New Cases Of Gastric Cancer Research Articles

Pathological complete response achieved with FLOT chemotherapy in two patients with MSI-H esophagogastric junction and gastric adenocarcinoma.

Globally, more than 1 million new cases of gastric cancer were estimated in 2020, ranking fourth in cancer mortality. Currently although in resectable gastric cancer and esophagogastric junction (EGJ) adenocarcinoma a perioperative triplet chemotherapy regimen including a fluoropyrimidine, a platinum compound and docetaxel (FLOT) demonstrated a better overall survival, the survival rate is still very low, and a massive effort is still required to improve clinical prognosis. High microsatellite instability (MSI-H) status in gastric cancer is a favorable prognostic factor but poor data are available on its predictive role for perioperative FLOT chemotherapy in resectable gastric cancer. Here, we presented the case of two patients with advanced MSI-H gastric cancer/EGJ adenocarcinoma who had no residual tumor following neoadjuvant FLOT chemotherapy maintaining a complete response for more than 30 months, suggesting MSI-H status to be a positive prognostic marker also in patients treated with a taxane-containing triplet in this setting. We also discuss the future perspectives including the opportunity to achieve excellent clinical outcomes with immune checkpoint inhibitor (ICI)-based regimens.

Global incidence and mortality trends of gastric cancer and predicted mortality of gastric cancer by 2035.

To study the historical global incidence and mortality trends of gastric cancer and predicted mortality of gastric cancer by 2035. Incidence data were retrieved from the Cancer Incidence in Five Continents (CI5) volumes I-XI, and mortality data were obtained from the latest update of the World Health Organization (WHO) mortality database. We used join-point regression analysis to examine historical incidence and mortality trends and used the package NORDPRED in R to predict the number of deaths and mortality rates by 2035 by country and sex. More than 1,089,000 new cases of gastric cancer and 769,000 related deaths were reported in 2020. The average annual percent change (AAPC) in the incidence of gastric cancer from 2003 to 2012 among the male population, South Korea, Japan, Malta, Canada, Cyprus, and Switzerland showed an increasing trend (P > 0.05); among the female population, Canada [AAPC, 1.2; (95%Cl, 0.5-2), P < 0.05] showed an increasing trend; and South Korea, Ecuador, Thailand, and Cyprus showed an increasing trend (P > 0.05). AAPC in the mortality of gastric cancer from 2006 to 2015 among the male population, Thailand [3.5 (95%cl, 1.6-5.4), P < 0.05] showed an increasing trend; Malta Island, New Zealand, Turkey, Switzerland, and Cyprus had an increasing trend (P > 0.05); among the male population aged 20-44, Thailand [AAPC, 3.4; (95%cl, 1.3-5.4), P < 0.05] showed an increasing trend; Norway, New Zealand, The Netherlands, Slovakia, France, Colombia, Lithuania, and the USA showed an increasing trend (P > 0.05). It is predicted that the mortality rate in Slovenia and France's female population will show an increasing trend by 2035. It is predicted that the absolute number of deaths in the Israeli male population and in Chile, France, and Canada female population will increase by 2035. In the past decade, the incidence and mortality of gastric cancer have shown a decreasing trend; however, there are still some countries showing an increasing trend, especially among populations younger than 45years. Although mortality in most countries is predicted to decline by 2035, the absolute number of deaths due to gastric cancer may further increase due to population growth.

DIABETES MELLITUS A RISK FACTOR OF GASTRIC CANCER : SYSTEMATIC REVIEW

Background: It is estimated that 500 million individuals globally would have diabetes mellitus (DM) by 2030. A deadly tumor that affects the digestive tract is called gastric cancer (GC). It ranks as the fourth leading cause of cancer death worldwide and the fifth most common kind of cancer. Every year, there are around 700,000 fatalities and one million new cases of GC globally. Aims : This systematic review is to review the association of diabetes mellitus as a risk factor of gastric cancer. Methods: This study demonstrated compliance with all requirements by means of a comparison with the standards established by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020. Thus, the specialists were able to guarantee that the research was as current as feasible. Publications released between 2014 and 2024 were considered for this search strategy. This was accomplished by utilizing a number of distinct online reference sites, including Pubmed, ScienceDirect, and SagePub. It was determined that reviews, previously published works, and partially completed works would not be included. Result: In the PubMed database, the results of our search brought up 343 articles, whereas the results of our search on SAGEPUB brought up 2178 articles, our search on SCIENCE DIRECT brought up 23102 articles. The results of the search conducted for the last year of 2014 yielded a total 231 articles for PubMed, 1017 articles for SAGEPUB and 12260 articles for SCIENCE DIRECT. In the end, we compiled a total of 5 papers, 2 of which came from PubMed, 1 of which came from SAGEPUB and 2 of which came from SCIENCE DIRECT. We included five research that met the criteria. Conclusion: In summary, there is no direct association of diabetes mellitus and gastric cancer, but diabetes mellitus can increase the risk factor of gastric cancer cases.

In Vitro and In Silico Evaluation of Red Algae Laurencia obtusa Anticancer Activity.

Studies estimate that nearly 2 million new cases of gastric cancer will occur worldwide during the next two decades, which will increase mortality associated with cancer and the demand for new treatments. Marine algae of the Laurencia genus have secondary metabolites known for their cytotoxic action, such as terpenes and acetogenins. The species Laurencia obtusa has demonstrated cytotoxicity against many types of tumors in previous analyses. In this study, we determined the structure of terpenes, acetogenins, and one fatty acid of Laurencia using mass spectrometry (ESI-FT-ICR/MS). In vitro cytotoxicity assays were performed with adenocarcinoma gastric cells (AGS) to select the most cytotoxic fraction of the crude extract of L. obtusa. The Hex:AcOEt fraction was the most cytotoxic, with IC50 9.23 µg/mL. The selectivity index of 15.56 shows that the Hex:AcOEt fraction is selective to cancer cells. Compounds obtained from L. obtusa were tested by the analysis of crystallographic complexes. Molecular docking calculations on the active site of the HIF-2α protein showed the highest affinity for sesquiterpene chermesiterpenoid B, identified from HEX:AcOEt fraction, reaching a score of 65.9. The results indicate that L. obtusa presents potential compounds to be used in the treatment of neoplasms, such as gastric adenocarcinoma.

The crosstalk between the RNA demethylase, non‐coding RNAs, and transcription factors in gastric cancer: An ALKBH5 perspective

The crosstalk between the RNA demethylase, non‐coding RNAs, and transcription factors in gastric cancer: An ALKBH5 perspective

Comparison of double contrast-enhanced ultrasonography and contrast-enhanced computed tomography in preoperative TNM stages of gastric cancer

Background: China accounts for about 40% of new cases of Gastric Cancer (GC) in the world every year. Preoperative TNM stages

Long-term trend of gastric cancer survival rate in Qidong, 1972-2016

Objective: The survival rate of gastric cancer cases in the whole population of Qidong City of Jiangsu Province from 1972 to 2016 was analyzed to provide a data basis for prevention and control of gastric cancer. Methods: The observed survival rate (OSR) was calculated by the life table method, the relative survival rate (RSR) was calculated by SURV 3.01 software, and the trend test was performed by Hakulinen's likelihood ratio test. Age-standardized relative survival rate (ARSR) was calculated using the International Cancer Survival Standard (ICSS). The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) of survival rate, and the trend analysis of the overall survival rate of gastric cancer and the survival rates of different sexes and ages was conducted. The ARIMA model was used to predict the survival rate. Results: From 1972 to 2016, there were 18 067 new cases of gastric cancer in Qidong City. The OSRs at 1, 5, and 10 years were 37.12%, 17.16%, and 12.86%, respectively, and the RSRs at 1, 5, and 10 years were 38.83%, 21.73%, and 21.20%. Dividing 1972-2016 into 9 periods at 5-year intervals, compared with 1972-1976, the 5-year RSR in 2012-2016 increased from 12.53% to 36.26%, and the RSR in the 9 periods increased with statistical significance (χ(2)=747.19, P<0.001). Both OSR and RSR were slightly higher in men than in women, and decreased with age. The AAPC results showed that the AAPC of the 5-year RSR of gastric cancer in Qidong was 2.88%, 2.75% in males and 3.05% in females, and the upward trend was statistically significant (P<0.001). From 1972 to 2016, the 5-year RSR of gastric cancer in all age groups showed an upward trend. Except for the 35-44-year-old group (AAPC=1.07%, t=2.16, P=0.067), the age groups had statistical significance ( AAPC=2.59% in the 45-54-year-old group, AAPC=3.19% in the AAPCs of other 55-64-year-old group, AAPC=3.99% in the 65-74-year-old group, and AAPC=2.97% in the 75-year-old group, all P<0.05). The prediction results of the ARIMA model showed that in 2026, the 5-year OSR of gastric cancer in Qidong will increase to 39.82%, and the 5-year RSR will increase to 49.23%. Conclusion: The overall survival rate of registered gastric cancer cases in Qidong has been greatly improved, but there is still large room for improvement. More attention should be paid to the prevention and treatment of gastric cancer.

Impact of Medicaid Expansion on Incidence and Mortality from Gastric and Esophageal Cancer.

Individuals in Medicaid expanded states have increased access to treatment for medical conditions and other health care resources. Esophageal and gastric cancer are associated with several modifiable risk factors (e.g. smoking, drinking, Helicobacter pylori infection). The impact of Medicaid expansion on these cancers incidence and mortality remains uninvestigated. We evaluated the association between Medicaid expansion and gastric and esophageal cancer incidence and mortality in adults aged 25-64. We employed an observational design using a difference-in-differences method with state level data, from 2010 to 2017. Annual, age-adjusted gastric and esophageal cancer incidence and mortality rates, from the CDC Wonder Database, were analyzed. Rates were adjusted for by several socio-demographic factors. Expansion and non-expansion states were similar in percent Hispanic ethnicity and female gender. The non-expansion states had significantly higher proportion of Black race, diabetics, obese persons, smokers, and those living below the federal poverty line. Adjusted analyses demonstrate that expansion states had significantly fewer new cases of gastric cancer: -1.6 (95% CI 0.2-3.5; P = 0.08) per 1,000,000 persons per year. No significant association was seen between Medicaid expansion and gastric cancer mortality (0.46 [95% CI -0.08 to 0.17;P = 0.46]) and esophageal cancer incidence (0.8 [95% CI -0.08 to 0.24; P = 0.33]) and mortality (1.0 [95% CI -0.06 to 0.26; P = 0.21]) in multivariable analyses. States that adopted Medicaid expansion saw a decrease in gastric cancer incidence when compared to states that did not expand Medicaid. Though several factors may influence gastric cancer incidence, this association is important to consider during health policy negotiations.

Profiling of gene fusion involving targetable genes in Chinese gastric cancer.

BACKGROUNDApproximately half of all new cases of gastric cancer (GC) and related deaths occur in China. More than 80% of patients with GC are diagnosed at an advanced stage, which results in poor prognosis. Although HER2-directed therapy and immune checkpoint inhibitors have been somewhat successful, new drugs are still needed for the treatment of GC. Notably, several gene fusion-targeted drugs have been approved by the United States Food and Drug Administration for solid tumors, including GC, such as larotrectinib for NTRK fusion-positive cancers and zenocutuzumab for NRG1 fusion-positive cancers. However, gene fusions involving targetable genes have not been well characterized in Chinese patients with GC.AIMTo identify the profile of fusions involving targetable genes in Chinese patients with GC using clinical specimens and determine the distribution of patients with gene fusion variants among the molecular subtypes of GC.METHODSWe retrospectively analyzed gene fusion events in tumor tissue samples from 954 Chinese patients with GC. Clinicopathological characteristics were obtained from their medical records. Genetic alterations, such as single nucleotide variants, indels, amplifications, and gene fusions, were identified using a targeted sequencing panel containing 825 genes. Fusions were validated by fluorescence in situ hybridization (FISH) using break-apart probes. The microsatellite instability (MSI) status was evaluated using MSIsensor from the targeted sequencing panel data. Tumor mutational burden (TMB) was calculated using the total number of nonsynonymous mutations divided by the total genomic targeted region. Chi-square analysis was used to determine the enrichment of gene fusions associated with the molecular subtypes of GC.RESULTSWe found that 1.68% (16/954) of patients harbored 20 fusion events involving targetable genes. RARA fusions (n = 5) were the most common, followed by FGFR2, BRAF, MET, FGFR3, RET, ALK, EGFR, NTRK2, and NRG1 fusions. Two of the RARA fusions, EML4-ALK (E6:E20) and EGFR-SEPTIN14 (E7:E10), have been identified in other tumors but not in GC. Surprisingly, 18 gene fusion events were previously not reported in any cancer types. Twelve of the eighteen novel gene fusions included complete exons encoding functional domains of targetable genes, such as the tyrosine kinase domain of receptor tyrosine kinases and the DNA- and ligand-binding domains of RARA. Consistent with the results of detection using the targeted sequencing fusion panel, the results of FISH (fluorescence in situ hybridization) confirmed the rearrangement of FGFR2 and BRAF in tumors from patients 04 and 09, respectively. Genetic analysis indicated that the fusion genes were significantly enriched in patients with ERBB2 amplification (P = 0.02); however, there were no significant differences between fusion-positive and fusion-negative patients in age, sex, MSI status, and TMB.CONCLUSIONWe characterized the landscape of fusions involving targetable genes in a Chinese GC cohort and found that 1.68% of patients with GC harbor potential targetable gene fusions, which were enriched in patients with ERBB2 amplification. Gene fusion detection may provide a potential treatment strategy for patients with GC with disease progression following standard therapy.

Geographic Variability of Gastric Cancer Incidence in Kazakhstan.

Objective:The article studies the geographical features of the incidence of gastric cancer (GC) in Kazakhstan. Methods:The retrospective study was done for the period 2009-2018. Descriptive and analytical methods of oncoepidemiology were used. Crude (CR), age-specific (ASIR), age-standardized (ASR), equalized incidence rates and approximation were calculated. The dynamics of indicators was investigated using component analysis according to methodological recommendations. The method of drawing up a cartogram based on the determination of the standard deviation (σ) from the mean (x) was applied. Results:During the study period, 27,467 new cases of GC were registered. The incidence rate increased from 16.80 (2009) to 15.10 in 2018 and the overall decline was 1.70 per 100,000 population, including due to the age structure – ∑ΔA=+1.51, due to the risk of acquiring illness – ∑ΔR=−2.91 and their combined effect – ∑ΔRA=−0.31. The component analysis revealed that the increase in the number of patients with GC was mainly due to the growth of the population (ΔP=+651.8%), changes in its age structure (ΔA=+433.9%) and changes associated with the risk of acquiring illness (ΔR=−832.1%). The cartograms were allocated according to the following criteria: low – up to 14.80/0000, average – from 14.8 to 19.20/0000, high – above 19.20/0000. The results of the spatial assessment showed the highest levels of GC incidence in following regions: Akmola (22.20/0000), North Kazakhstan (22.30/0000), and Pavlodar (23.20/0000). Conclusion:Thus, as a result of the epidemiological analysis, the role of the influence of demographic factors and the risk of acquiring illness on the formation of the number of patients and the incidence of GC was evaluated, while sex differences and geographical variability were established.

Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and the esophagogastric junction: a retrospective analysis from an experienced single center.

Gastric cancer remains the fourth leading cause of cancer-related death in Europe, while the proportion of adenocarcinomas of the esophagogastric junction has risen by more than one third over recent years. In 2018, 14,700 new cases of gastric cancer were estimated in Germany, while the 5-year relative survival rate is reported to be 33% for women and 30% for men; in the USA almost the same rate was reported, with 31% 5-year survival. Between 2001 and 2014, 590 patients with a diagnosis of gastric cancer underwent surgery in our institution, including 120 Siewert type II/III carcinomas of the esophagogastric junction. All patients underwent distal resection of the stomach, gastrectomy or total gastrectomy combined with transhiatal distal esophageal resection. All operations included D2-D3 lymph node dissection (LND). Data were recorded by the cancer registry of the department of surgery and analyzed retrospectively. The patients were classified according to the TNM (UICC 2010) and Lauren classification. 29% of the patients underwent primary surgery and 31% received neoadjuvant therapy. The median number of harvested lymph nodes was 33 for patients diagnosed with gastric cancer, and 29 for esophagogastric adenocarcinomas, respectively. The anastomotic leak rate was 3%. In this study, the 5-year overall survival rate was 51% concerning gastric carcinomas, 44% for Siewert type II and 47% for Siewert III cancers of the esophagogastric junction. Increased survival with low complication rates were achieved after individualized and multimodal treatment concepts combined with consistently applied extended lymphadenectomy.

S1416 Medicaid Expansion Is Associated with Decreased Gastric Cancer Incidence

Introduction: Individuals in Medicaid expanded states have increased access to treatment for medical conditions and other health care resources, including preventive healthcare. Esophageal and gastric cancer are associated with several modifiable risk factors (i.e. smoking, drinking, obesity, Helicobacter pylori infection). The impact of Medicaid expansion on gastric and esophageal cancer incidence and mortality remains uninvestigated. Methods: We evaluated the association between Medicaid expansion and gastric and esophageal cancer incidence and mortality in adults aged 25-64. This study employed an observational design using a difference-in-differences method with state level data from 31 states (given the availability of complete data), from 2010 – 2017. Annual, age-adjusted gastric and esophageal incidence and mortality rates, from the CDC Wonder Database, were analyzed and were accounted for by ICD-O-3 and ICD-10, respectively. Rates were adjusted for gender, race, poverty, median household income, unemployment, insurance, smoking, alcohol consumption, diabetes mellitus, obesity, and number of physicians per 100,000 population. Results: In expansion states, median (IQR) gastric cancer incidence was unchanged: from 4.6 (4.2-5.2) to 4.6 (4.1-5.4) per 100,000 population from the pre-expansion to post-expansion period. There was an increase in median (IQR) gastric cancer incidence among non-expansion states, from 4.6 (4.2-5.0) to 4.8 (4.3-5.1) per 100,000 from pre- to post-expansion. There was no considerable change in gastric cancer mortality and esophageal cancer incidence and mortality pre- and post- expansion. Adjusted analyses demonstrate that expansion states had significantly fewer new cases of gastric cancer: -1.6 (95% CI: 0.2-3.5; P = .08) per 1,000,000 persons per year. No significant association was seen between Medicaid expansion and gastric cancer mortality (0.46 [95% CI: -0.08-0.17; P = .46]) and esophageal cancer incidence (0.8 [95% CI: -0.08- 0.24; P = .33]) and mortality (1.0 [95% CI: -0.06-0.26; P = 0.21]) in multivariable analyses. Annual adjusted medians for gastric and esophageal cancer mortality and incidence are shown in Figure 1. Conclusion: States that adopted Medicaid expansion saw a decrease in gastric cancer incidence among adults aged 25-64 when compared to states that did not expand Medicaid. Though several factors may influence gastric cancer incidence, this association is important to consider during health policy negotiations.Figure 1.: Annual distribution of age-adjusted gastric and esophageal cancer incidence and mortality rates pre- and post- Medicaid expansion.Table 1.: Comparison of sociodemographic and clinical characteristics of Expansion Vs Non-Expansion States based on 2010 data.

Global Incidence and Mortality of Gastric Cancer, 1980-2018

Gastric cancer is one of the most common cancers, with a high mortality-to-incidence ratio. It is uncertain whether developed nations may encounter an increasing burden of gastric cancer in young adults, as occurs for other cancers. To evaluate the incidence and mortality of gastric cancer and compare the global incidence trends between younger (<40 years) and older (≥40 years) populations. This population-based cohort study analyzed data from global and national cancer registries, including data from 1980 to 2018, with at least 15 calendar years of incidence and mortality data. Data on age-standardized incidence and mortality rates of gastric cancer among 48 countries were retrieved from the Surveillance, Epidemiology, and End Results Program, the National Cancer Institute, the Nordic Cancer Registries, and the World Health Organization Mortality Database. The 10-year incidence trend of gastric cancer was assessed by age and sex. The 2018 GLOBOCAN database was used for reporting the global incidence and mortality of gastric cancer, the most recent data available at the time of analysis. Analyses were performed between January 10, 2020, and March 20, 2020. The average annual percent change (AAPC) of the incidence and mortality trends as evaluated by joinpoint regression analysis. A total of 1 033 701 new cases of gastric cancer and 782 685 related deaths were reported in 2018. Overall, the incidence of gastric cancer decreased in 29 countries, and mortality decreased in 41 countries. The age-standardized incidence of gastric cancer decreased from a range of 2.6 to 59.1 in 1980 to a range of 2.5 to 56.8 in 2018 per 100 000 persons. The overall age-standardized mortality rate changed from a range of 1.3 to 25.8 in 1980 to a range of 1.5 to 18.5 in 2018 per 100 000 persons, but increasing mortality was observed in Thailand (female: AAPC, 5.30; 95% CI, 4.38-6.23; P < .001; male: AAPC, 3.92; 95% CI, 2.14-5.74; P < .001). The incidence of gastric cancer decreased in most regions among individuals 40 years or older and increased in populations younger than 40 years in several countries, including Sweden (male: AAPC, 13.92; 95% CI, 7.16-21.11; P = .001), Ecuador (female: AAPC, 6.05; 95% CI, 1.40-10.92; P = .02), and the UK (male: AAPC, 4.27; 95% CI, 0.15-8.55; P = .04; female: AAPC, 3.60; 95% CI, 3.59-3.61; P < .001). In this population-based cohort study, an increasing incidence of gastric cancer was observed in younger individuals in some countries, highlighting the need for more preventive strategies in younger populations. Future research should explore the reasons for these epidemiologic trends.

Study of association between drinking water and gastric cancer of the residents in Sheyang county Jiangsu Province: a case-control study

A total of 189 new cases of gastric cancer in Sheyang County from 2014 to 2018 were selected as the case group, and 189 other people without gastric cancer were matched according to age and gender as the control group. A case-control study was conducted on the relationship between drinking water and gastric cancer. After adjusting BMI, family annual income, dietary taste, monthly pickle consumption, monthly chili consumption, monthly soy product consumption, whether experiencing misfortune, whether suffering from superficial gastritis, whether having family history of gastric cancer, the results of multivariate logistic regression showed that compared with those who had no sources of pollution at the end of drinking water 10 years ago and who mainly consumed boiled water, those who had sources of pollution at the end of drinking water 10 years ago and who only drank raw water had a higher risk of stomach cancer ［OR (95%CI) were 2.20 (1.13-4.29), 6.12 (1.25-29.93)］; Compared with drinking water source from tap water, the risk of stomach cancer of those who drink clean water is lower ［OR (95%CI): 0.55 (0.35-0.85)］; And those who drink more water every day have a lower risk of stomach cancer ［OR (95%CI): 0.67 (0.48-0.92)］.

Screening as a method of early effective diagnostics of gastric cancer

One of the most common forms of malignant neoplasms in the world for more than a decade is gastric cancer. It ranks 2nd in the structure of overall cancer and tends to grow steadily. According to the latest data, the WHO registers 750-850 thousand new cases of gastric cancer every year and more than 600 thousand people die from this disease [1]. Almost the only preventive method today, aimed at early detection of tumors is cancer screening. Its use helps to reduce mortality rate from certain types of malignant neoplasms including gastric cancer. Reasonability to perform screening of the population for malignant neoplasms in Ukraine today remains a matter of debate due to lack of awareness of the population and doctors, lack of clear understanding of the concept and process of screening, complexity and relatively high cost of screening methods, insufficient convincing evidence of its need for certain nosology of malignant tumors [3]. But at the same time, there is an urgent need inUkraine to introduce a gastric cancer screening program to determine its type, as well as to substantiate its reasonability.

Impacts of the Coronavirus 2019 Pandemic on Gastrointestinal Endoscopy Volume and Diagnosis of Gastric and Colorectal Cancers: A Population-Based Study

Impacts of the Coronavirus 2019 Pandemic on Gastrointestinal Endoscopy Volume and Diagnosis of Gastric and Colorectal Cancers: A Population-Based Study

Survival Rate of Gastric Cancer Patients in Jordan: Secondary Data Analysis.

BackgroundGastric cancer accounts for 2.7% of all newly diagnosed cancer cases in Jordan.ObjectiveThe aim of this study was to calculate the survival rate and its determinants among Jordanian patients who were diagnosed with gastric cancer between 2010 and 2014.MethodsA descriptive study was conducted based on secondary analysis of data from the Jordan Cancer Registry during the period of 2010-2014. Only cancer-related deaths were recorded as “death” in the survival analysis.ResultsA total of 1388 new cases of gastric cancer were recorded between 2010 and 2014. Of these, 872 (62.8%) were Jordanians and 60.5% were males. The mean age at diagnosis was 58.9 years and the median follow-up time was 1.6 years. The 5-year survival rate decreased significantly from 89% in patients with well-differentiated cancer to 32% in patients with poorly differentiated cancer (P=.005). The overall 5-year survival rate was 37.7% and the median survival was 1.48 years (95% CI 1.179-1.783). The 5-year survival rate decreased significantly with increasing age and with advanced stage of the disease: the 5-year survival rate was 75% for localized-stage, 48% for regional-stage, and 22.7% for distant-metastasis disease (P=.005).ConclusionsThis study showed that the overall 5-year survival rate among patients with gastric cancer in Jordan between 2010 and 2014 was 37.7%, which is higher than the reported rates from different countries in the Eastern Mediterranean region such as Egypt.

Динамика некоторых показателей онкологической службы при раке желудка в Казахстане

About 1.8 million new cases of gastric cancer (GC) are predicted and it is expected that about 1.4 million human will die from this pathology, according to the forecasts of the International Agency for Research on Cancer in 2040. To this aim, an analysis studying the indicators of the oncological service for GC also makes it possible to evaluate the ongoing anti-cancer measures in the Republic of Kazakhstan. Aim. Evaluate some indicators of the oncological service at GC in Kazakhstan in 2009 to 2018. Material and methods. The research material was data from the Ministry of Health of the Republic of Kazakhstan – annual form No. 7 and 35 regarding GC (ICD 10-C50) for 2009 2018 – incidence, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. Results and discussion. For 2009-2018, 27,468 new cases of GC were registered in the republic for the first time and 19,672 deaths from this pathology were registered. The average annual crude incidence rate of GC was 16.1±0.20/0000 (95% CI=15.7-16.5) and decreased in dynamics from 16.8±0.30/0000 (2009) to 15.1±0.30/0000 in 2018, the difference was statistically significant (t=4.01 and p=0.000). In dynamics, mortality rates from GC tended to statistically significant (t=12.02 and p=0.000) decrease from 14.0±0.30/0000 (2009) to 8.9±0.20/0000 in 2018 year, and the average annual crude mortality rate from GC was 11.6±0.60/0000 (95% CI=10.5-12.7). The research of the study period reveals a trend: early diagnosis indicators (specific weight of patients with I-II stage) improved from 24.5% (2009) to 41.3% in 2018, and accordingly the specific weight of neglected patients significantly decreased with stage III (from 46.2% to 41.1%) and with stage IV (from 29.3% to 17.5%). The morphological verification indicators for GC over the studied years improved from 85.1% to 95.0%. Conclusion. An analysis of the indicators of the oncological service in GC revealed an improvement in morphological verification and early diagnosis, a decrease in neglect and mortality rates, which is undoubtedly associated with ongoing anti-cancer measures in Kazakhstan, in particular with the screening, which was carried out in 2012-2016. Keywords: gastric cancer, incidence, mortality, early diagnosis, neglect, morphological verification.

1233 Disaggregation of Gastric Cancer Risk Between Asian American Subgroups

INTRODUCTION: Within the United States (US), 26,000 new cases of gastric cancer (GC) and over 10,000 related deaths occur annually. Within the US, Asians and Pacific Islanders (API) in aggregate are known to be at increased risk for GC. There is limited data regarding GC risk between API subgroups. While screening of the general American population is not cost-effective, improved understanding of GC risk by disaggregated API subgroups may allow for targeted and cost-effective endoscopic screening. METHODS: All incident cases of GC diagnosed in the years 2011-2014 were identified from the Surveillance, Epidemiology, and End Results Program registries incorporating California (CA) and Hawaii (HI). From these incidence registries, API subgroup of patients were identified: Korean (CA and HI), Japanese (CA and HI), Chinese (CA and HI), Vietnamese (CA only), Filipino (CA and HI), and Indian (CA only). API subgroup population estimates were obtained from the American Community Survey (ACS). The age-adjusted incidence rates per 100,000 population and 95% confidence intervals (CIs) were generated for each subgroup, and among non-Hispanic whites (NHWs) for reference. RESULTS: 2,132 incident API GCs, and 3,984 incident NHW GCs were identified. Significant differences in GC incidence exist between API subgroups. In CA, Koreans (23.4 per 100,000, 95% CI 15.8 to 31.0) and Japanese (21.4, CI 16.1 to 26.7) demonstrated high incidence, Chinese (11.0, CI 10.4 to 11.6) and Vietnamese (10.3, CI 7.8 to 12.8) demonstrated intermediate incidence, and Filipinos (4.6, CI 3.4 to 5.8) and Indians (3.7, CI 2.9 to 4.5) demonstrated low incidence (Figure 1). The incidence among NHWs in CA was 6.6 (CI 6.0 to 7.2). In HI, Koreans (16.3, CI 11.4 to 21.2) and Japanese (16.0, CI 12.5 to 19.5) demonstrated high incidence, while Filipino (5.0, CI 3.4 to 6.6) and Chinese (4.8, CI 2.1 to 7.5) demonstrated low incidence (Figure 2). The incidence among NHWs in HI was 4.7 (CI 3.1 to 6.3). CONCLUSION: Substantial heterogeneity in risk for GC exist between API subgroups. Koreans and Japanese are at highest risk, with incidence nearly five-fold higher than Filipinos and Indians. This suggests that the higher GC-risk in APIs in aggregate are driven by certain subgroups. This may hold implications for screening for GC. There is a lower incidence of GC in HI compared to CA, even within API subgroups. These differences may represent cohort effects from generational migration, or regional dietary and environmental differences.

2721 Back Pain Can Be Hard to Digest

INTRODUCTION: With over 1,000,000 new cases of gastric cancer in 2018, and 783,000 estimated deaths, gastric cancer remains an important cancer worldwide.1 Gastric malignancy will commonly present in patients with weight loss and persistent abdominal pain. Patients can also present with findings of metastatic disease. This clinical vignette is an example of a rare metastatic location of gastric cancer. CASE DESCRIPTION/METHODS: 55-year-old Middle Eastern male presents with intractable low back pain. An MRI of the thoracic and lumbar spine revealed multiple osseous lesions of the thoracic vertebral bodies and fractures of the L2 and L3 vertebral bodies, concerning for metastasis (Figure 1). A CT of the chest, abdomen and pelvis revealed enlarged mediastinal and hilar lymph nodes. Enlarged lymph nodes at the gastrohepatic interval and celiac level measuring up to 2 cm were noted, and multiple enlarged mesenteric and retroperitoneal lymph nodes. The patient underwent bone biopsy during kyphoplasty of the L2 and L3 vertebrae, which revealed metastatic carcinoma. Serum markers of malignancy were unrevealing, a CA19-9 of 15, CEA of 7.1, and PSA of 0.74. Urology was consulted and cystoscopy performed. No mass or filling defect was noted, and urine cytology returned negative for malignant cells. Gastroenterology was consulted and upon further history, the patient did acknowledge a history of H. Pylori, in 2016, with eradication confirmed by a negative stool antigen test. Gastroenterology recommended EGD and colonoscopy, but patient was unable to tolerate the bowel prep. The patient underwent an EGD, which revealed a 3.0 × 3.5 cm, cratered gastric ulcer without stigmata of bleeding at the incisura (Figure 2). Biopsy of this ulcer was positive for adenocarcinoma. DISCUSSION: This case demonstrates a presentation of bony metastasis of gastric cancer. This metastatic location is rare and unusual. It highlights the importance of maintaining high clinical suspicion in patients with metastatic disease. Additionally, it reinforces the relevance of a multidisciplinary approach when evaluating malignancy.