• Title/Summary/Keyword: Metastatic gastric cancer

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Clinical Experience of Small-cell Carcinomas of the Stomach (위에 발생한 소세포암의 임상 경험)

  • Kim, Hyoung-Ju;Park, Moon-Hyang;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.252-259
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    • 2005
  • To clarify the clinicopathologic features of small-cell carcinomas (SCC) of the stomach, we reviewed three cases of surgically treated SCC. The first case was a pure SCC, with severe pancreatic invasion and peritoneal seeding. A gastro-jejunostomy was performed. Postoperative chemotherapy was performed with CDDP and VP-16 (8 cycles) but showed disease progression (PD); a consecutive chemotherapy with CDDP and irinotencan (2 cycles) also showed PD. A third line with CDDP, VP16, ifosfamide, and mesna was followed by a 4th line (CDDP and Taxol). The male patient died with liver metastasis and peritoneal seeding 14 months after the operation. The second case was a SCC mixed with a poorly differentiated adenocarcinoma. Profound lymphadenopathy and liver metastasis were found. Two cycles of preoperative chemotherapy with TS-1 and CDDP were performed, which showed nearly complete remission for lymphadenopathy and partial response for the primary tumor site and liver metastatic lesion. A total gastrectomy and extended lymphadenectomy was performed. There were no viable cancer cells in 35 retrieved lymph nodes. Postoperative chemotherapy using the same regimen was performed for 4 cycles. Enlarged liver metastasis was found at the follow-up CT scan, so a posterior segmentectomy of liver was performed. After liver surgery, the chemotherapy regimen was changed to irinotecan and cisplatin. This male patient has been in good health for the f4 months since gastric surgery. The third case was a pure SCC, and a subtotal gastrectomy was performed curatively. That male patient received 5 cycles of TS-1 and is still in good health 14 months after operation.

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Verification of the Correlation between Progression-free Survival and Overall Survival Considering Magnitudes of Survival Post-progression in the Treatment of Four Types of Cancer

  • Liu, Li-Ya;Yu, Hao;Bai, Jian-Ling;Zeng, Ping;Miao, Dan-Dan;Chen, Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1001-1006
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    • 2015
  • Background: With development and application of new and effective anti-cancer drugs, the median survival post-progression (SPP) is often prolonged, and the role of the median SPP on surrogacy performance should be considered. To evaluate the impact of the median SPP on the correlation between progression-free survival (PFS) and overall survival (OS), we performed simulations for treatment of four types of cancer, advanced gastric cancer (AGC), metastatic colorectal cancer (MCC), glioblastoma (GBM), and advanced non-small-cell lung cancer (ANSCLC). Materials and Methods: The effects of the median SPP on the statistical properties of OS and the correlation between PFS and OS were assessed. Further, comparisons were made between the surrogacy performance based on real data from meta-analyses and simulation results with similar scenarios. Results: The probability of a significant gain in OS and HR for OS was decreased by an increase of the SPP/OS ratio or by a decrease of observed treatment benefit for PFS. Similarly, for each of the four types of cancer, the correlation between PFS and OS was reduced as the median SPP increased from 2 to 12 months. Except for ANSCLC, for which the median SPP was equal to the true value, the simulated correlation between PFS and OS was consistent with the values derived from meta-analyses for the other three kinds of cancer. Further, for these three types of cancer, when the median SPP was controlled at a designated level (i.e., < 4 months for AGC, < 12 months for MCC, and <6 months for GBM), the correlation between PFS and OS was strong; and the power of OS reached 34.9% at the minimum. Conclusions: PFS is an acceptable surrogate endpoint for OS under the condition of controlling SPPs for AGC, MCC, and GBM at their limit levels; a similar conclusion cannot be made for ANSCLC.

Brachiocephalic Venous Aneurysm Mimicking Metastatic Cervical Lymphadenopathy in a Patient with Gastric Cancer: A Case Report (위암 환자에서 경부 전이성 림프절로 오인될 수 있는 팔머리정맥류: 증례 보고)

  • Min Jung Ryu;Jae-Kwang Lim;Hoseok Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.933-938
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    • 2020
  • Brachiocephalic venous aneurysm (BVA) development is an extremely rare, particularly as a primary vascular disorder. BVAs may be misinterpreted as lymphadenopathies owing to the variable degrees of enhancement seen in imaging studies, especially among patients with underlying malignancy. We report a BVA that mimicked lymph node metastasis on CT in a 60-year-old female who had undergone subtotal gastrectomy for stomach cancer. After follow-up chest CT with different bolus times and Doppler ultrasonography, a venous aneurysm originating from the brachiocephalic vein was diagnosed. We emphasize that, to make an accurate diagnosis, physicians should be aware of the potential diagnostic pitfalls and have a high index of suspicion for BVA when encountering certain lesions in the cervical area.

The effect of retinoic acid on the expression of cell adhesion molecules and binding ability to peritoneal mesothelium in gastric cancer cells (위암세포에서 세포유착물질의 발현 및 위암세포의 복막 내피세포에 대한 결합 능에 미치는 retinoicacid의 영향)

  • Hong, Young Seon;Park, Cho Hyun;Park, Jin-No;Lee, Kyung Shik;Kim, In Chul
    • IMMUNE NETWORK
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    • v.1 no.1
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    • pp.36-44
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    • 2001
  • Background : Peritoneal metastasis is one of the maj or types of the stomach cancer recurrence and the role of the adhesion molecules is thought to be very much important in this event. Retinoic acid (RA) has been known to induce the growth inhibition and differentiation of various malignancies, and apoptpsis and the change of expression of adhesion molecules have been reported to be involved in the action of RA. Methods : We studied the adhesion abilities of SNU-1, SNU-5, and SNU-6 cells to the peritoneal endothelial cells as well as the expression of the adhesion molecules (CD44, ICAM-1) in Western blot analysis. And also we studied the expression of apoptosis and the change of expression patterns of the various isoforms of CD44 and the change of the adhsion abilities of the cell line cells after RA treatment. Results: CD44 was expressed in SNU-5 and -16, together with an isoform in SNU-16. ICAM-1 was not expressed in any of the cell line cells tested. After the treatment of RA in the concentration range of $1-5{\times}10^{-5}M$ to three stomach cancer cell lines, growth inhibition, apoptosis and the change of expression of the CD44 were noted. After RA treatment, the expression of CD44H was weakly increased in SNU-1, and was markedly increased in SNU-5. In SNU-16, the expression of CD44H was decreased while that of CD44E were markedly increased. The adhesibility of cells to peritoneal cells was increased in relation with the increase of the CD44H expression, which shows the fact that the adhesibility of tumor cells to peritoneal mesothelial cells is mediated by CD44H recognizing hyaluronic acid. Conclusion : RA induces growth inhibition of stomach cancer cell line cells and increase the adhesiblity of stomach cancer cell line cells to peritoneal mesothelium. It is believed that RA decreases the metastatic ability of stomach cancer cells by upregulating the CD44H expression.

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