiences to report in April 2022. Citation Format: Sana Raoof. A randomized phase III study assessing the efficacy of liquid biopsy in early diagnosis of recurrence and second malignancies in lung cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 689.

Function-preserving gastrectomy for early gastric cancer based on Japanese researches

In the past, people only focused on surgical resection of gastric cancer to obtain satisfactory therapeutic effect, while the concept of function-preserving in gastric cancer surgery has not been emphasized. Gastric function-preserving surgery was originally performed by Japanese doctor Maki for surgical treatment of gastroduodenal ulcer. With the definition of early gastric cancer being accepted, the pylorus-preserving gastrectomy can be used continuously in the treatment of gastric cancer. Because of high incidence of early gastric cancer in Japan, a variety of application and research about function-preserving gastrectomy in other areas for treatment of early gastric cancer, such as proximal gastrectomy and jejunal interposition, segmental gastrectomy, gastric local resection and laparoscopic and endoscopic cooperative surgery (LECS) at the same time, and regional or sentinel lymph node dissection were performed for the purpose of radical cure. Function-preserving gastrectomy for the treatment of early gastric cancer should include four important factors: (1) decrease of the scope of gastrectomy; (2)retaining pylorus; (3)retaining vagus nerve; (4)regional or sentinel lymph node dissection. The technique of sentinel lymph node can reduce the extent of gastric resection, avoid distal gastrectomy or total gastrectomy, and make gastric resection more suitable for laparoscopic partial gastrectomy, segmental resection, pylorus-preserving gastrectomy and proximal gastrectomy. Function-preserving gastrectomy has the advantage of improving the quality of life and has great potential in the treatment of early gastric cancer. However, the various treatment methods including LECS need strict technical standardization for confirmation of oncology safety. We need careful design, prospective multicenter randomized controlled trials to provide theoretical and technical support.

EMR for Early Gastric Cancer

Endoscopic mucosal resection (EMR) has become standard therapy in Asian countries that have a high incidence of early gastric cancer. Such cancer is

How To Diagnose Early Rectal Adenocarcinoma? Endoscopic Features and Predictors of Submucosal Invasion at National Cancer Center Tokyo

Background: Rectal cancer is usually diagnosed at late stage, however, the incidence of early cancer (confined to the mucosa and submucosa) is increasing in Japan. Endoscopic resection improves patients's QOL and is the accepted treatment for mucosal cancer, however, remains controversial in submucosal tumors. In this regard, endoscopic differences between mucosal and submucosal tumors will determine treatment strategies, however have been scarcely studied and the role of endoscopic treatment is still unclear Aim: The aim of this study was to evaluate the endoscopic features of mucosal and submucosal rectal adenocarcinoma and the endoscopic predictors of submucosal invasion. Material and Methods: Early rectal adenocarcinoma diagnosed between October, 1988 and November, 2002 were the subject of the study. Age, gender, location (Rs, Ra and Rb), size, macroscopic type, depressed component (IIc), growth type: polypoid growth (PG), non polypoid growth (NPG), clinical pit pattern (non invasive, invasive) were analyzed to predict submucosal invasion. Treatment (endoscopic, surgical) and lymph node metastases (LNM) data were also analyzed. Results: There were 268 early rectal cancers, 196 (73%) mucosal and 72 (27%) submucosal. Overall mean age and size were 62±10.7 years and 15±8.4 mm respectively. There were no significant differences in age, gender, location and macroscopic type and the layer of invasion, however, mean size, presence of IIc component, NPG and invasive pattern were significantly different between mucosal and submucosal tumors. Multivariate analysis revealed that invasive pattern (OR = 68), NPG (OR = 17) and size ≥15 mm (OR = 14) were independent factors predicting submucosal invasion. Endoscopic treatment was performed in all mucosal resections (curative rate:100%). Submucosal tumors were treated endoscopically in 26 (36%) and surgically in 46 (64%) cases. Among the endoscopic resected lesion, 9 (34%) lesions invaded ≤1000 um (sm1) and 17 (66%) invaded >1000 um (sm2). Additional surgery was performed in sm2 cases. LNM was found in 7 out of 72 (10%) submucosal tumors. Conclusions: Endoscopic resection effectively removed most early rectal adenocarcinomas. Invasive pit pattern, NPG and size ≥15 mm are accurate predictive factors of submucosal invasion and useful to define the therapeutic strategy. Endoscopic diagnosis might of early rectal adenocarcinoma is feasible and might reduce unnecessary surgical procedures.

Clinicopathological and Endoscopic Studies on Gastric Cancer Located; the Cardia

Abstract: In this study the definition of cardiac cancer (histologically adenocarcinoma) was taken to be a cancerous lesion, the size of which is less than 4 cm and the center of which is located within 2 cm from the esophagocardiac junction. 42 patients (0.8%) fit the above definition of cardiac cancer out of 4,958 patients with solitary gastric cancer operated on at the National Cancer Center Hospital daring the period between 1962 and 1988. The clinicopathological and endoscopic findings of these 42 patients were compared with those of 132 patients with gastric cancer located in the upper third of the stomach other than in the cardia (cancer in the other C‐area). In the group with cardiac cancer, the male patients (M/F ratio: 3.7), the elderly patients (mean age: 61.3 years), a differentiated type of adenocarcinoma (90%), lesions located at the lesser curvature (62%) and the elevated type of lesion were found to predominate. The incidence of early cancer (60%) and the incidence of small lesions less than 2 cm (32%) in diameter were lower than in the patients with cancers in the other C‐area. In the group with cardiac cancer, however, the incidence of such types of early cancer as the depressed lesion, a small lesion less than 2 cm in diameter and lesions difficult to diagnose endoscopically, have been increasing. In recent years, cardicac cancers have been found not only on the lesser curvature, but also in different areas of the cardia.These results suggest an improvement in endoscopic diagnosis for cardiac cancer. To make early detection more precise, it will be indispensable not to overlook even faint or indistinct mucosal abnormalities at the area adjacent to the esophagocardiac junction.

Clinico-pathological study of gastric cancers in the greater curvature.

The cases of gastric cancer in the greater curvature were 343 of 3,727, 9.2%, of which the early cancers were 62 of 1,060 cases or 5.9%. The average age of the patients with gastric cancer in this area was somewhat higher in comparison to that of all gastric cancers. In the early cancers of this area, the incidence of intestinal type cancers was rather frequent than that in the early cancers of the other areas. However, in the advanced cancers of this area, the incidence of diffuse type cancers was more frequent than that in the advanced cancers of the other areas. It should be considered that the difficulty of early diagnosis of cancer in the fundic gland area caused the discrepancy of the histological incidences of early and advanced cancers in the greater curvature. The incidence of early cancers with the size beyond 5 cm in diameter was 4.8% (15.5% in all early gastric cancers). Probably, the cancers in the greater curvature grow rapidly in comparison to those in the other areas.