Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2012

Open Access 01-12-2012 | Research article

Survival in patients with stage IV noncardia gastric cancer - the influence of DNA ploidy and Helicobacter Pyloriinfection

Authors: John Syrios, Stavros Sougioultzis, Ioannis D Xynos, Nikolaos Kavantzas, Christos Kosmas, George Agrogiannis, John Griniatsos, Ioannis Karavokyros, Emmanouil Pikoulis, Efstratios S Patsouris, Nikolas Tsavaris

Published in: BMC Cancer | Issue 1/2012

Login to get access

Abstract

Background

Palliative surgery followed by postoperative chemotherapy is a challenging approach in the treatment of stage IV gastric cancer yet patients must be carefully selected on the basis of likely clinical benefit.

Methods

The records of 218 patients with histological diagnosis of gastric adenocarcinoma who underwent palliative surgery followed by postoperative chemotherapy were retrospectively reviewed. Twelve potential prognostic variables including tumour DNA index and serum IgG anti- Helicobacter pylori (HP) antibodies were evaluated for their influence on overall survival by multivariate analysis.

Results

The median survival was 13.25 months [95% Confidence Interval (CI) 12.00, 14.50]. Three factors were found to have an independent effect on survival: performance status (PS) [PS 60–70 vs. 90–100 Hazard Ratio (HR) 1.676; CI 1.171-2.398, p = 0.005], liver metastases (HR 1.745; CI 1.318-2.310, p < 0.001), and DNA Index as assessed by Image cytometry (2.2-3.6 vs. >3.6 HR 3.059; CI 2.185-4.283, p < 0.001 and <2.2 vs. >3.6 HR; 4.207 CI 2.751-6.433 <0.001). HP infection had no statistically significant effect on survival by either univariate or multivariate analysis.

Conclusion

Poor pre-treatment PS, the presence of liver metastasis and high DNA Index were identified factors associated with adverse survival outcome in patients with Stage IV gastric cancer treated with palliative gastrectomy and postoperative chemotherapy. HP infection had no influence on survival of these patients.
Appendix
Available only for authorised users
Literature
1.
D’Angelica M, Gonen M, Brennan MF, Turnbull AD, Bains M, Karpeh MS: Patterns of initial recurrence in completely resected gastric adenocarcinoma. Ann Surg. 2004, 240 (5): 808-816. 10.1097/01.sla.0000143245.28656.15.CrossRefPubMedPubMedCentral
2.
Fujitani K, Yang HK, Kurokawa Y, do Park J, Tsujinaka T, Park BJ, Fukuda H, Noh SH, Boku N, Bang YJ, et al: Randomized controlled trial comparing gastrectomy plus chemotherapy with chemotherapy alone in advanced gastric cancer with a single non-curable factor: Japan Clinical Oncology Group Study JCOG 0705 and Korea Gastric Cancer Association Study KGCA01. Jpn J Clin Oncol. 2008, 38 (7): 504-506. 10.1093/jjco/hyn058.CrossRefPubMed
3.
4.
Kim JG, Ryoo BY, Park YH, Kim BS, Kim TY, Im YH, Kang YK: Prognostic factors for survival of patients with advanced gastric cancer treated with cisplatin-based chemotherapy. Cancer Chemother Pharmacol. 2008, 61 (2): 301-307.CrossRefPubMed
5.
Lee J, Lim T, Uhm JE, Park KW, Park SH, Lee SC, Park JO, Park YS, Lim HY, Sohn TS, et al: Prognostic model to predict survival following first-line chemotherapy in patients with metastatic gastric adenocarcinoma. Ann Oncol. 2007, 18 (5): 886-891. 10.1093/annonc/mdl501.CrossRefPubMed
6.
Sougioultzis S, Syrios J, Xynos ID, Bovaretos N, Kosmas C, Sarantonis J, Dokou A, Tzivras D, Zografos G, Felekouras E, et al: Palliative gastrectomy and other factors affecting overall survival in stage IV gastric adenocarcinoma patients receiving chemotherapy: a retrospective analysis. Eur J Surg Oncol. 2011, 37 (4): 312-318. 10.1016/j.ejso.2011.01.019.CrossRefPubMed
7.
Lin SZ, Tong HF, You T, Yu YJ, Wu WJ, Chen C, Zhang W, Ye B, Li CM, Zhen ZQ, et al: Palliative gastrectomy and chemotherapy for stage IV gastric cancer. J Cancer Res Clin Oncol. 2008, 134 (2): 187-192.CrossRefPubMed
8.
Saidi RF, ReMine SG, Dudrick PS, Hanna NN: Is there a role for palliative gastrectomy in patients with stage IV gastric cancer?. World J Surg. 2006, 30 (1): 21-27. 10.1007/s00268-005-0129-3.CrossRefPubMed
9.
Tsavaris N, Kavantzas N, Tsigritis K, Xynos ID, Papadoniou N, Lazaris A, Kosmas C, Agrogiannis G, Dokou A, Felekouras E, et al: Evaluation of DNA ploidy in relation with established prognostic factors in patients with locally advanced (unresectable) or metastatic pancreatic adenocarcinoma: a retrospective analysis. BMC Cancer. 2009, 9: 264-10.1186/1471-2407-9-264.CrossRefPubMedPubMedCentral
10.
Chelidonis G, Kavantzas N, Patsouris E, Pagaki E, Athanasiadou AM, Agrogiannis G, Athanasiadou P: DNA ploidy, E-cadherin, beta-catenin expression and their clinicopathologic significance in imprints of non-small cell lung cancer. Anal Quant Cytol Histol. 2009, 31 (5): 332-339.PubMed
11.
Tsavaris N, Kosmas C, Kopterides P, Tsikalakis D, Skopelitis H, Sakelaridi F, Papadoniou N, Tzivras M, Balatsos V, Koufos C, et al: Retinol-binding protein, acute phase reactants and Helicobacter pylori infection in patients with gastric adenocarcinoma. World J Gastroenterol. 2005, 11 (45): 7174-7178.CrossRefPubMed
12.
Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, Scarffe JH, Lofts FJ, Falk SJ, Iveson TJ, et al: Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006, 355 (1): 11-20. 10.1056/NEJMoa055531.CrossRefPubMed
13.
Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, Haller DG, Ajani JA, Gunderson LL, Jessup JM, et al: Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001, 345 (10): 725-730. 10.1056/NEJMoa010187.CrossRefPubMed
14.
Chau I, Norman AR, Cunningham D, Waters JS, Oates J, Ross PJ: Multivariate prognostic factor analysis in locally advanced and metastatic esophago-gastric cancer–pooled analysis from three multicenter, randomized, controlled trials using individual patient data. J Clin Oncol. 2004, 22 (12): 2395-2403. 10.1200/JCO.2004.08.154.CrossRefPubMed
15.
Kanagavel D, Pokataev IA, Fedyanin MY, Tryakin AA, Bazin IS, Narimanov MN, Yakovleva ES, Garin AM, Tjulandin SA: A prognostic model in patients treated for metastatic gastric cancer with second-line chemotherapy. Ann Oncol. 2010, 21 (9): 1779-1785. 10.1093/annonc/mdq032.CrossRefPubMed
16.
Moon YW, Rha SY, Jeung HC, Kim C, Hong MH, Chang H, Roh JK, Noh SH, Kim BS, Chung HC: Outcomes of multiple salvage chemotherapy for advanced gastric cancer: implications for clinical practice and trial design. Cancer Chemother Pharmacol. 2010, 66 (4): 797-805. 10.1007/s00280-010-1295-z.CrossRefPubMed
17.
Jeung HC, Rha SY, Jang WI, Noh SH, Chung HC: Treatment of advanced gastric cancer by palliative gastrectomy, cytoreductive therapy and postoperative intraperitoneal chemotherapy. Br J Surg. 2002, 89 (4): 460-466. 10.1046/j.0007-1323.2001.02048.x.CrossRefPubMed
18.
Wang S, Sun Z, Wang S: Study on factors influencing survival in patients with advanced gastric carcinoma after resection by Cox’s proportional hazard model. Zhonghua Zhong Liu Za Zhi. 1996, 18 (6): 433-435.PubMed
19.
Belien JA, Buffart TE, Gill AJ, Broeckaert MA, Quirke P, Meijer GA, Grabsch HI: Gross genomic damage measured by DNA image cytometry independently predicts gastric cancer patient survival. Br J Cancer. 2009, 101 (6): 1011-1018. 10.1038/sj.bjc.6605266.CrossRefPubMedPubMedCentral
20.
Haroske G, Baak JP, Danielsen H, Giroud F, Gschwendtner A, Oberholzer M, Reith A, Spieler P, Bocking A: Fourth updated ESACP consensus report on diagnostic DNA image cytometry. Anal Cell Pathol. 2001, 23 (2): 89-95.CrossRefPubMedPubMedCentral
21.
Ormerod MG, Tribukait B, Giaretti W: Consensus report of the task force on standardisation of DNA flow cytometry in clinical pathology. DNA Flow Cytometry Task Force of the European Society for Analytical Cellular Pathology. Anal Cell Pathol. 1998, 17 (2): 103-110.CrossRefPubMedPubMedCentral
22.
23.
Baba H, Korenaga D, Okamura T, Saito A, Watanabe A, Sugimachi K: Prognostic significance of DNA content with special reference to age in gastric cancer. Cancer. 1989, 63 (9): 1768-1772.CrossRefPubMed
24.
Danova M, Riccardi A, Mazzini G, Wilson G, Dionigi P, Brugnatelli S, Fiocca R, Ucci G, Jemos V, Ascari E: Flow cytometric analysis of paraffin-embedded material in human gastric cancer. Anal Quant Cytol Histol. 1988, 10 (3): 200-206.PubMed
25.
Osterheld MC, Caron L, Demierre M, Laurini R, Bosman FT: DNA-ploidy in advanced gastric carcinoma is less heterogeneous than in early gastric cancer. Cell Oncol. 2004, 26 (1–2): 21-29.PubMedPubMedCentral
26.
Fujimaki E, Sasaki K, Nakano O, Chiba S, Tazawa H, Yamashiki H, Orii S, Sugai T: DNA ploidy heterogeneity in early and advanced gastric cancers. Cytometry. 1996, 26 (2): 131-136. 10.1002/(SICI)1097-0320(19960615)26:2<131::AID-CYTO6>3.0.CO;2-J.CrossRefPubMed
27.
Helicobacter and Cancer Collaborative Group: Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts. Gut. 2001, 49 (3): 347-353. 10.1136/gut.49.3.347.CrossRef
28.
Correa P, Piazuelo MB: Helicobacter pylori Infection and Gastric Adenocarcinoma. US Gastroenterol Hepatol Rev. 2011, 7 (1): 59-64.PubMedPubMedCentral
29.
Gonzalez CA, Megraud F, Buissonniere A, Lujan Barroso L, Agudo A, Duell EJ, Boutron-Ruault MC, Clavel-Chapelon F, Palli D, Krogh V, et al: Helicobacter pylori infection assessed by ELISA and by immunoblot and noncardia gastric cancer risk in a prospective study: the Eurgast-EPIC project. Ann Oncol. 2012, 23 (5): 1320-1324. 10.1093/annonc/mdr384.CrossRefPubMed
30.
Mitchell H, English DR, Elliott F, Gengos M, Barrett JH, Giles GG, Forman D: Immunoblotting using multiple antigens is essential to demonstrate the true risk of Helicobacter pylori infection for gastric cancer. Aliment Pharmacol Ther. 2008, 28 (7): 903-910.PubMed
31.
Meimarakis G, Winter H, Assmann I, Kopp R, Lehn N, Kist M, Stolte M, Jauch KW, Hatz RA: Helicobacter pylori as a prognostic indicator after curative resection of gastric carcinoma: a prospective study. Lancet Oncol. 2006, 7 (3): 211-222. 10.1016/S1470-2045(06)70586-1.CrossRefPubMed
32.
Marrelli D, Pedrazzani C, Berardi A, Corso G, Neri A, Garosi L, Vindigni C, Santucci A, Figura N, Roviello F: Negative Helicobacter pylori status is associated with poor prognosis in patients with gastric cancer. Cancer. 2009, 115 (10): 2071-2080. 10.1002/cncr.24253.CrossRefPubMed
33.
Kang SY, Han JH, Ahn MS, Lee HW, Jeong SH, Park JS, Cho YK, Han SU, Kim YB, Kim JH, et al: Helicobacter pylori infection as an independent prognostic factor for locally advanced gastric cancer patients treated with adjuvant chemotherapy after curative resection. Int J Cancer. 2012, 130 (4): 948-958. 10.1002/ijc.26081.CrossRefPubMed
34.
Apostolopoulos P, Vafiadis-Zouboulis I, Tzivras M, Kourtessas D, Katsilambros N, Archimandritis A: Helicobacter pylori (H pylori) infection in Greece: the changing prevalence during a ten-year period and its antigenic profile. BMC Gastroenterol. 2002, 2: 11-10.1186/1471-230X-2-11.CrossRefPubMedPubMedCentral
35.
Hobsley M, Tovey FI, Holton J: Helicobacter pylori and gastric cancer: neither friend nor foe. Gastroenterology. 2007, 132 (5): 2076-CrossRefPubMed
36.
Qiu HB, Zhang LY, Keshari RP, Wang GQ, Zhou ZW, Xu DZ, Wang W, Zhan YQ, Li W: Relationship between H. Pylori infection and clinicopathological features and prognosis of gastric cancer. BMC Cancer. 2010, 10: 374-10.1186/1471-2407-10-374.CrossRefPubMedPubMedCentral
Metadata
Title
Survival in patients with stage IV noncardia gastric cancer - the influence of DNA ploidy and Helicobacter Pyloriinfection
Authors
John Syrios
Stavros Sougioultzis
Ioannis D Xynos
Nikolaos Kavantzas
Christos Kosmas
George Agrogiannis
John Griniatsos
Ioannis Karavokyros
Emmanouil Pikoulis
Efstratios S Patsouris
Nikolas Tsavaris
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2012
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-12-264

Other articles of this Issue 1/2012

BMC Cancer 1/2012 Go to the issue

Research article

Brain metastases from hepatocellular carcinoma: clinical features and prognostic factors

Research article

A randomized, phase 2 study comparing pemetrexed plus best supportive care versus best supportive care as maintenance therapy after first-line treatment with pemetrexed and cisplatin for advanced, non-squamous, non-small cell lung cancer

Research article

Risk factors for nasal malignancies in German men: the South-German Nasal cancer study

Research article

Association of estrogen receptor betavariants and serum levels of estradiol with risk of colorectal cancer: a case control study

Case report

Development of coronary artery stenosis in a patient with metastatic renal cell carcinoma treated with sorafenib

Research article

Nutrition deficiency increases the risk of stomach cancer mortality
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits