Stomach Cancer Group Research Articles

Microbial and Metabolic Gut Profiling across Seven Malignancies Identifies Fecal Faecalibacillus intestinalis and Formic Acid as Commonly Altered in Cancer Patients.

The key association between gut dysbiosis and cancer is already known. Here, we used whole-genome shotgun sequencing (WGS) and gas chromatography/mass spectrometry (GC/MS) to conduct metagenomic and metabolomic analyses to identify common and distinct taxonomic configurations among 40, 45, 71, 34, 50, 60, and 40 patients with colorectal cancer, stomach cancer, breast cancer, lung cancer, melanoma, lymphoid neoplasms and acute myeloid leukemia (AML), respectively, and compared the data with those from sex- and age-matched healthy controls (HC). α-diversity differed only between the lymphoid neoplasm and AML groups and their respective HC, while β-diversity differed between all groups and their HC. Of 203 unique species, 179 and 24 were under- and over-represented, respectively, in the case groups compared with HC. Of these, Faecalibacillus intestinalis was under-represented in each of the seven groups studied, Anaerostipes hadrus was under-represented in all but the stomach cancer group, and 22 species were under-represented in the remaining five case groups. There was a marked reduction in the gut microbiome cancer index in all case groups except the AML group. Of the short-chain fatty acids and amino acids tested, the relative concentration of formic acid was significantly higher in each of the case groups than in HC, and the abundance of seven species of Faecalibacterium correlated negatively with most amino acids and formic acid, and positively with the levels of acetic, propanoic, and butanoic acid. We found more differences than similarities between the studied malignancy groups, with large variations in diversity, taxonomic/metabolomic profiles, and functional assignments. While the results obtained may demonstrate trends rather than objective differences that correlate with different types of malignancy, the newly developed gut microbiota cancer index did distinguish most of the cancer cases from HC. We believe that these data are a promising step forward in the search for new diagnostic and predictive tests to assess intestinal dysbiosis among cancer patients.

Pro-Inflammatory Diet as a Risk Factor for Stomach Cancer: Findings from a Multicenter Study in Central and Western China.

We conducted a multicenter cross-sectional study in central and western China to explore the association between inflammatory diet and stomach cancer odds. Participants from five hospitals in the central and western regions were collected. All participants completed the questionnaire we provided before the gastroscopy examination, which includes inquiries about risk factors for stomach cancer and food frequency. All participants underwent gastroscopy, and a mucosal biopsy was confirmed pathologically. Pathological findings were classified as chronic gastritis group, precancerous lesions group and stomach cancer group. Dietary Inflammatory Index (DII) scores were calculated based on the frequency of food occurrences in the questionnaire, and finally SPSS was used to calculate the correlation between variables. A total of 1162 patients were included in this study, including 668 cases of chronic gastritis, 411 cases of precancerous lesions, and 83 cases of cancer. A single factor analysis was conducted to examine the risk factors of stomach cancer, revealing a significant association between a pro-inflammatory diet and the stomach cancer odds (p value < 0.05). The results of binary classification analysis further confirmed that a pro-inflammatory diet is a risk factor for stomach cancer 【odds ratio (OR) =7.400)】. Moreover, correlation analysis demonstrated a positive correlation between the severity of gastric mucosal diseases and an inflammatory diet (including anti-inflammatory and pro-inflammatory diets) (rs=0.274, p-value < 0.001). Pro-Inflammatory diet is a risk factor for stomach cancer, and may accelerate the progression of stomach mucosal disease.

ANTHROPOMETRIC AND BIO-IMPEDANSOMETRIC PARAMETERS AS DIAGNOSTIC PREDICTORS IN PATIENTS WITH GASTRIC CANCER

The study of anthropometric and bioimpedance parameters in assessing the physical development of patients helps to clarify the diagnosis, predict the course of the disease, and identify groups of increased risk for the development of the disease. The aim of this study was to identify anthropometric and bioimpedance metrics in patients with stomach cancer. Anthropometric and bioimpedansometric examination of 250 patients with verified gastric cancer, 123 men and 127 women was carried out. As a comparison group, the study used the results of anthropometric and bioimpedance measurements of healthy 221 men and 267 women of the same age in the Krasnoyarsk Territory population. To determine a set of anthropometric and bioimpedansometric variables, allowing to classify the observed people depending on the presence (group of patients with gastric cancer) or the absence of stomach cancer (group of healthy people), the method of discriminant analysis was applied. To test the hypothesis about the homogeneity of the covariance matrices of the compared groups, the multidimensional Box M-criterion was used. The statistical significance of the power of the discriminant function was assessed using the Wilks test. For each discriminant function, the role of its components was assessed by comparing the matrices of total variances and covariances using the F-test. Shoulder diameter for men and women, chest diameter (transverse size) for men and women, waist circumference for men, waist / hip ratio for men and women; lean mass in men, total fluid in men, fat mass in women, phase angle in men and women are statistically significantly different in the observed groups. The developed discriminant models with an accuracy of 75-77% suggest the presence of gastric cancer in patients and can be used in clinical practice at the stage of general medical examination in groups at increased risk of developing the disease.

Comparison between S-1 monotherapy and S-1 plus cisplatin as postoperative chemotherapy after R0 resection for stage IV gastric cancer patients with oligometastasis: A multicenter retrospective study.

123 Background: Gastric cancer (GC) with liver metastasis (M1: HEP) and para-aortic lymph node metastasis (M1: LYM) is categorized as stage IV. Based on the retrospective reports, surgical resection is weakly recommended for oligo-metastasis (O-Meta), if resectable, in the Japanese GC Treatment Guidelines 2018. Whereas S-1 monotherapy as adjuvant chemotherapy after surgery for stage II/III GC and S-1 plus cisplatin (SP) as palliative chemotherapy for unresectable stage IV GC are standard treatments, there is no consensus about post-operative chemotherapy (Post-Cx) after R0 resection of stage IV GC with O-Meta. Methods: The criteria for this retrospective study were: 1) no prior treatment for GC, 2) R0 resection including O-Meta (HEP or LYM) at 20 institutions in the Stomach Cancer Group of the Japan Clinical Oncology Group between 2007 and 2012, 3) histological confirmation of adenocarcinoma for primary tumor and O-Meta (M1: HEP or LYM), 4) no other distant metastasis such as peritoneal metastasis. Results: A total of 110 patients were collected. Of the 94 eligible patients, 84 patients underwent gastrectomy followed by Post-Cx with S-1 (S-1 group: n = 55), SP (SP group: n = 22) or others (Others group: n = 7), and 10 patients did not receive post-Cx (non-Cx group). Median age for the S-1, SP, Others and non-Cx groups were 66, 60, 61, and 79 years old. Sites of oligo-metastasis (HEP/LYM) was 21/34, 9/13, 2/5, and 7/3 in the S-1, SP, Others and non-Cx groups. The 3- / 5-year overall and relapse free survival (OS and PFS) rates of all the patients were 45.6/31.4% and 24.5/21.3%, respectively. Median OS was 28.5 and 36.5 months in the S-1 and SP groups (HR 0.99; 95% CI 0.54-1.82, p = 0.986). In multivariate analysis, no Post-Cx, over 70 years old were identified as the independent poor prognostic factor for OS (p &lt; 0.05). Conclusions: R0 resection followed by Post-Cx for GC patients with O-Meta showed favorable survival, while there seems no additional benefit of cisplatin to S-1 alone.

The impact of pre-operative chemotherapy in patients with peritoneal lavage cytology positive or localized peritoneum metastasis for gastric cancer: A multicenter retrospective study.

95 Background: Peritoneal lavage cytology of positive and localized peritoneum metastasis of gastric cancer (GC) are defined as CY1 and P1 in the 14th edition of the Japanese Classification of GC. Patients (pts) with CY1 and/or P1 have poor prognosis after removing all macroscopically visible disease by standard gastrectomy followed by S1. The aim of this study was to investigate the efficacy of pre-operative chemotherapy (Pre-Cx) in patients with CY1 and/or P1. Methods: We retrospectively reviewed the GC pts who were diagnosed to have CY1 and/or P1 at 34 institutions participating in the Stomach Cancer Group of Japan Clinical Oncology Group between 2007 and 2012. Inclusion criteria were: no distant metastasis other than CY1 or P1, no prior treatment for GC. The subjects were divided to two groups according to treatment strategy with/without Pre-Cx before surgery. In the Pre-Cx group, status of CY and P was diagnosed by laparoscopy before and after Pre-Cx, and indication of surgical resection was decided by each physician. Results: A total of 824 pts were collected from 34 institutions. Of the 713 eligible pts, 150 pts received Pre-Cx (Pre-Cx group) and 563 pts underwent surgery followed by Cx (Post-Cx group). Proportions of P0CY1/P1CY0/P1CY1 were 69/12/19% and 69/17/14% in the Pre- and Post-Cx. Cx regimen for Pre-Cx were S1 plus cisplatin/ docetaxel and cisplatin plus S1/others (n=90/37/23). In the Pre-Cx, 57 (38%) pts who achieved P0CY0 after Pre-Cx showed better survival than the remaining 92 pts (overall survival (OS), 31.0 vs. 19.9 months (M), HR=1.99, 95% CI 1.32-2.93, p=0.001). OS was 24.8 and 24.0 M in the Pre- and Post-Cx (HR 1.07; 95% CI 0.87-1.32, p=0.502). In multivariate analysis, P1CY1, over 65 years old and clinical N3 lymph node metastasis were identified as the independent prognostic factor for OS (p&lt;0.05). Conclusions: Although Pre-Cx showed favorable survival in case of achieving P0 and CY0, Pre-Cx did not show a survival benefit for GC pts with CY1 and /or P1.

Comparison of S-1 and S-1 plus cisplatin as post-operative chemotherapy for gastric carcinoma with peritoneal lavage cytology positive or localized peritoneum metastasis: A multicenter retrospective study.

109 Background: Peritoneal lavage cytology of class V and localized peritoneum metastasis of gastric cancer (GC) are defined as CY1 and P1 in the 14th edition of the Japanese Classification of GC. Because patients (pts) with CY1 and/or P1 have poor prognosis after resecting all macroscopically visible disease by standard surgical resection, post-operative chemotherapy (post-Cx) is commonly performed in the clinical practice in Japan. However, no standard chemotherapy has not been established. The aim of this study was to investigate the efficacy of post-Cx in patients with CY1 and/or P1. Methods: We retrospectively reviewed the GC pts who were diagnosed to have CY1 and/or P1 at 34 institutions participating in the Stomach Cancer Group of Japan Clinical Oncology Group between 2007 and 2012. Inclusion criteria were: PS 0-2, histology of adenocarcinoma, no distant metastasis other than CY1 or P1, no prior treatment for GC. The subject of this study was the patients who received surgery followed by post-Cx. Results: A total of 824 pts were collected from 34 institutions. Of the 506 eligible pts, 444 pts underwent standard gastrectomy followed by post-Cx: S-1 (n=267), S1 plus cisplatin (SP) (n=114) or others (n=63). 62 pts did not receive post-Cx (non-Cx). Median age for the S1/SP/Others/non-Cx group were 69/63/66/75. In the S-1 group, pts with P0CY1/P1CY0/P1CY1 were 197/44/26, and those were 81/21/12 in SP, 45/9/9 in Others, and 44/7/11 in non-Cx. Conclusions: Post-Cx may have survival benefit after surgery for GC with CY1 or P1, while there seems no additional benefit over S-1. [Table: see text]

Cancer report-a statistical analysis by site, age and sex distribution in rural area of Melmaruvathur, South India

Background: Among various diseases, cancer has become a big threat to human beings globally. The incidence of cancer is increasing nowadays because of modernized world and changing life pattern. Objective: This study aim to measure the incidence and pattern of cancer in rural area of Melmaruvathur, Tamilnadu. Materials and Methods: A retrospective study was carried out in the pathology department of Melmaruvathur Adhiparasakthi institute of medical sciences. Data was collected from cancer register maintained in the pathology department from 2009-2015 .A total of 393 cases were collected and statistically analyzed. Results: The common type of cancer noted in this area was squamous cell carcinoma (43%) affecting cervix, penis, skin, esophagus followed by adenocarcinoma affecting thyroid, breast, stomach, prostate and colon. The age and sex of predominantly affected were females (64%) between the age group of 40-60 years (55%) with an exception that males were commonly affected with stomach cancer (57%) and younger age group of less than 40 years were affected predominantly by thyroid cancer (100%). Conclusion: The incidence of cancer is more common among females and between the age group of 40-60 years in this rural area. The most common cancer affecting females are cancer of cervix, breast and thyroid and males are affected frequently by cancer of penis, prostate and stomach. This study concludes that, the population resides in this rural area is more commonly affected by Genital squamous cell carcinoma followed by papillary carcinoma of thyroid and breast carcinoma. Keywords: Cancer-incidence, Statistics, Trends, India, Cervical cancer

Determination of Cancer Antigen CA15-3 and Carcino Embryonic Antigen CEA concentration as Tumor Markers in Patients with Stomach and Colorectal cancers.

Background: Tumor markers are often requested as part of a diagnostic workup, and increased concentrations in serum may suggest malignancy of a particular organ. However, definitive diagnosis is based on histological evaluation of the involved tissue.Objective: The aim of present study is to evaluated CEA and CA15-3 in order to clarify at least in part their possible use as an early diagnosis tools in sera of patients with stomach, colon and rectum cancers.Patients and methods: The study was carried out on 61 subjects comprising of 16 patients with colon cancer group (G1), 10 patients with rectum cancer group (G2), 10 patients with stomach cancer group (G3) and 25 normal healthy control The patients were selected, during the period from (February 2010 to January 2011) with age range of (40-55) years. The patients were admitted to Al khadmiya Teaching Hospital, Iraq for treatment. Serum CA15-3 and CEA were measured by enzyme linked immunosorbent assay (ELISA).Results: The serum value of CA15-3, was highly significant increase (p≤0.001) in G1 and G2 cancer groups compared to normal healthy subjects. while the serum value of CEA of G1 and G2 was a significant increase (p≤0.05)compared to control but CA15-3 and CEA in serum of G3 showed no significant difference(p&gt;0.05) compared to control.Conclusions: In this study CA15-3 and CEA could not be of valuable use as diagnostic markers in serum of stomach cancer while in colon and rectal cancers are of useful value.

Association Between C1019T Polymorphism in the Connexin 37 Gene and Helicobacter Pylori Infection in Patients with Gastric Cancer

To investigate the association between the connexin 37 C1019T polymorphism and Helicobacter pylori infection in patients with gastric cancer. 388 patients with gastric cancer (GC), 204 with chronic superficial gastritis (CSG) were studied. H. pylori was detected by gastric mucosal biopsies biopsy dyeing method. Connexin 37 gene polymorphism 1019 site genotypes were determined by gene sequencing technology. Genotypes and alleles frequencies were compared. (1) Connexin37 gene 1019 site distribution frequency (CC type, TC type, TT type) in the CSG group was 18.1%, 45.1% and 36.8%; in the stomach cancer group it was 35.1%, 45.9% and 19.%, conforming to the Hardy-Weinberg euilibrium. (2) In comparison with CSG group, the frequency of Connexin37 C allele was higher in the gastric cancer group (58.0% vs 40.7%, OR=2.01, 95%CI=1.58-2.57, P<0.01). The prevalence of gastric cancer risk was significantly increased in the carriers of C allele (CC+TC) than in TT homozygote (OR=2.47, 5%CI=1.68-3.610. (3) Gastric cancer patients complicated with Hp infection 211 cases, gastric cancer group of the male patients with HP positive patients with 187 cases, 40 cases of female patients with negative patients, 24 cases were HP positive, negative in 137 cases, control group male patients, 28 cases were Hp positive, negative in 95 patients, female patients with Hp positive 6 cases, 75 cases were negative. On hierarchical analysis, the male group OR value was 15.9 (95%CI to 9.22-27.3), and the female OR was 2.19 (95%CI 0.88-5.59), indicating a greater contribution in males (P<0.01). After elimination of gender effects, positive HP and gastric cancer were closely related (OR 8.82, 95% CI: 5.45-14.3). (4) The distribution frequency of C allele in patients with Hp infection was much higher than that in Hp negative cases in the GC group (64.5% vs 47.0%, OR=2.05, 95%CI=1.54-2.74, P<0.01). Compared with TT homozygotes, (CC+TC) genotype prevalence of gastric cancer risk increased significantly (OR=2.96, 5%CI=1.76-2.99). The T allele in the connexin37 gene might not only be associated with gastric cancer but also with H. pylori infection.

The Synchronous Prevalence of Colorectal Neoplasms in Patients with Stomach Cancer

See Article on Page 246-251 Stomach cancer is still the most common malignancy in Korea in spite of its dramatically decreasing tendency during the last two decades. More importantly, the incidence of colorectal cancer has been increasing during the same period, so clinicians frequently experience synchronous or metachronous stomach cancer with colorectal cancer. Several reports on colorectal cancer with stomach cancer have been published in Asian countries. In 2010, Yoon et al. [1] reported clinicopathologic data for colorectal cancer with synchronous and metachronous stomach cancer. They reviewed 8,680 patients who underwent surgery for primary sporadic colorectal cancer from 1989 to 2008. They revealed that the incidences of synchronous and metachronous gastric cancer were 0.93 and 1.4%, respectively (combined 2.4%). The standardized incidence ratio was 1.199 (95% confidence interval, 1.005 to 1.420). This result is slightly lower than the data for Japan [2] published in 1999. However, Eom et al. [3] reported that the incidence of synchronous or metachronous cancer with gastric cancer was 3.4% based on data for 4,593 patients who underwent gastric cancer surgery. The most common other primary cancer was colorectal cancer (20.1%), followed by lung cancer and liver cancer. Actually, this result is little different from the results published in other papers. Wu et al. [4] analyzed 99 multiple primary cancers with gastric cancer in Taiwan. In the 77 male patients, prostate cancer was the most common (19.5%), followed by cancers of the colon (18.2%) and liver (14.3%). In the 22 female patients, colon cancer was the most common (31.9%), followed by breast and cervix cancers (22.7%). Such data revealed the importance of colorectal cancer screening because colorectal cancer is second common cancer occurring with stomach cancer. In Korea, Lim et al. [5] reported a prospective study that analyzed the esophagogastroduodenoscopy results from 1,542 consecutive colorectal cancer patients. In their series, synchronous gastric cancers were detected in 31 cases (2.0%). Of these 31 cases, 26 had early gastric cancer (EGC, 83.9%) and 5 had advanced gastric cancer. Ten (38.5%) of the 26 EGC cases were managed using an endoscopic mucosal resection. Compared to colorectal cancer patients without synchronous gastric cancer, the group of patients with synchronous gastric cancer was older (65.5+/-9.6 vs. 58.4+/-11.3 years, P = 0.001) and had a greater proportion of males (77.4 vs. 59.4%, P = 0.043). In this research from July 2005 to June 2010, the authors included a total of 123 patients with stomach cancer (86 male), and 246 consecutive, age- and sex-matched persons without stomach cancer were analyzed. All of them underwent a colonoscopy within 6 months after undergoing a gastroscopy. The prevalence of colorectal neoplasms was significantly higher in the stomach cancer group (35.8%) than in the control group (17.9%, P < 0.001). This paper reports on a kind of case-control study, but still had a weak point of no randomization and retrospective analysis. Also, the authors analyzed all kinds of neoplasms in the colon, including tubular adenomas, villous adenomas and adenocarcinomas. The incidences of pure adenocarcinomas were 6.8% and 0% in the stomach cancer group and the normal control group, respectively. Another weak point is the small size of materials compared to other reports. We have to be cautious in accepting the statistical results reported in this paper. The biology of stomach cancer is apparently different from that of colorectal cancer, as are the risk factors for occurrence and the incidence of relapse. A larger-scale epideiologic study would be essential before concluding that the incidence of colorectal cancer in patients with stomach cancer is higher than it is in the general population.

The Synchronous Prevalence of Colorectal Neoplasms in Patients with Stomach Cancer

PurposeThe association between stomach cancer and colorectal cancer is controversial. The purpose of this study was to determine the synchronous prevalence of colorectal neoplasms in patients with stomach cancer.MethodsA total of 123 patients with stomach cancer (86 male) and 246 consecutive, age- and sex-matched persons without stomach cancer were analyzed from July 2005 to June 2010. All of them underwent colonoscopy within 6 months after undergoing gastroscopy.ResultsThe prevalence of colorectal neoplasms was significantly higher in the stomach cancer group (35.8%) than in the control group (17.9%) (P < 0.001). Colorectal neoplasms were more prevalent in the patients with stomach cancer (odds ratio [OR], 3.10; 95% confidence interval [CI], 1.71 to 5.63). In particular, the difference in the prevalence of colorectal neoplasms was more prominent in the patients above 50 years old (OR, 3.54; 95% CI, 1.80 to 6.98).ConclusionThe results showed that the synchronous prevalence of colorectal neoplasms was higher in patients with stomach cancer than in those without stomach cancer. Therefore, patients with stomach cancer should be regarded as a high-risk group for colorectal neoplasms, and colonoscopy should be recommended for screening.

15주간 재활프로그램이 위암과 유방암 환자의 건강관련체력과 대사증후군 인자에 미치는 영향

The purpose of this study was to analyze health-related physical fitness, metabolic syndrome factors through an examination of health-related physical fitness items and blood test. The rehabilitation programs were consisted of a chair exercise program(40~50minutes) included warm ups, posture exercise, upper and lower flexibility exercising, muscular endurance exercising and aerobic fitness includes waking, jogging and stepping with chair, and cool dow, and cancer recovery nutrition and health care class(30 minutes) two times a week during 15 weeks. The program was conducted by 20 persons (9 in an stomach cancer group and 11 in a breast cancer group), who have completed both chemotherapy and(or) radiation therapy after surgery. The result of the analysis was as follows. In the comparison of health-related physical fitness, SCG and BCG showed significant improvement in fitness test items of sit-and-reach within and between two groups. In BCG, fat mass had significant decrease before and after chair exercise. In the comparison of metabolic syndrome factors, SCG and BCG showed significant decrease within two group in TC, but there were no significance between two groups. SCG showed significant increase in HDL-C, and BCG had significant decrease in TG, but there were no significance between two groups.

Multiple primary malignancies involving colorectal cancer—clinical characteristics and prognosis with reference to surveillance

The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to suggest potential surveillance tool. We retrospectively reviewed 1,063 patients who were treated with potentially curative surgery for colorectal cancer at Gachon University, Gil Hospital from 1997 to 2007. The incidence of synchronous or metachronous cancer in addition to colorectal cancer was 5.3% (57 patients). The most common second primary cancer was stomach (54.3%), followed by cancers in cervix (12.2%). The time interval between the first and second tumor in colorectal cancer associated with metachronous extracolonic malignancy ranged from 1.1 to 10.8 years. The incidence of early-stage tumor was higher in patients with synchronous cancer than in those with a metachronous cancer with statistical significance (p = 0.034). The 5-year survival rate of the colorectal cancer group without second primary cancer was 70.1%, whereas that for the second primary cancer group was 63.8% (p = 0.253). The 5-year survival rate of the colorectal cancer group with stomach cancer was 70.5%, whereas that for the second primary cancer other than stomach cancer group was 56.6% (p = 0.282). The frequent association between colorectal cancer and gastric cancer suggests an inclusion of gastrofiberscope when surveillancing patients with colorectal cancer in Korean population. Second primary cancers may develop even 10 years after the initial operation; thus, a need for lifelong surveillance even more than 5 years may be necessary.

Preliminary experience using high intensity focused ultrasound for treating liver metastasis from colon and stomach cancer

Purpose: To determine the efficacy and safety from our preliminary results of using high intensity focused ultrasound (HIFU) to treat liver metastasis from colon and stomach cancer.Materials and methods: Ten patients with liver metastasis from colon cancer and three from stomach cancer underwent HIFU under general anesthesia. HIFU was performed using an extracorporeal, ultrasound-guided focused system. Complications during the study, extent of coagulative necrosis at two-week follow up, and evidence of tumor on further follow up were analyzed. Patients were divided into four categories: (I) complete ablation with no evidence of recurrence on follow up; (II) apparent complete ablation of target mass with new foci of disease in the target organ or distant malignancy and no local tumor progression; (III) local tumor progression after apparent complete ablation; (IV) partial ablation.Results: Mean follow-up period was 22 weeks in the colon cancer group and 58 weeks in the stomach cancer group. The sum of total lesion size was between 1.8 cm and 21.4 cm (mean: 8.4 cm ± 6.7 cm) for the colon cancer group and between 1.7 and 16.3 cm (mean: 8.8 cm ± 7.3 cm) for the stomach cancer group. In the colon cancer group, one patient was categorized as category I, one as category II, three as category III, and the remaining five as category IV. The stomach cancer group showed two patients as category I, and one as category II.Conclusion: For treating liver metastasis from colon and stomach cancer HIFU seems safe but its efficacy is questionable. Further research is warranted.

Resection-line involvement in gastric cancer: a continuing problem.

Surgeons are aware of the adverse effect that resection-line disease has on anastomotic leakage, perioperative mortality and long-term survival. In an attempt to assess the effect of this knowledge on surgical practice, patients entered into the second British Stomach Cancer Group adjuvant therapy trial were studied. The presence of resection-line disease was compared with the operative stage. Of 555 patients for whom complete data were available, resection-line disease was present in 105 (19 per cent). Of 424 patients undergoing what the surgeon considered to be a potentially curative operation, 55 (13 per cent) had involvement of one or both resection lines, rendering the surgery palliative. Only 9 per cent of patients with stage I-III disease and resection-line involvement survived beyond 5 years, compared with 27 per cent of those with clear lines. Despite knowledge of the adverse effects of resection-line disease, surgeons continue to perform inadequate resections. This demonstrates the need for a more aggressive approach to assessment of resection margins at operation.

Decreased expression of alpha2,8 sialyltransferase and increased expression of beta1,4 N-acetylgalactosaminyltransferase in gastrointestinal cancers.

Gangliosides such as GD3, GM2, and GD2 are abundantly expressed on the cell surfaces of various malignant cells, suggesting the potential for anti-ganglioside antibody therapy for tumors. Anti-ganglioside GD2 antibody treatment is currently undergoing clinical trials for melanoma and neuroblastoma. We previously reported high in vivo antitumor effects of anti-GM2 ganglioside antibody against lung cancer. To determine whether anti-GM2 antibody may be clinically indicated for gastrointestinal cancers, we evaluated the mRNA expression of alpha2,8 sialyltransferase, a GD3 synthase, and beta1,4 N-acetylgalactosaminyltransferase (beta1,4 GalNAc-T), a GM2/GD2 synthase, in gastrointestinal cancers. We performed modified semi-quantitative RT-PCR, which reduces complexity incidental to radiolabeling on samples taken from small surgically removed clinical specimens. Stomach (19/22) and colorectal (21/30) cancers showed decreased expression of alpha2,8 sialyltransferase as compared with respective normal tissues (P < 0.05). In contrast, increased expression of beta1,4 GalNAc-T was detected in both types of tumors. Clinicopathological analysis revealed significantly higher expression level of alpha2,8 sialyltransferase in the poorly differentiated than in the well-differentiated stomach cancer group (P < 0.05). Furthermore, the expression level of alpha2,8 sialyltransferase was significantly decreased in male as compared with female colorectal cancer patients (P < 0.05). These results suggest that expression level of GM2 ganglioside is elevated in gastrointestinal cancer, and that anti-GM2 antibody may be applicable to its treatment.

British Stomach Cancer Group Meeting held at the Stakis Hotel, Leicester, on 5 June 1998

British Stomach Cancer Group Meeting held at the Stakis Hotel, Leicester, on 5 June 1998

High prevalence of hepatitis C virus antibody and RNA in patients with oral cancer

We have investigated the correlation between the prevalence of hepatitis C virus (HCV), which is detectable in saliva, and oral cancer and other digestive tract cancers in the Northern Kyushu region of Japan. Anti-HCV antibodies were detected in sera from 24 of the 100 patients with oral cancer (24%, p < 0.05 vs the control group, p < 0.01 vs the stomach cancer group), in 11 of 104 patients with non-malignant diseases receiving dental treatment (the control group, 10.6%), and in 12 of 113 patients with stomach cancer (10.6%). HCV-RNA was detected in sera from 17 of 100 oral cancer patients (17%, p < 0.05 vs the control group) and 4 of 104 patients of the control group (3.9%). These results indicate a high prevalence of HCV infection in oral cancer patients, which warrants a systematic study of etiological associations between oral cancer and HCV.

Pathological prognostic factors in the second British Stomach Cancer Group trial of adjuvant therapy in resectable gastric cancer

The second British Stomach Cancer Group trial was a prospective randomised controlled trial of adjuvant radiotherapy or cytotoxic chemotherapy after gastrectomy for adenocarcinoma. It recruited between 1981 and 1986. No survival advantage has been demonstrated for the patients receiving either type of adjuvant therapy compared with those undergoing surgery alone. We report on 436 patients randomised into the trial together with 203 patients, who did not fulfil the trial criteria, referred to the trial. A univariate (log-rank) analysis of pathological factors obtained from the local referring centres showed that tumour size, macroscopic type, number os sites involved, depth of invasion, involvement of resection lines and lymph nodes and histological grade were significant determinants of survival. Histological review by two experienced histopathologists found that the Lauren classification and histological grade, but not the Ming classification, were significant prognostic factors. The degree of lymphocytic and eosinophilic infiltration and presence of dysplasia assessed by one of the pathologists showed a significant correlation with survival. However, inter-observer correlation for these histological parameters and grade was poor. Multivariate analysis identified only depth of invasion, resection line and nodal involvement as significant independent pathological variables influencing survival. This study confirms the need for expert preparation of the resected specimen to obtain the important information on depth of invasion and nodal status and also reveals some variation in histological assessment, particularly grading, in gastric carcinoma.

British Stomach Cancer Group

British Stomach Cancer Group