12 results on '"Yi-Hui Tang"'
Search Results
2. Long-term survival outcomes of robotic total gastrectomy for locally advanced proximal gastric cancer: a prospective study.
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Qing Zhong, Yi-Hui Tang, Zhi-Yu Liu, Zhi-Quan Zhang, Qi-Chen He, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Qi-Yue Chen, Chao-Hui Zheng, and Chang-Ming Huang
- Abstract
Background: Robotic gastrectomy is a safe and feasible approach for gastric cancer (GC); however, its long-term oncological efficacy remains unclear. The authors evaluated the long-term survival outcomes and recurrence patterns of patients with locally advanced proximal GC who underwent robotic total gastrectomy (RTG). Methods: This prospective study (FUGES-014 study) enrolled 48 patients with locally advanced proximal GC who underwent RTG between March 2018 and February 2020 at a tertiary referral teaching hospital. Patients who underwent laparoscopic total gastrectomy (LTG) in the FUGES-002 study were enrolled in a 2:1 ratio to compare the survival outcomes between RTG and LTG. The primary endpoint of the FUGES-014 study was postoperative 30-day morbidity and has been previously reported. Here, the authors reported the results of 3-year disease-free survival (DFS), 3-year overall survival (OS), and recurrence patterns. Results: After propensity score matching, 48 patients in the RTG and 96 patients in the LTG groups were included. The 3-year DFS rates were 77.1% (95% CI: 66.1-89.9%) for the RTG and 68.8% (95% CI: 60.1-78.7%) for the LTG groups (P = 0.261). The 3-year OS rates were not significantly different between the groups (85.4 vs. 74.0%, P = 0.122). Recurrence occurred in nine patients (18.8%) in the RTG and 27 (28.1%) patients in the LTG groups (P = 0.234). Recurrence patterns and causes of death were similar between the groups (P > 0.05). Conclusions: The oncological outcome of RTG was noninferior to that of LTG. Thus, RTG might be an alternative surgical treatment for locally advanced proximal GC. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Assessment of Laparoscopic Indocyanine Green Tracer-guided Lymphadenectomy After Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Randomized Controlled Trial.
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Ze-Ning Huang, Yi-Hui Tang, Qing Zhong, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Long-Long Cao, Mi Lin, Ru-Hong Tu, Chao-Hui Zheng, Qi-Yue Chen, and Chang-Ming Huang
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Objective: To assess the effectiveness of indocyanine green (ICG)-guided lymph node (LN) dissection during laparoscopic radical gastrectomy after neoadjuvant chemotherapy (NAC) in patients with locally advanced gastric cancer (LAGC). Background: Studies on ICG imaging use in patients with LAGC on NAC are rare. Methods: Patients with gastric adenocarcinoma (clinical T2-4NanyM0) who received NAC were randomly assigned to receive ICG-guided laparoscopic radical gastrectomy or laparoscopic radical gastrectomy alone. Here, we reported the secondary endpoints including the quality of lymphadenectomy (total retrieved LNs and LN noncompliance) and surgical outcomes. Results: Overall, 240 patients were randomized. Of whom, 236 patients were included in the primary analysis (118 in the ICG group and 118 in the non-ICG group). In the ICG group, the mean number of LNs retrieved was significantly higher than in the non-ICG group within the D2 dissection (48.2 vs 38.3, P < 0.001). The ICG fluorescence guidance significantly decreased the LN noncompliance rates (33.9% vs 55.1%, P = 0.001). In 165 patients without baseline measurable LNs, ICG significantly increased the number of retrieved LNs and decreased the LN noncompliance rate (P < 0.05). For 71 patients with baseline measurable LNs, the quality of lymphadenectomy significantly improved in those who had a complete response (P < 0.05) but not in those who did not (P > 0.05). Surgical outcomes were comparable between the groups (P > 0.05). Conclusions: ICG can effectively improve the quality of lymphadenectomy in patients with LAGC who underwent laparoscopic radical gastrectomy after NAC. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Neoadjuvant Camrelizumab and Apatinib Combined with Chemotherapy for Locally Advanced Gastric Cancer: A Randomized, Multicenter, Open-Label, Phase 2 Trial
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Jian-Xian Lin, Yi-Hui Tang, Hua-Long Zheng, Kai Ye, Jian-Chun Cai, Li-Sheng Cai, Wei Lin, Jian-Wei Xie, Jia-Bin Wang, Jun Lu, QiYue Chen, Long-Long Cao, Chao-Hui Zheng, Ping Li, and Chang-Ming Huang
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- 2023
5. Body composition parameters predict pathological response and outcomes in locally advanced gastric cancer after neoadjuvant treatment: A multicenter, international study
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Amilcare Parisi, Qi-Yue Chen, Fabio Cianchi, Jacopo Desiderio, Yu-Bin Ma, Chao-Hui Zheng, Long-Long Cao, Jun Lu, Mi Lin, Ping Li, Chang-Ming Huang, Yi-Hui Tang, Ru-Hong Tu, Jian-Wei Xie, Wen-Xing Zhou, Fabio Staderini, Lorenzo Antonuzzo, Jia-Bin Wang, Chiara Peluso, Felice Borghi, Jian-Xian Lin, and Alessandra Marano
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Male ,China ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Locally advanced ,Pathological response ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Gastrectomy ,Predictive Value of Tests ,Reference Values ,Stomach Neoplasms ,Neoadjuvant treatment ,Internal medicine ,medicine ,Humans ,Postoperative Period ,Muscle, Skeletal ,Adiposity ,Aged ,Retrospective Studies ,Nutrition and Dietetics ,business.industry ,Skeletal muscle ,Cancer ,Middle Aged ,Prognosis ,medicine.disease ,Neoadjuvant Therapy ,Survival Rate ,Treatment Outcome ,medicine.anatomical_structure ,Italy ,Southern china ,Body Composition ,Female ,Tomography, X-Ray Computed ,business - Abstract
Body composition profiles influence the prognosis of several types of cancer; however, the role of body composition in patients with locally advanced gastric cancer (LAGC) after neoadjuvant treatment (NT) has not been well characterized.A total of 213 patients with LAGC who underwent gastrectomy after NT at a high-volume institution from southern China were comprehensively evaluated for primary analysis. Additionally, 170 and 77 patients from Western China and Italy, respectively, were reviewed for external validation. The skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), and the subcutaneous as well as the visceral adiposity index were assessed from clinically acquired CT scans at diagnosis and preoperatively.Overall, none of the body composition parameters significantly changed after NT. The pre-NT skeletal muscle radiodensity (SMD) and change in SMI (ΔSMI) were both significantly lower in the patients with poor response (tumor regression50%; mean SMD: 43.5 vs 46.5, P = 0.003; mean ΔSMI: -1.0 vs 2.2, P 0.001), and the cutoff values were calculated according to the Youden index as 43.7 and 1.2, respectively. Based on these 2 parameters, a novel model, the Skeletal Muscle Score (SMS), was proposed to predict the pathological response (AUC = 0.764 alone and = 0.822 in combination with the radiological response). Moreover, patients with an SMI loss1.2 had a significantly prolonged drainage tube removal time (mean: 10.0 vs 8.2, P = 0.003) and postoperative hospital stay (mean: 11.1 vs 9.8, P = 0.048), as well as a significantly higher rate of postoperative complications (30.9% vs 16.7%, P = 0.015). In the multivariate analysis, SMI loss1.2 independently predicted poor overall survival (HR: 1.677, 95% CI 1.040-2.704, P = 0.034) and recurrence-free survival (HR: 1.924, 95% CI 1.165-3.175, P = 0.011). ΔSMI was also significantly associated with pathological response, surgical outcomes, and survival in the 2 external cohorts (P all 0.05).For LAGC, the pre-NT SMD and ΔSMI could accurately predict the pathological response after NT. An SMI loss1.2 is closely associated with poorer outcomes and may indicate the need more supportive treatment.
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- 2021
6. Reappraise role of lymph node status in patterns of recurrence following curative resection of gastric adenocarcinoma
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Mi Lin, Long-Long Cao, Jun Lu, Qi-Yue Chen, Jian-Wei Xie, Chao-Hui Zheng, Jia-Bin Wang, Jun-Peng Lin, Jian-Xian Lin, Ru-Hong Tu, Chang-Ming Huang, Yi-Hui Tang, and Ping Li
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Curative resection ,Cancer Research ,medicine.medical_specialty ,business.industry ,gastric cancer ,post-recurrence survival ,Disease ,Gastroenterology ,lymph node status ,Gastric adenocarcinoma ,medicine.anatomical_structure ,Oncology ,Time to recurrence ,Recurrence patterns ,Internal medicine ,Late Recurrence ,medicine ,Recurrent disease ,Original Article ,recurrence-free survival ,Stage (cooking) ,business ,Lymph node - Abstract
Objective To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma. Methods We retrospectively assessed 1,694 patients who underwent curative gastrectomy from January 2010 to August 2014. Patients stratified according to lymph node status and recurrence patterns among different subgroups were compared. Results Of all, 517 (30.5%) patients developed recurrent disease, and complete data of recurrence could be obtained in 493 (95.4%) patients. For pN0 patients, the patterns of recurrence were different according to pT stage: locoregional recurrence was most common in patients with pT1-2 disease (57.1%), distant recurrence was most common in patients with pT3 disease (57.1%), and peritoneal recurrence was most common in patients with pT4a disease (66.7%). For pN+ patients, distant metastasis was most common pattern irrespective of pT stage. The site-specific trend of recurrence showed that locoregional recurrence increased within 5 years in patients with pN0-2 disease but plateaued 3 years after surgery in patients with pN3 disease. Time to recurrence was significantly longer for the pN0 patients compared with the pN+ patients (median: 25 vs. 16 months, P=0.001). Moreover, post-recurrence survival was significantly better for the pN0 patients than for the pN+ patients (median: 12 vs. 6 months, P
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- 2021
7. Laparoscopic Splenic Hilar Lymph Node Dissection is Recommended for Pathologic Stage IIIA Middle and Upper Gastric Cancer: A Comparative Study with Standard D2 Laparoscopic Distal Gastrectomy
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Jian-Xian Lin, Ying-Qi Huang, Yi-Hui Tang, Jian-Wei Xie, Jia-Bin Wang, Jun Lu, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin, Ping Li, Chang-Ming Huang, and Chao-Hui Zheng
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Purpose D2 lymphadenectomy is considered a standard procedure for distal gastrectomy (DG). However, whether splenic hilar (No. 10) lymph node (LN) should be included in the extent of D2 lymphadenectomy for total gastrectomy (TG) is still controversial. Therefore, we assessed the survival benefit of laparoscopic No.10 LN dissection based on the comparison of long-term survival of patients undergoing laparoscopic TG (LTG) with laparoscopic No.10 LN dissection and laparoscopic DG (LDG). Methods The clinicopathological data of 2069 patients who underwent laparoscopic radical gastrectomy were retrospectively analyzed. The survival of the LDG group, the LTG with dissection of No. 10 LN (LTG+No. 10) group and the LTG without dissection of No. 10 LN (LTG-No. 10) group was compared. Results After adjusting for age, pT stage, pN stage and pTNM stage by 1:1:1 propensity score matching (PSM), there were 373 patients in each group. Kaplan-Meier (K-M) survival analysis showed that only in the pIIIA stage, the 5-year survival overall survival (OS) and cancer specific survival (CSS) of the LTG+No. 10 group was significantly better than that of the LTG-No. 10 group and comparable with that of the LDG group. Multivariate Cox regression analyses showed that dissection of No. 10 LN was an independent favorable factor for OS and CSS in all patients and patients with pIIIA. Conclusion In patients with stage pIIIA, those undergoing LTG with No. 10 LN dissection could achieve a long-term outcome comparable to that of patients at the same pathological stage undergoing LDG.
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- 2021
8. Which Nutritional Scoring System Is More Suitable for Evaluating the Short- or Long-Term Prognosis of Patients with Gastric Cancer Who Underwent Radical Gastrectomy?
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Li-Zhen Lin, Mi Lin, Yi-Hui Tang, Chao-Hui Zheng, Jia-Bin Wang, Long-Long Cao, Jun Lu, Jian-Wei Xie, Ru-Hong Tu, Qi-Yue Chen, Ping Li, Chang-Ming Huang, and Jian-Xian Lin
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medicine.medical_specialty ,Multivariate analysis ,Scoring system ,Nutritional Status ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Stomach Neoplasms ,Internal medicine ,medicine ,Humans ,Risk factor ,Stage (cooking) ,Retrospective Studies ,Univariate analysis ,Radical gastrectomy ,business.industry ,Area under the curve ,Cancer ,Prognosis ,medicine.disease ,Nutrition Assessment ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
To evaluate the effects of three nutritional scoring systems: Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT), and Naples Prognostic Score (NPS) on the short- or long-term prognosis of gastric cancer (GC) patients who underwent radical gastrectomy. The clinicopathological data of 2182 patients who underwent radical gastrectomy at the Fujian Medical University Union Hospital (FMUUH) from 2009 to 2014 were retrospectively analyzed. The effects of the PNI, CONUT, and NPS on the short- or long-term prognosis of GC patients were analyzed. Overall, 359 (16.5%) patients had postoperative complications. There was no significant association between the PNI, CONUT, and NPS and postoperative complications (P > 0.05); however, high CONUT and NPS were significantly associated with severe postoperative complications (P
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- 2019
9. Association of Adjuvant Chemotherapy With Overall Survival Among Patients With Locally Advanced Gastric Cancer After Neoadjuvant Chemotherapy
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Jian-Xian, Lin, Yi-Hui, Tang, Guan-Jie, Lin, Yu-Bin, Ma, Jacopo, Desiderio, Ping, Li, Jian-Wei, Xie, Jia-Bin, Wang, Jun, Lu, Qi-Yue, Chen, Long-Long, Cao, Mi, Lin, Ru-Hong, Tu, Chao-Hui, Zheng, Amilcare, Parisi, Mark J, Truty, and Chang-Ming, Huang
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Cohort Studies ,Male ,Chemotherapy, Adjuvant ,Stomach Neoplasms ,Humans ,General Medicine ,Middle Aged ,Prognosis ,Neoadjuvant Therapy - Abstract
Neoadjuvant chemotherapy (NAC) is a standard treatment option for locally advanced gastric cancer (LAGC); however, the indications for adjuvant chemotherapy (AC) in patients with LAGC who received NAC remain controversial.To compare survival rates between patients with LAGC who received AC and those who did not after NAC followed by surgery.This multicenter, international cohort study included 353 patients with LAGC undergoing curative-intent gastrectomy after NAC at 2 tertiary referral teaching hospitals in China between June 1, 2008, and December 31, 2017. To externally validate the findings in the Chinese patients, 109 patients from the US and Italy between June 1, 2006, and June 30, 2013, were reviewed. The follow-up period of the Chinese patients was completed in December 2020, and the follow-up period of the Western patients was completed between February and July 2017. Data analysis was performed from December 1, 2020, to February 28, 2021.Patients who received AC and those who did not were propensity score matched to evaluate the association of AC with survival.Overall survival (OS), disease-free survival, and disease-specific survival.Of 353 patients from China (275 [78.1%] male; mean [SD] age, 58.0 [10.7] years), 262 (74.1%) received AC and 91 (25.9%) did not. After propensity score matching, the 3-year OS was significantly higher in patients who received AC (60.1%; 95% CI, 53.1%-68.1%) than in those who did not (49.3%; 95% CI, 39.8%-61.0%) (P = .02). Lymph node ratio (LNR) was significantly associated with AC benefit (P .001 for interaction), and a plot of the interaction between LNR and AC demonstrated that AC was associated with improved OS in patients with higher (≥9%) LNRs (3-year OS: 46.6% vs 21.7%; P .001), but not in patients with LNRs less than 9% (3-year OS: 73.9% vs 71.3%; P = .30). When stratified by AC cycles, only those patients who completed at least 4 AC cycles exhibited a significant survival benefit in the 6-month (hazard ratio, 0.56; 95% CI, 0.33-0.96; P = .03) and 9-month landmark analysis (hazard ratio, 0.50; 95% CI, 0.27-0.94; P = .03). In the external cohort, improved OS with AC administration was also found in patients with LNRs of 9% or greater (3-year OS: 53.0% vs 26.3%; P = .04).In this cohort study, the administration of AC after NAC and resection of LAGC was associated with improved prognosis in patients with LNRs of 9% or greater. These findings suggest that LNR might be valuable in AC selection in future decision-making processes.
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- 2022
10. Efficacy and Safety of Apatinib Combined with S-1 Plus Oxaliplatin as Neoadjuvant Treatment for Locally Advanced Gastric Cancer: A Multicenter, Prospective Study
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Jun You, Jian-Wei Xie, Yan-Chang Xu, Chang-Ming Huang, Lisheng Cai, Jian-Hua Xu, Jian-Xin Ye, Chao-Hui Zheng, Jian-Chun Cai, Yi-Hui Tang, Wei-Dong Zang, Fangqin Xue, Wei Lin, Ping Li, and Jian-Xian Lin
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Chemotherapy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Cancer ,medicine.disease ,Oxaliplatin ,chemistry.chemical_compound ,chemistry ,Informed consent ,Internal medicine ,medicine ,Clinical endpoint ,Apatinib ,Prospective cohort study ,business ,Neoadjuvant therapy ,medicine.drug - Abstract
Background: Apatinib, a tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2 (VEGFR-2), is a novel treatment option for advanced gastric cancer (AGC) refractory to two or more lines of prior chemotherapy but has not yet been evaluated in patients with locally AGC. This trial investigated the efficacy and safety of apatinib combined with S-1 plus oxaliplatin (SOX) as a neoadjuvant treatment for locally AGC. Methods: Patients with M0 and either T2-T4 or N+ disease received apatinib (500 mg orally once daily on days 1-21 and discontinued in the last cycle) plus SOX (S-1, 40-60 mg orally twice daily on days 1-14; oxaliplatin, 130 mg/m2 intravenously on day 1) given every 3 weeks for 2-5 cycles. D2 gastrectomy was performed 2-4 weeks after the last cycle. To further compare the efficacy and safety between apatinib plus SOX (ASOX group) and SOX alone (SOX group), we reviewed historical control patients receiving SOX as neoadjuvant chemotherapy at the central center. The primary end point was the R0 resection rate. Findings: Between July 2017 and June 2019, 48 and 58 patients were enrolled in the ASOX and SOX groups, respectively. Forty patients in the ASOX group (83.3%) and 47 patients in the SOX group (81.0%) underwent surgery, with R0 resection rates of 75.0% and 67.2%, respectively (P=0.382). For patients proceeding surgery, the R0 resection rates were 90.0% (36/40) and 82.3% (39/47), respectively (P = 0.534). The proportion of patients with T downstaging in the ASOX group was significantly higher than that in the SOX group (36.4% vs 18.5%, P=0.036). For patients with target lesions, the radiological response rate was significantly higher in the ASOX group (75.0% vs 38.5%, P=0.015). Moreover, the ASOX group was associated with significantly higher proportions of patients achieving major pathological response (25.0% vs 10.3%, P=0.046). Grade 3 toxicities occurred in 33.3% of the ASOX patients, and no grade 4 toxicities or drug-related deaths were observed. Interpretation: Apatinib combined with SOX showed promising efficacy with an acceptable safety profile as the first-line neoadjuvant treatment for locally AGC. Trial Registration: The trial is registered with ClinicalTrials.gov, number NCT03192735. Funding Statement: This study was supported by Scientific and technological innovation joint capital projects of Fujian Province, China (No.2017Y9011, No.2017Y9004). Minimally invasive medical center of Fujian Province (No. [2017]171). National natural science foundation of China (No.81871899). The second batch of special support funds for Fujian Province innovation and entrepreneurship talents (No.2016B013). Declaration of Interests: There are no conflicts of interest or financial ties to disclose from any authors. Ethics Approval Statement: The informed consent form and study protocol were approved by the Institutional Review Boards of each participating institution. The study was conducted in accordance with the International Conference on Harmonization Good Clinical Practice guidelines, the Declaration of Helsinki, and Chinese law. All patients provided written informed consent before enrollment.
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- 2020
11. Effectiveness and Safety of Apatinib Plus Chemotherapy as Neoadjuvant Treatment for Locally Advanced Gastric Cancer
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Jian-Wei Xie, Jian-Xian Lin, Wei Lin, Lisheng Cai, Yan-Chang Xu, Jian-Chun Cai, Yi-Hui Tang, Ping Li, Jian-Hua Xu, Chao-Hui Zheng, Fangqin Xue, Wei-Dong Zang, Chang-Ming Huang, Jun You, and Jian-Xin Ye
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medicine.medical_specialty ,business.industry ,Surrogate endpoint ,medicine.medical_treatment ,General Medicine ,Chemotherapy regimen ,Gastroenterology ,Oxaliplatin ,law.invention ,chemistry.chemical_compound ,chemistry ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Clinical endpoint ,Gastrectomy ,Apatinib ,business ,Neoadjuvant therapy ,medicine.drug - Abstract
Importance Apatinib is a novel treatment option for chemotherapy-refractory advanced gastric cancer (GC), but it has not been evaluated in patients with locally advanced GC. Objective To investigate the effectiveness and safety of apatinib combined with S-1 plus oxaliplatin (SOX) as a neoadjuvant treatment for locally advanced GC. Design, setting, and participants This multicenter, prospective, single-group, open-label, phase 2 nonrandomized controlled trial was conducted in 10 centers in southern China. Patients with M0 and either clinical T2 to T4 or N+ disease were enrolled between July 1, 2017, and June 30, 2019. Statistical analysis was performed from December 1, 2019, to January 31, 2020. Interventions Eligible patients received apatinib (500 mg orally once daily on days 1 to 21 and discontinued in the last cycle) plus SOX (S-1: 40-60 mg orally twice daily on days 1 to 14; oxaliplatin: 130 mg/m2 intravenously on day 1) every 3 weeks for 2 to 5 cycles. A D2 gastrectomy was performed 2 to 4 weeks after the last cycle. Main outcomes and measures The primary end point was R0 resection rate. Secondary end points were the response rate, toxic effects, and surgical outcome. Results A total of 48 patients (mean [SD] age, 63.2 [8.2] years; 37 men [77.1%]) were enrolled in this study. Forty patients underwent surgery (38 had gastrectomy, and 2 had exploratory laparotomy), with an R0 resection rate of 75.0% (95% CI, 60.4%-86.4%). The radiologic response rate was 75.0%, and T downstaging was observed in 16 of 44 patients (36.4%). The pathological response rate was 54.2% (95% CI, 39.2%-68.6%); moreover, this rate was significantly higher in patients who achieved a radiologic response compared with those who did not (12 [80.0%] vs 1 [20.0%]; P = .03) and in those who had an Eastern Cooperative Oncology Group Performance Status score of 0 (20 [76.9%] vs 10 [45.5%]; P = .03) or had tumors located in the upper one-third of the stomach (16 [61.5%] vs 7 [31.8%]; P = .04). Patients who achieved a pathological response (vs those who did not) had significantly less blood loss (median [range]: 60 [10-200] mL vs 80 [20-300] mL; P = .04) and significantly more lymph nodes harvested (median [range]: 40 [24-67] vs 32 [19-51]; P = .04) during surgery. Postoperative complications were observed in 7 of 38 patients (18.4%). Grade 3 toxic effects occurred in 16 of 48 patients (33.3%), and no grade 4 toxic effects or preoperative deaths were observed. Conclusions and relevance This nonrandomized controlled trial found that apatinib combined with SOX was effective and had an acceptable safety profile as a neoadjuvant treatment for locally advanced GC. A large-scale randomized clinical trial may be needed to confirm the findings. Trial registration ClinicalTrials.gov Identifier: NCT03192735.
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- 2021
12. Blood parameters score predicts long-term outcomes in stage II-III gastric cancer patients
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Chang-Ming Huang, Chao-Hui Zheng, Jun Lu, Jian-Wei Xie, Yi-Hui Tang, Mi Lin, Long-Long Cao, Jian-Xian Lin, Qi-Yue Chen, Ru-Hong Tu, Jia-Bin Wang, and Ping Li
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Oncology ,Male ,Kaplan-Meier Estimate ,Nomogram ,0302 clinical medicine ,Carcinoembryonic antigen ,Risk Factors ,Long term outcomes ,Neoplasm Metastasis ,Aged, 80 and over ,biology ,Gastroenterology ,General Medicine ,Middle Aged ,Prognosis ,Surgical Oncology ,Treatment Outcome ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Cohort ,Calibration ,cardiovascular system ,030211 gastroenterology & hepatology ,Female ,circulatory and respiratory physiology ,Adult ,medicine.medical_specialty ,Blood parameters score ,TNM staging system ,Stage ii ,03 medical and health sciences ,Young Adult ,Long-term survival ,Gastrectomy ,Stomach Neoplasms ,Retrospective Study ,Internal medicine ,medicine ,Humans ,Lymphocyte Count ,Discrimination and calibration ,Aged ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Proportional hazards model ,Nomograms ,Multivariate Analysis ,biology.protein ,business ,Blood parameters ,Gastric cancer ,human activities ,Follow-Up Studies - Abstract
Background Increasing numbers of laboratory blood parameters (BPM) have been reported to greatly affect the long-term outcomes of gastric cancer (GC) patients. However, the existing prognostic models do not comprehensively analyze these predictors. Aim To construct a new prognostic tool, based on all the prognostic BPM, to achieve more accurate prognosis prediction for GC. Methods We retrospectively assessed 850 consecutive patients who underwent curative resection for stage II-III GC from January 2010 to April 2013. The patients were classified into developing (n = 567) and validation (n = 283) cohorts using computer-generated random numbers. A scoring system, namely BPM score, was then constructed using least absolute shrinkage and selection operator (LASSO) Cox regression model in the developing cohort, and validated in the validation cohort. A nomogram consisting of BPM score and tumor-lymph node-metastasis (TNM) stage was further created. The discrimination and calibration of the nomogram were evaluated via Harrell's C-statistic and the Hosmer-Lemeshow test. Results Using the LASSO model, we established the BPM score based on five BPM: Albumin, lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, carcinoembryonic antigen, and carbohydrate antigen 19-9. The BPM scores were divided into high- and low-BPM groups based on a cut-off value of -0.93. High-BPM patients were significantly older and had more advanced, larger tumors. In the developing cohort, significant differences were found in 5-year overall survival (OS) and 5-year disease-specific survival between the high-BPM and low-BPM patients. Similar results were found in the validation group. Multivariable analysis showed that the BPM score was an independent predictor of OS. High-BPM patients had a poorer 5-year OS for each subgroup. Furthermore, a nomogram that combined the BPM score and TNM stage had significantly better prognostic value compared with TNM stage alone. Conclusion The BPM score provides more accurate prognosis prediction in stage II-III GC patients and is an effective complement to the TNM staging system.
- Published
- 2019
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