-
1.
Thirty-Day Readmission After Radical Gastrectomy for Gastric Cancer: A Meta-analysis.
Dan, Z, YiNan, D, ZengXi, Y, XiChen, W, JieBin, P, LanNing, Y
The Journal of surgical research. 2019;:180-188
Abstract
BACKGROUND Readmission is a commonly accepted parameter to evaluate surgical quality, but previous studies reported inconsistent results in radical gastrectomy. The purpose of our study is to clarify the prevalence, potential causes, and risk factors of 30-d readmission after radical gastrectomy for gastric cancer. METHODS PubMed and Embase were systematically searched from inception to September 2018 for any possible inclusion. Prevalence, potential causes, and risk factors of 30-d readmission in included studies were extracted using a standardized EXCEL table. The overall 30-d readmission rate was pooled using a random-effects model. Odds ratios with 95% confidence intervals were used to estimate potential risk factors for 30-d readmission. Publication bias was assessed using a funnel plot and statistical tests. RESULTS A total of nine studies with 16,581 patients were included in the current meta-analysis. The pooled 30-d readmission rate after radical gastrectomy was 8% (95% confidence interval, 0.04-0.12). Nutritional difficulty and surgical site infections were the main causes for 30-d readmission. Cardiovascular comorbidity, total gastrectomy, nutritional risk screening 2002 score ≥3, any complications, laparoscopic gastrectomy, and C-reactive protein on postoperative day 3 ≥12 were strong predictors for 30-d readmission, whereas combined multiorgan resection was a weaker predictor. No significant publication bias was identified through the funnel plot and statistical tests. CONCLUSIONS The 30-d readmission rate after radical gastrectomy ranges from 4% to 12% and can mainly result from nutritional difficulty and surgical site infections. Nutritional risk screening 2002 score ≥3, cardiovascular comorbidity, total gastrectomy, any complications, and laparoscopic gastrectomy were potential risk factors for 30-d readmission.
-
2.
Long noncoding RNA FEZF1-AS1 in human cancers.
Zhou, Y, Xu, S, Xia, H, Gao, Z, Huang, R, Tang, E, Jiang, X
Clinica chimica acta; international journal of clinical chemistry. 2019;:20-26
Abstract
Long noncoding RNAs (lncRNAs) have been shown to play key roles in various human tumors. Ectopic expression of the lncRNA FEZ finger zinc 1 antisense 1 (FEZF1-AS1) have been reported in different cancers, including colorectal cancer, gastric neoplasia, hepatocellular carcinoma and so on. Summarizing all literature correlated with FEZF1-AS1, it is obvious that FEZF1-AS1 is mainly involved in tumorigenesis and progression through competing endogenous RNA (ceRNA) which sponges tumor-suppressive microRNA (miRNA) and recruiting mechanism. Moreover, the aberrant expression of FEZF1-AS1 is related to clinical features of patients with cancers, and regulates cellular proliferation, anti-apoptosis, invasion and metastasis through diverse underlying mechanisms. The role of FEZF1-AS1 in carcinogenesis and progression suggests that it may be a potential diagnostic biomarker or a novel therapeutic target for cancers.
-
3.
Palliative Management of Gastric and Esophageal Cancer.
Halpern, AL, McCarter, MD
The Surgical clinics of North America. 2019;(3):555-569
Abstract
In patients with advanced esophageal or gastric cancer, it is highly likely that palliation of symptoms will become a focus of treatment. Dysphagia and obstruction are the most common complaints, and many of these patients can be treated with endoscopic interventions to alleviate symptoms. Bleeding, perforation, and nutritional issues are common problems. Attempts at palliation should be guided by thoughtful discussions regarding patients' goals of care. Owing to the high morbidity and mortality in patients with limited life expectancy, a strategy of working from the least invasive to the most invasive interventions should be guided by the patient's goals.
-
4.
Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer.
Makuuchi, R, Irino, T, Tanizawa, Y, Bando, E, Kawamura, T, Terashima, M
Surgery today. 2019;(3):187-196
Abstract
Esophagojejunal anastomotic leakage (EJAL) is a serious complication of total or proximal gastrectomy for gastric cancer, with a reported incidence of 2.1-14.6% and mortality of up to 50%. EJAL is an independent prognostic factor for the poor survival of gastric cancer patients. Meticulous surgical techniques, experience with anastomotic devices, and a thorough understanding of various risk factors and preventive measures are essential and early diagnosis is critical for preventing EJAL-related death. Patients with suspected EJAL must be evaluated promptly, but contrast swallow is not recommended. There is no standard treatment strategy for EJAL, although conservative treatment with drainage and nutritional support is the most common approach. Effective endoscopic treatments have been reported but need further validation. Surgical treatment is associated with high mortality but should be considered to prevent death from suboptimal EJAL management, for patients with severe sepsis or when conservative treatment has failed.
-
5.
Supportive therapy in gastroenteropancreatic neuroendocrine tumors: Often forgotten but important.
Jin, XF, Spampatti, MP, Spitzweg, C, Auernhammer, CJ
Reviews in endocrine & metabolic disorders. 2018;(2):145-158
Abstract
Neuroendocrine tumors (NETs) are a group of rare and heterogeneous malignancies that can develop in various organs. A significant number of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) is functionally active and presents with symptoms related to the secretion of biologically active substances, leading to the development of distinct clinical syndromes. There are various therapeutic approaches for GEP-NETs, including curative surgery, palliative surgery, local-ablative and loco-regional therapies as well as systemic therapeutic options including peptide receptor radionuclide therapy, cytotoxic therapy, and molecularly targeted therapies. Specific supportive therapy of patients with NETs includes management or prevention of hormone-related clinical syndromes and paraneoplastic states. Supportive therapy plays a key role in NET treatment. Supportive therapy includes debulking surgery and interventional radiologic techniques to reduce tumour bulk or load, as well as systemic medical treatment options to manage or prevent hypersecretion syndromes and treatment-related side effects. Supportive therapies are a type of of comprehensive treatment addressing the patient as a whole person throughout the process of NET treatment. Therefore, supportive therapy also encompasses psychosocial support, expert nursing, nutritional support and management of cancer related pain.
-
6.
Removal of Nasogastric Tube Accidentally Stitched to Roux-en-Y Oesophagojejunostomy Following a Radical Gastrectomy for Stomach Cancer: Case report and review of the literature.
Azzam, AZ, Azzam, KA, Amin, T
Sultan Qaboos University medical journal. 2018;(1):e110-e111
Abstract
Nasogastric tubes (NGTs) are important for feeding, stenting and decompression after gastrointestinal surgeries, particularly in the upper gastrointestinal tract. Resistance in the removal of a NGT is a rare surgical complication and may be due to a knot in the tube or a stitch anchoring the tube to an anastomosis. We report a 41-year-old male patient who was admitted to the King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia, in 2015 with stomach cancer. He underwent a radical total gastrectomy with a Roux-en-Y oesophagojejunostomy. One week after the surgery, removal of the NGT was attempted; however, this was very difficult and the proximal end of the tube was cut off as a temporary measure. Six weeks later, an upper gastrointestinal tract endoscopy revealed that the distal end of the NGT had been accidentally stitched to the Roux-en-Y oesophagojejunostomy. The stitch was removed and the rest of the NGT was successfully extracted using a snare.
-
7.
ECCO essential requirements for quality cancer care: Oesophageal and gastric cancer.
Allum, W, Lordick, F, Alsina, M, Andritsch, E, Ba-Ssalamah, A, Beishon, M, Braga, M, Caballero, C, Carneiro, F, Cassinello, F, et al
Critical reviews in oncology/hematology. 2018;:179-193
Abstract
BACKGROUND ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific type of cancer. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. OESOPHAGEAL AND GASTRIC ESSENTIAL REQUIREMENTS FOR QUALITY CARE CONCLUSION Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality OG cancer service. The ERQCC expert group is aware that it is not possible to propose a 'one size fits all' system for all countries, but urges that access to multidisciplinary units or centres must be guaranteed for all those with OG cancer.
-
8.
Immunotherapy in Advanced Gastric Cancer: An Overview of the Emerging Strategies.
Magalhães, H, Fontes-Sousa, M, Machado, M
Canadian journal of gastroenterology & hepatology. 2018;:2732408
Abstract
Gastric cancer (GC) remains a public health problem, being the fifth most common cancer worldwide. In the western countries, the majority of patients present with advanced disease. Additionally, 65 to 75% of patients treated with curative intent will relapse and develop systemic disease. In metastatic disease, systemic treatment still represents the state of the art, with less than a year of median overall survival. The new molecular classification of GC was published in 2014, identifying four distinct major subtypes of gastric cancer, and has encouraged the investigation of new and more personalized treatment strategies. This paper will review the current evidence of immunotherapy in advanced gastric cancer.
-
9.
[Good Controlled Chylothorax in Gastric Carcinoma].
Tsuji, H, Hara, S, Urano, J, Samukawa, T, Makio, T, Sugiyama, Y, Hosoi, K, Ogiyama, H, Murayama, Y, Min, KY
Gan to kagaku ryoho. Cancer & chemotherapy. 2018;(10):1449-1451
Abstract
Chylothorax has been reported to be caused by accidental injuries in half of all cases in Japan, and < 10% of these cases have been associated with malignant tumors, including lymphoma. Chylothorax is a rare complication of gastric carcinoma. We successfully treated a 58-year-old man with gastric carcinoma, chylothorax, and ascites using a combination of talc pleurodesis and a lipid-limited diet. Case: A 58-year-old man with advanced stage of poorly differentiated gastric adenocarcinoma presented to our hospital with complaints of shortness of breath. Whole-body computerized tomographic images suggested massive pleural effusion and ascites. Examination of pleural fluid and ascites revealed elevated serum triacylglycerol levels of up to 913mg/dL with numerous free-floating cancer cells. Malignant chylothorax was diagnosed. A lipid-limited diet and octreotide were started, followed by talc pleurodesis for pleural effusion. The patient with controlled pleurisy died of gastric cancer on day 55 after pleurodesis.
-
10.
Benign and malignant gastroduodenal diseases associated with Helicobacter pylori: a narrative review and personal remarks in 2018.
Buzás, GM
Minerva gastroenterologica e dietologica. 2018;(3):280-296
Abstract
The subject of Helicobacter pylori continues to elicit worldwide interest in many research fields. Epidemiological data suggest that the prevalence of the infection is decreasing in Western/developed countries and even in some developing regions, but this is masked by the high prevalence in the most populous regions. Chronic gastritis, caused invariably by the bacterium, was again classified in Kyoto and Helicobacter pylori-associated gastritis was included as a distinct entity. The prevalence of peptic ulcers is decreasing, but bleeding ulcers are a challenging problem, with stable mortality levels even in the endoscopic era. With the extended use of endoscopy, gastric polyps (GP) have become more prevalent: some are associated with the infection, some are not. Autoimmune and Helicobacter-induced gastritis can share common pathogenetic mechanisms. Gastric cancer (GC) is ranked highly on mortality lists worldwide. Its surgical treatment has registered some progress though. Little, if any improvement has been achieved in the medical treatment of advanced GC. With proper organization, GC seems a preventable disease. In spite of many guidelines, the Pan-European registry of Helicobacter pylori management shows that eradication rates obtained in many places are suboptimal. A new therapeutic regimen was compiled with promising pilot results. The results obtained with vonaprazan are limited to Asia. New avenues of both antibiotic and non-antibiotic treatments are expected to accelerate the eradication of this ulcerogenic and carcinogenic bacterium.