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Background: Laparoscopic surgery is frequently performed, and laparoscopic gastrectomy (LG) is also widely performed for gastric cancer. Elderly population with gastric cancer has increased in East Asia, including in Japan.Methods: We examined 1131 patients with gastric cancer who underwent laparoscopic and open standard surgeries (OG). A total of 921 patients of age < 75 years (non-E group) and 210 patients of age ≥ 75 years (E group) underwent surgery for gastric cancer. The mortality, morbidity, and prognosis of LG and OG were compared by propensity score-matched analysis.Results: Mortality and morbidity in the E group were significantly higher than those in the non-E group (p < 0.05). Propensity score-matching revealed that the incidence of postoperative complications of grade ≥ 2 in the OG subgroup was significantly higher than that in the LG subgroup in the E group (p < 0.05). The overall survival rate of the LG subgroup was significantly higher than that of the OG subgroup in both the non-E and E groups (p < 0.05). The depth of tumor invasion, lymph node metastasis, and the number of dissected lymph nodes were dependent factors for survival in the non-E group, whereas the depth of tumor invasion was the only dependent factor for survival in the E group in the multivariate analysis.Conclusion: The survival rate of patients who underwent LG showed significantly good prognosis in both the non-E and E groups, although the E group patients who underwent OG subgroup showed higher severe complication incidences than those who underwent LG subgroup. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to clarify the surgical indications for gastrectomy combined with distal or partial pancreatectomy (GP) in patients with gastric cancer. Methods: From January 1994 to December 2009, 29 patients with primary gastric cancer surgically invading the pancreas without distant organ metastasis underwent GP for R0 resection. The patients' characteristics, surgical data, and clinicopathological features were used for the analysis of survival and prognostic factors. Results: The median disease-free survival and median survival time (MST) of all patients were 15 and 30 months, respectively. Only pN3 status (characterized by 7 or more pathologically metastatic lymph nodes) according to the Japanese Classification of Gastric Carcinoma, 14th edition, was shown to be a prognostic factor in a multivariate analysis. The MST of the patients with pN3 and the other patients were 12 and 51 months, respectively ( p < 0.001). Conclusions: We suggest that pancreas invasion should not be considered a contraindication for gastrectomy and that patients with a small number of lymph node metastases (six or fewer) might be candidates for GP in the case of gastric cancer that requires pancreatectomy for R0 resection. [ABSTRACT FROM AUTHOR]

Purpose: Both squamous cell carcinomas and adenocarcinomas can develop in the esophagogastric junction. To clarify the appropriate lymph node dissection range, lymph node metastases from cancers in the esophagogastric junction were investigated. Methods: The nodal metastases were analyzed in 64 patients with squamous cell carcinoma and 129 with adenocarcinoma according to Siewert's classification, which is based on topographic anatomical criteria for adenocarcinoma. Results: The squamous cell carcinomas located above the esophagocardial junction had more frequent metastasis to the lower and middle mediastinal lymph nodes in proportion to the depth of the tumor. Nodal metastasis was also often detected in the abdominal lymph nodes. In contrast, adenocarcinomas metastasized less frequently to the mediastinal lymph nodes, and the metastatic rates in the abdominal nodes were higher than those from squamous cell carcinoma. Conclusion: Esophagectomy with mediastinal and abdominal lymph node dissection is considered to be an appropriate approach for surgical resection of squamous cell carcinomas, whereas transhiatally extended gastrectomy with lower mediastinal and abdominal lymph node dissection is recommended for the treatment of adenocarcinomas. [ABSTRACT FROM AUTHOR]

Purpose: With the broadening indications for hepatectomy to treat colorectal liver metastases (CRLM), early recurrence is a major problem. The aim of this study is to identify risk factors of early recurrence, defined as recurrence within 1 year after surgery. Methods: A retrospective analysis was performed on 121 consecutive patients who underwent hepatectomy for CRLM. Results: Among 121 patients, 52 (43.0%) developed early recurrence. The independent risk factor for early recurrence was 'number of liver metastases ≥3' (odds ratio 2.65). There were significantly more patients with liver recurrence (51.9%) and recurrence beyond curative surgical resection (63.5%) in those with early recurrence. In addition, patients with three or more liver metastases had significantly more liver recurrence (66.7%; P = 0.02) and recurrence beyond curative surgical resection (70.8%; P = 0.04). The overall survival rates of both patients with early recurrence (5-year survival rate 20%) and those with three or more liver metastases (5-year survival rate 24%) were significantly worse. Conclusions: The independent risk factor for early recurrence is the 'number of liver metastases ≥3.' Patients with three or more liver metastases have a significantly higher risk of liver recurrence and a higher rate of recurrence beyond curative surgical resection, and these are correlated with a poor prognosis. [ABSTRACT FROM AUTHOR]

MTA (metastasis-associated gene) is a newly discovered family of cancer progression-related genes and their encoded products. MTA1, the first gene found in this family, has been repeatedly reported to be overexpressed along with its protein product MTA1 in a wide range of human cancers. In addition, the expression of MTA1/MTA1 correlates with the clinicopathological properties (malignant properties) of human cancers. MTA proteins are transcriptional co-repressors that function in histone deacetylation and are involved in the NuRD complex, which contains nucleosome remodeling and histone deacetylating molecules. MTA1 expression correlates with tumor formation in the mammary gland. In addition, MTA1 converts breast cancer cells to a more aggressive phenotype by repression of the estrogen receptor (ER) α trans-activation function through deacetylation of the chromatin in the ER-responsive element of ER-responsive genes. Furthermore, MTA1 plays an essential role in c-MYC-mediated cell transformation. Another member of this family, MTA3, is induced by estrogen and represses the expression of the transcriptional repressor Snail, a master regulator of “epithelial to mesenchymal transitions”, resulting in the expression of the cell adhesion molecule E-cadherin and maintenance of a differentiated, normal epithelial phenotype in breast cells. In addition, tumor suppressor p53 protein is deacetylated and inactivated by both MTA1 and MTA2, leading to inhibition of growth arrest and apoptosis. Moreover, a hypoxia-inducible factor-1α (HIF-1α) is also deacetylated and stabilized by MTA1, resulting in angiogenesis. Thus, MTA proteins, especially MTA1, represent a possible set of master co-regulatory molecules involved in the carcinogenesis and progression of various malignant tumors. MTA proteins are proposed to be important new tools for clinical application in cancer diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Aim: We investigated the clinical significance of metastasis to the lymph node (LN) along the superior mesenteric vein (14v) in gastric cancer. Methods: A retrospective study of 2,513 gastrectomy patients with a 14v dissection was done using the Ganken Igan Database. Results: The incidence of 14v metastasis correlated with tumor location, depth of tumor invasion, regional LN metastases, peritoneal metastasis, peritoneal cytology-positive, hepatic metastasis and postoperative recurrence (p < 0.01). Metastases to the infrapyloric LN (6), suprapyloric LN (5) and left paracardial LN (2) were independent variables affecting 14v metastasis (p < 0.05), and the 6 status was a useful predictive factor for a 14v-negative status with a low false-negative rate (1.9%). The patients with 14v metastasis after curative surgery demonstrated a significantly lower survival rate than those without (5-year overall survival rate; 11.3 vs. 60.2%, p < 0.0001). In them, LN around the abdominal aorta (16)-positive group showed a significantly lower survival rate than the negative group (p < 0.05). Conclusions: Advanced gastric cancer with invasion to the lower stomach often metastasizes to 14v, and the 6 status can predict 14v negative. Most patients with 14v metastasis have a poor prognosis, similar to those with systemic metastasis, although some such patients may benefit from a curative dissection. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Esophageal squamous cell carcinoma is often accompanied by intramural metastases, and it has been reported to carry a poor prognosis. Intramural metastasis from gastric cancer to the esophageal wall, however, has rarely been reported. We herein report a rare case of a 46-year-old man with an elevated esophageal lesion, resembling a 0-IIa-type esophageal cancer, which was discovered 13 months after a total gastrectomy performed for gastric cancer. The esophageal tumor, resected by endoscopic mucosal resection (EMR), was an adenocarcinoma with the same histology as the previously resected primary gastric cancer, and it showed massive lymphatic permeation. Soon after the EMR, other similar lesions emerged on the esophageal wall. We therefore considered the esophageal tumor to be a systemic expansion of the primary gastric cancer, and we administered the anticancer drug, S-1. Esophageal intramural metastases from a gastric cancer imply a systemic expansion of the gastric cancer, and portend a poor prognosis. [ABSTRACT FROM AUTHOR]

We report a case of adenosquamous carcinoma of the stomach that produced granulocyte-colony stimulating factor (G-CSF). The patient, who had an admission diagnosis of advanced gastric cancer, had marked leukocytosis without evidence of infection. After leukemia and metastatic leukemoid reaction were excluded by bone marrow examination, a G-CSF-producing cancer was suspected as the cause of the abnormally elevated serum G-CSF level. The resected stomach tumor was histologically diagnosed as adenosquamous carcinoma; positive expression of G-CSF by tumor cells was shown with immunohistochemical detection, which confirmed the preoperative diagnosis. Recurrent disease in the liver and lymph nodes, accompanied by leukocytosis and re-elevation of serum G-CSF, developed just 3 months after the curative gastrectomy and adjuvant chemotherapy. All of the recurrent disease was resected, restoring normal levels of serum G-CSF. The patient survived for almost 2 years after the initial surgery with extensive chemotherapy, including weekly treatment with paclitaxel, before finally succumbing to liver failure secondary to extensive liver metastasis. [ABSTRACT FROM AUTHOR]

Abstract: The yeast two-hybrid system was used to search for partners of mouse metastasis-associated protein 1 (Mta1). Screening of a cDNA library prepared from mouse embryo yielded positive clones coding for endophilin 3. The site of interaction was suggested to be the SH-3-binding domain of Mta1 and SH-3 domain of endophilin 3. This interaction was confirmed by GST pull-down assay in vitro and immunoprecipitation in vivo. The Mta1 and endophilin 3 transcripts were highly expressed in testis and brain. But, Mta1 localized mainly in nucleus and to a lesser extent in cytoplasm while endophilin 3 localized mainly in cytoplasm. If Mta1 functions in cytoplasm, it might be involved in the regulation of endocytosis mediated by endophilin 3. [Copyright &y& Elsevier]