Primary gastric squamous cell carcinoma (GSCC) is a rare and aggressive malignancy, accounting for less than 0.1% of all gastric cancers. Its clinical presentation and management remain a challenge due to the lack of standardized treatment protocols and limited understanding of its molecular profile.

We report the case of a 33-year-old male presented with significant weight loss, severe acid reflux, and progressive subcutaneous masses. Diagnostic imaging and biopsies confirmed stage IV GSCC, with no evidence of other potential metastatic origins. Genetic analysis revealed pathogenic variants in the phosphatase and tensin homolog gene (PTEN), ataxia telangiectasia mutated gene (ATM), and Fanconi anemia, complementation group M (FANCM), along with intermediate tumor mutational burden (TMB). The patient was treated with a combination of leucovorin calcium, fluorouracil, and oxaliplatin (FOLFOX) chemotherapy and nivolumab. Despite aggressive treatment, the patient experienced rapid disease progression and severe thrombocytopenia likely resulting from multifactorial causes, including severe sepsis, liver dysfunction, chemotherapy effects, tumor progression, and possible immune checkpoint inhibitor-related thrombocytopenia (irTCP). The severe complications led to death following palliative extubation.

This case highlights the complexity of diagnosing and managing GSCC, especially in younger patients. Identifying genetic alterations provides valuable insights into the disease's molecular profile. Further research is needed to develop effective and standardized treatment strategies for this rare malignancy.

The prognosis of gastric cancer (GC) patients is poor, and an accurate prognostic staging system would help assess patients' prognostic status before treatment and determine appropriate treatment strategies.

To develop positive lymph node ratio (LNR) and machine learning (ML)-based staging systems for GC patients with varying differentiation.

This multicenter retrospective cohort study included 11772 GC patients, with 5612 in the training set (Harbin Medical University Cancer Hospital) and 6160 in the validation set (Surveillance, Epidemiology, and End Results Program database). X-tile software identified optimal cutoff values for the positive LNR, and five ML models were developed using pT and LNR staging. Risk scores were divided into seven stages, constructing new staging systems tailored to different tumor differentiation levels.

In both the training and validation sets, regardless of the tumor differentiation level, LNR staging demonstrated superior prognostic stratification compared to pN. Extreme Gradient Boosting exhibited better predictive performance than the other four models. Compared to tumor node metastasis staging, the new staging systems, developed for patients with different degrees of differentiation, showed significantly better predictive performance.

The new positive lymph nodes ratio staging and integrated staging systems constructed for GC patients with different differentiation grades exhibited better prognostic stratification capabilities.

Gastric malignancies are common worldwide, with a high incidence rate and mortality. Relevant studies are needed to further demonstrate the harmfulness of gastric malignancies to promote awareness of its prevention. The aim of the study was to analyze the clinicopathological features and prognosis of gastric malignancies.

The Surveillance, Epidemiology, and End Results (SEER) database was used to obtain the clinical data of 122,793 patients diagnosed with gastric malignancies from 2000 to 2019. Along with performing univariate and multivariate analyses, the associated survival rates of each variable were analyzed using SPSS software. Columnar line graph prediction models were developed and validated using R software.

In total, 122,793 gastric malignancy patients were included in this study, including 74,303 males (60.5%) and 48,490 females (39.5%). The predominant age group among patients was 60-74 years, comprising a total of 45,603 individuals (37.1%). The follow-up time was 0-239 months, the median follow-up time was 11.7 months, and 91,869 patients (74.8%) died. Gastric adenocarcinoma was the main pathological type, accounting for 96,259 patients (82.7%). The main disease site was the cardia of the stomach, accounting for 34,019 patients (34.0%); most (109,706; 89.3%) patients lived in cities. Univariate and multivariate analyses showed that gender, age, tumor size, tumor location, American Joint Committee on Cancer (AJCC) stage, pathological type, rural/urban, and treatment were independent risk factors for prognosis (P<0.001). The Concordance index (C-index) of the nomogram prognostic model was 0.763±0.002, and the areas under the receiver operating characteristic (ROC) curve (AUC) of the 1-, 3-, and 5-year survival rates were 0.76, 0.79, and 0.79, respectively. The calibration curve showed that the predicted survival rate of the nomogram was in good agreement with the observed survival rate.

The prognosis for tumors located in the greater curvature of the stomach is relatively favorable. The level of care available in a patient's city is directly correlated with their prognosis. Notably, the outcomes for gastric stromal tumors (GSTs) and gastric neuroendocrine neoplasms (G-NENs) are significantly more favorable compared to other pathological types. Patients who meet surgical criteria should undergo surgery as early as possible to enhance survival duration.

Primary squamous cell carcinoma (SCC) can originate in different parts of the body, including the head, neck, lung, bronchus, cervix uteri, esophagus, and cardia, and subsequently metastasize to the stomach. Primary gastric squamous cell carcinoma (GSCC) is a rare disease. To better understand GSCC, we present the case of a 72-year-old woman with a primary GSCC. A chest and abdominal CT scan highlighted a 36×26 mm mass with a 41 mm longitudinal diameter, which included the origin of the celiac tripod. The disease appeared to originate exophytically from the gastric wall. An ultrasound-endoscopy showed a hypoechoic formation with not well-defined margins measuring 40×30 mm involving the origin of the celiac tripod, about 10 mm from the gastric wall. An endoscopic fine-needle aspiration showed a poorly differentiated carcinoma. A PET/CT scan showed a hyperaccumulation of the known expansive formation at the celiac tripod (SUV 11.9) without specific cleavage planes from the stomach. A gastroscopy showed a regular esophagus and an absence of gastric protruding lesions. In the subcardial area, on the posterior wall, there was a slightly raised sub-centimetric area covered by bleeding mucosa where the biopsy had been performed. The pathological report showed chronic gastritis. An eco-endoscopy confirmed a hypoechoic neoformation measuring 30×40 mm that appeared to originate from the muscular layer of the gastric wall. The biopsy report was positive for broad-spectrum cytokeratins (AE1/AE3), CK5/6/7, p40, p63 and negative for CK20, PAS, TTF-1, anti-smooth muscle actin, CD45 (LCA), ERG, and S100. The clinical picture suggested poorly differentiated carcinoma with squamous differentiation. We analyzed the main classifications of GSCC cases and compared their characteristics. It is clear that to have an appropriate definition of GSCC, well-defined diagnostic criteria are needed. Currently, there is no consensus. For practical purposes, it would be better to include a panel of CK and p40 to distinguish GSCC from adenocarcinoma. A GSCC outside the mucosa is not rare and could be a true entity.

Primary Gastric Squamous Cell Carcinoma (GSCC), especially in late-stage, is a very rare pathological type with poor prognosis. We report a long duration of Complete Response (CR) of GSCC case with multiple metastases by an elaborate three-staged radical Concurrent Chemoradiotherapy (CCRT).

A 36-year-old male suffered from weakness and melena, and then was diagnosed as primary GSCC with cT3N3M1, Stage IV. According to the characteristics of multiple lymph nodes metastases at supraclavicular, perigastric and pelvic regions, an individualized therapeutic strategy of three-staged radical CCRT was elaborately designed and cautiously performed even after the accidental massive hemorrhage of the upper digestive tract under the guidance of a multidisciplinary team. A long-term CR was achieved, with Progression Free Survival (PFS) and Overall Survival (OS) of 74 months by the last follow-up. The case with multiple metastases was radically treated as local advanced disease with complete success.

Patient with stage IV mGSCC who has achieved CR and unexpected long-term PFS and OS through CCRT due to precise judgement and well-designed individualized therapy. The immunomodulatory effect of radiation therapy on the tumor microenvironment may be a potential mechanism affecting treatment efficacy.

Squamous cell carcinoma (SCC) of the stomach is a rare entity with fewer than 100 cases of primary SCC reported in the literature, while esophageal SCC is prevalent and more common. However, a synchronous squamous cell carcinoma found in the esophagus and stomach remains very uncommon. We present the case of a 64-year-old with a history of dysphagia who had an endoscopy that showed an impassable stenosis of the middle esophagus, with histopathology in favor of an esophagus squamous cell carcinoma. A computed tomography scan (CT-SCAN) then showed an exophytic mass of the lesser curvature of the stomach with the biopsy in favor of a squamous cell carcinoma. Our case report aims to keep in clinicians´ and anaomopathologists´ minds that esophageal SCC may coexist with gastric SCC and that the role of imaging is important in the diagnostic procedure.

Gastric cancer serves a major role in the global cancer burden, being the fourth most frequent cause of mortality among all types of cancer. Gastric squamous cell carcinoma (GSCC) is a rare histological variant accounting for 0.04-0.5% of all gastric cancer cases. Diagnostic work-up of GSCC is essential and involves multiple criteria: i) Tumour not located in the cardia, ii) no oesophageal extension of the tumour, and iii) no evidence of SCC in any other part of the body. Little is known about this rare variant in terms of pathogenesis, risk factors or evolution. Consequently, neither the European Society of Medical Oncology nor the National Comprehensive Cancer Network societies have published recommendations for GSCC. The aim of the present review is to provide an in-depth analysis of the current literature on this pathology, from pathophysiological hypothesis and clinical presentation to diagnostic work-up and treatment trends, in order to establish a possible management algorithm.

The incidence of gastrointestinal malignancies in Kenya is increasing, although there is a paucity of data on survival outcomes among gastric cancer patients. Hence, this study aimed to assess survival outcomes among adult gastric cancer patients at Kenyatta National Hospital.

A retrospective cohort study design was used to assess the survival outcomes among 247 gastric cancer patients. All medical records of adult (≥18 years) gastric cancer patients with complete medical records of diagnosis, stage of cancer, and treatment regimen in the study setting in the last 5 years (2016-2020) were included. A simple random sampling technique was employed to select the study participants. Data were collected using a data abstraction tool composed of socio-demographic and clinical characteristics. Survival outcomes were reported as the percentage of mortality, mean survival estimate, and mean cancer-specific survival. The data were entered and analyzed using version 20.0 SPSS statistical software. The mean survival estimates and predictors of mortality were computed using the Kaplan-Meier and Cox regression analysis.

The study showed that 33.3% (64) had new distant metastasis, and 42.1% (104) had disease progression. Besides, the mortality rate was high (33.6%), and 14.6% and 7.7% of patients had complete and partial responses, respectively. The five-year survival was 32.7% among gastric cancer patients. Comorbidity (p = 0.014), advanced-stage diseases (p = 0.03), chemotherapy (p = 0.008), and gastrectomy (p = 0.016) were significant determinants of mortality.

A significant proportion of patients had distant metastasis, disease progression, and a low five-year survival rate. Hence, early cancer-screening programs are indispensable to circumvent disease progression and improve survival outcomes.

Primary gastric squamous cell carcinoma (GSCC) is an extremely rare malignancy with a poor prognosis. Despite the improved knowledge regarding its pathogenesis and biology, the treatment options remain limited. The present study reported on the unique case of a mismatch repair-deficient (dMMR) primary GSCC in a 79-year-old woman reporting fatigue and symptoms of upper gastrointestinal tract bleeding. Physical examination revealed abdominal pain at palpation. Gastroscopy revealed a large, exophytic, bleeding tumor. Medical imaging confirmed a mushroom-like polyp in the lumen of the stomach, with no signs of disease spread. Total gastrectomy and D2 lymphadenectomy were performed. Pathological examination of the post-operational material confirmed a well-differentiated SCC invading the mucosa, submucosa and muscle layer. There were no signs of dissemination observed in any of the 32 excised lymph nodes. Notably, according to the last follow-up, the patient remains well, supporting the 5-year GSCC survival rate statistics. To the best of our knowledge, this is the first such GSCC case reported in the Surgical Oncology Outpatient Clinic (Copernicus Memorial Hospital, Lodz, Poland) and these findings add to the limited data on GSCC. Although this is a very rare condition, it should always be considered during the process of diagnosis of gastric tumors.

Primary squamous cell carcinoma of the stomach is a rare type of gastric malignancies. Diagnosis criteria are well defined but diagnosis is generally late being made at an advanced stage with metastases explaining its poor diagnosis.

Primary gastric squamous cell carcinoma (SCC) is rarely encountered clinically. SCC, which presents as a submucosal tumor, is even rarer. Without the support of pathological evidence, it is difficult to make a correct preoperative diagnosis. Due to limited clinical data, the pathogenesis and treatment of gastric SCC remain unclear.

A 69-year-old man was admitted to our hospital with unexplained weight loss. Endoscopy revealed a submucosal mass without any ulcer on its surface located on the body of the stomach. The results of 2 gastroscopic mucosal biopsies were chronic inflammation.

The clinical diagnosis by computed tomography (CT) and gastroscopy was gastrointestinal stromal tumor (GIST) preoperatively. The postoperative pathological examination demonstrated this tumor as moderately differentiated SCC.

Total gastrectomy, distal pancreatectomy, and splenectomy were performed.

The patient was discharged 7 days after the surgery without any complications. The follow-up CT scan showed no evidence of metastatic disease 6 months after surgery.

Large primary gastric SCC could present as a submucosal mass. Gastroscopic mucosal biopsy may not be able to get tumor tissue due to inflammatory reaction.

To analysis the expression of VEGF in gastric carcinoma cell and tumor tissue, our study determined the relationship between the expression of VEGF and tumor incidence, metastasis and prognosis in human gastric carcinoma.

Treatment of ZD6474 at dose of 30 μmol/L was performed in gastric carcinoma cell BGC823. qPCR and Western-blot were used to analysis the mRNA and protein expression of VEGF. MTT, wound healing and Transwell experiments were conducted to study the effect of VEGF on tumor incidence, metastasis and prognosis. Sixty patients with gastric cancer were selected as the gastric cancer group, and 30 patients with gastric ulcer receiving main gastric resection were selected as control group. The survival curve of patients with gastric cancer in five years was recorded. The correlation between expression of VEGF to incidence, metastasis and prognosis of gastric cancer was evaluated by Cox multifactor regression.

The mRNA and protein expression of VEGF in treatment group were significantly lower than that of control group (P< 0.01). The results of MTT, wound healing and Transwell experiments were showed that the cell proliferation, migration and invasion capacity in treatment group were significantly reduced compared to that of the control group (P< 0.01). The 5-year survival rate for patients with VEGF positive expression was significantly decreased compared to the patients with VEGF expression negative (P< 0.01). The tumor size, differentiation, lymph node metastasis and tumor stage were statistically related to VEGF level (P< 0.05). The results of Cox regression multifactor analysis showed that lymph node metastasis, tumor staging and the expression of VEGF were significantly associated to the prognosis of gastric cancer patients (P< 0.05).

Our data demonstrated that the expression of VEGF was significantly related to the tumor incidence, metastasis and prognosis of patients with gastric cancer, which provides new leads to the diagnosis of gastric cancer.

Gastric squamous cell carcinoma (GSCC) and gastric adenosquamous carcinoma (GASC) comprise less than 2% of gastric cancers. The current knowledge about clinical presentation, treatment modalities and outcomes of GSCC and GASC is limited. The aim of this study is to characterize the clinicopathological features, treatment modalities, and outcomes of GSCC and GASC in comparison to gastric adenocarcinoma (GAC) in National Cancer Database (NCDB).

Patients with GSCC, GASC and GAC between 2004 and 2013 were identified using ICD-O-3 histology and topography codes 8070/3, 8560/3, 8140/3 and C16.0-9. Univariate, and multivariate analysis were performed, and Kaplan-Meier curves was used to compare survival based on histological subtype.

A total of 61,215 patients were identified, 836 (1.4%) GSCC, 327 (0.5%) GASC, 60,052 (98.1%) GAC between 2004 and 2013, in which 77.4% was Caucasian and 68.7% was male, 46.6% of tumors were in gastric cardia and 13.7% in gastric antrum. Neoadjuvant and adjuvant chemotherapy was administered in 11.2%, 14.1%, 8.9% vs. 2.9%, 11.9%, 9.5% for GSCC, GASC, GAC. Surgery was performed in 26.0%, 54.4%, 45.2% of GSCC, GASC, GAC. Radiotherapy was administered in 48.1%, 37.6%, 31.6% of GSCC, GASC, GAC. Median overall survival was 8.9, 9.9 and 13.2 months for GSCC, GASC, GAC. On multivariate analysis squamous cell (HR =1.14; 95% CI, 1.06-1.24, P=0.001) and adenosquamous cell histology (HR =1.52; 95% CI, 1.35-1.73, P<0.001) was associated with worse survival compared to adenocarcinoma.

GSCC and GASC have poorer survival outcomes compared to GAC. Less patients with GSCC received surgery and adjuvant chemotherapy, more patients with GSCC received radiation therapy.