• c-reactive protein to albumin ratio
• crp/alb
• gastric cancer
• prognostic biomarker
• stomach cancer

• 3D laparoscopic-assisted gastrectomy
• Gastric cancer
• Long-term prognosis
• Post-recurrence survival
• Recurrence patterns
• Recurrence-free survival

• Humans
• Stomach Neoplasms/pathology
• Disease-Free Survival
• Progression-Free Survival
• Gastrectomy/methods
• Laparoscopy/methods
• Treatment Outcome
• Retrospective Studies

• MWYZ [2021] No.76 Province Medical Creating high-level hospitals, high-level medical centers and key specialty projects
• 2022XH041 Talent Initiation Fund Project of Fujian Medical University Union Hospital
• 202105AF150040 Yunnan Provincial Science and Technology Department

• Consolidation chemotherapy
• Gastric cancer
• Gastroesophageal junction cancer
• Locally advanced
• Neoadjuvant concurrent chemoradiotherapy

• Humans
• Neoadjuvant Therapy
• Stomach Neoplasms/therapy
• Stomach Neoplasms/pathology
• Prospective Studies
• Chemoradiotherapy
• Esophageal Neoplasms/therapy
• Esophageal Neoplasms/pathology
• Adenocarcinoma/therapy
• Adenocarcinoma/pathology
• Esophagogastric Junction/pathology
• Antineoplastic Combined Chemotherapy Protocols/adverse effects
• Treatment Outcome

• No.LC2018L03 Beijing Hope Run Special Fund of Cancer Foundation of China
• 2022-CICAMS-80102022203 National High Level Hospital Clinical Research Funding
• 82073352 National Natural Science Foundation of China
• SZSM202211030 Sanming Project of Medicine in Shenzhen

• SOS
• gastric cancer
• oxidative stress
• prognosis
• surgery

• gastric cancer
• lymphadenectomy
• neoadjuvant

• Humans
• Stomach Neoplasms/drug therapy
• Stomach Neoplasms/surgery
• Stomach Neoplasms/pathology
• Neoadjuvant Therapy
• Prognosis
• Neoplasm Recurrence, Local/surgery
• Lymph Node Excision

• Adjuvant chemoradiotherapy
• Adjuvant chemotherapy
• Gastroesophageal junction
• Recurrence
• Siewert type II/III
• Survival

• Adjuvant chemotherapy
• Deep learning
• Gastric cancer
• Survival benefit

• Chemotherapy, Adjuvant
• Humans
• Neoplasm Staging
• Neoplasms, Second Primary
• Peritoneal Neoplasms
• Prognosis
• Retrospective Studies
• Stomach Neoplasms/drug therapy

• laparoscopic surgeries
• locally advanced gastric cancer
• navigational landmarks

• Indocyanine green
• fluorescence imaging
• gastric cancer
• meta-analysis
• radical gastrectomy

This study was designed to investigate the prognostic effect of preoperative body mass index (BMI) for Type 2 diabetes mellitus (T2DM) patients with non-metastasis gastric cancer (GC) who underwent D₂ gastrectomy.

T2DM patients with pT_1–4bN_0–3bM₀ GC were retrospectively collected in Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital from January, 2000 to December, 2010. These patients underwent D₂ radical resection of the stomach combined with regional lymphadenectomy. Chi-square test was used to analyze unordered categorical variables and ranked data, followed by Kaplan–Meier analysis as well as Cox regression models to detect risk factors for survival outcomes. In addition, the cut-off point was determined by the X-tile program. All analyses were carried out using survival package of R and SPSS Software.

A total of 302 T2DM patients with pT_1–4bN_0–3bM₀ GC were collected and analyzed. The cut-off points of BMI, identified by the X-tile program, was 19 kg/m². Patients with low BMI (< 19 kg/m²) had a higher percentage of advanced T stage (T_4a and T_4b), more advanced TNM stage (stage IIIA, IIIB and IIIC), and more elevated level of serum carcinoembryonic antigen (CEA), compared to those with high BMI (> 19 kg/m²) (all P < 0.05). In the low BMI subgroup, the 5-year overall survival rate was 39.02%, which was as high as 58.11% in the high BMI subgroup (P < 0.05). In the multivariate Cox regression model revealed that III_C stage (OR = 3.101), N_3b stage (OR = 3.113) were the most important prognostic indicators, followed by pretreatment BMI (OR = 2.136).

Low preoperative BMI (< 19 kg/m²) was a poor prognostic marker for T2DM patients with pT_1–4bN_0–3bM₀ GC.

• BMI
• Gastric cancer
• Survival rate
• Type 2 diabetes mellitus
• X-tile

• 3D laparoscopic gastrectomy
• Adjuvant chemotherapy
• Gastric cancer
• Post-recurrence survival
• Recurrence patterns
• Recurrence-free survival

• Adult
• Age Factors
• Aged
• Chemoradiotherapy, Adjuvant
• Disease-Free Survival
• Follow-Up Studies
• Gastrectomy/methods
• Humans
• Imaging, Three-Dimensional
• Kaplan-Meier Estimate
• Laparoscopy/methods
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Recurrence, Local/therapy
• Neoplasm Staging
• Retrospective Studies
• Stomach Neoplasms/drug therapy
• Stomach Neoplasms/surgery
• Surgery, Computer-Assisted
• Time Factors

• C-reactive protein
• adjuvant chemotherapy
• gastric cancer
• prognosis
• recurrence

• Aged
• Biomarkers, Tumor/blood
• C-Reactive Protein/metabolism
• Chemotherapy, Adjuvant
• China
• Female
• Gastrectomy/adverse effects
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Perioperative Period
• Predictive Value of Tests
• Progression-Free Survival
• Risk Assessment
• Risk Factors
• Stomach Neoplasms/blood
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Time Factors

• Natural Science Foundation of Fujian Province

Background and Aim: Measuring postoperative carcinoembryonic antigen (CEA) is recommended by guidelines to help detecting recurrence of gastric cancer patients. However, the prognostic significance of elevated preoperative CEA is unclear. This study aims to investigate whether patients with elevated preoperative CEA have a higher risk of recurrence than patients with normal preoperative CEA.

Methods: We conducted a retrospective cohort study at a gastric cancer center in South China. Consecutive patients with stage I to III gastric adenocarcinoma who underwent curative resection at the center from January 2001 to February 2016 were identified. Patients were grouped into two cohorts: normal preoperative CEA (≤ 5 ng/ml), and elevated preoperative CEA (> 5 ng/ml). 3-year recurrence-free survival (RFS) and hazard function curves over time were estimated.

Results: A total of 1,596 patients (1,063 {66.6%} male; median {Interquartile range, IQR} age, 59 {50-66} years) were identified. Patients with elevated preoperative CEA had 15.5% lower 3-year RFS (n=222 {70.4%}) than the cohorts with normal preoperative CEA (n=1,374 {85.9%}). The hazard function of recurrence for the two cohorts peaked at the similar time (around 10 months after surgery). Multivariate Cox analyses confirmed that elevated preoperative CEA was independently associated with shorter RFS (Hazard Ratio {HR}, 1.69; 95% confidence interval {CI}, 1.26-2.27; P = 0.001).

Conclusions: Patients with elevated preoperative CEA are at increased risk for recurrence, especially within the first 24 months after surgery.

• CEA
• Gastric cancer
• prognostic factor
• recurrence

• adjuvant chemotherapy benefit
• gastric cancer
• nomogram
• recurrence patterns
• web-based tool

Through analyzing the data from a single institution in Northeast China, this study revealed the possible clinicopathologic characteristics that influence the prognosis of patients with gastric cancer (GC).

To evaluate the changing trends of clinicopathologic features and survival duration after surgery in patients with GC in Northeast China, which is a high-prevalence area of GC.

The study analyzed the difference in clinicopathologic features and survival duration after surgery of 5887 patients who were histologically diagnosed with GC at the Harbin Medical University Cancer Hospital. The study mainly analyzed the data in three periods, 2000 to 2004 (Phase 1), 2005 to 2009 (Phase 2), and 2010 to 2014 (Phase 3).

Over time, the postoperative survival rate significantly increased from 2000 to 2014. In the past 15 years, compared with Phases 1 and 2, the tumor size was smaller in Phase 3 (P < 0.001), but the proportion of high-medium differentiated tumors increased (P < 0.001). The proportion of early GC gradually increased from 3.9% to 14.4% (P < 0.001). A surprising improvement was observed in the mean number of retrieved lymph nodes, ranging from 11.4 to 27.5 (P < 0.001). The overall 5-year survival rate increased from 24% in Phase 1 to 43.8% in Phase 3. Through multivariate analysis, it was found that age, tumor size, histologic type, tumor-node-metastasis stage, depth of invasion, lymph node metastasis, surgical approach, local infiltration, radical extent, number of retrieved lymph nodes, and age group were independent risk factors that influenced the prognosis of patients with GC.

The clinical features of GC in Northeast China changed during the observation period. The increasing detection of early GC and more standardized surgical treatment effectively prolonged lifetimes.

• Gastric cancer
• Clinicopathologic features
• Survival
• Time trends
• Epidemiology
• Gastrectomy

Recently, totally laparoscopic gastrectomy has been gradually accepted by surgeons worldwide for gastric cancer treatment. Complete dissection of the lymph nodes and the establishment of the surgical margin are the most important considerations for curative gastric cancer surgery. Previous studies have demonstrated that indocyanine green (ICG)-traced laparoscopic gastrectomy significantly improves the completeness of lymph node dissection. However, it remains difficult to identify the tumor location intraoperatively for gastric cancers that are staged ≤T3. Here, we investigated the feasibility of ICG fluorescence for lymph node mapping and tumor localization during totally laparoscopic distal gastrectomy.

Preoperative and perioperative data from consecutive patients with gastric cancer who underwent a totally laparoscopic distal gastrectomy were collected and analyzed. The patients were categorized into the ICG (n=61) or the non-ICG (n=75) group based on whether preoperative endoscopic mucosal ICG injection was performed.

The ICG group had a shorter operation time and less intraoperative blood loss. Moreover, significantly more lymph nodes were harvested in the ICG group than the non-ICG group. No pathologically positive margin was found and there was no significant difference in either the proximal or distal surgical margins between the 2 groups.

Near-infrared fluorescence imaging with ICG can be successfully used in totally laparoscopic distal gastrectomy, and it contributes to both the completeness of D2 lymph node dissection and confirmation of the gastric transection line. Well-designed prospective randomized studies are needed in the future to fully validate our findings.

• Gastrectomy
• Gastric cancer
• Indocyanine green
• Lymph node dissection
• Tumor

The results of D1-plus lymphadenectomy following gastric resection are seldom investigated. The aim of this study was to compare results of D1-plus vs D2 resections and to provide a literature review.

Patients who underwent upfront R0 gastrectomy for adenocarcinoma from 2000 to 2016 in three Institutions were selected using propensity scores and categorized according to lymphadenectomy. Statistical analyses were performed for the nodal harvest (LNH) and survival. Published literature comparing D1-plus and D2 was reviewed and analyzed according to PICO and PRISMA guidelines.

Two matched groups of 93 D1-plus and 93 D2 resections were selected. LNH was significantly greater in D2 vs D1-plus dissections (mean 31.2 vs 27.2, p 0.04), however LNH distribution was similar. The cumulative incidence curves for overall survival, disease free and disease specific events did not report significant differences, however Cox regression analysis disclosed that total gastrectomies (HR 1.8; 95% 1.0–2.9), advanced stages (HR 5.9; 95% 3.4–10.3) and D1-plus nodal dissection (HR 2.1; 95% 1.26–3.50) independently correlated with disease free survival. Literature review including 297 D1-plus and 556 D2 lymphadenectomies documented LNH in favor of D2 sub-group (SMD -0.772; 95%CI -1.222- -0.322).

D2 provided greater LNH than D1-plus dissections; prospective studies should aim to investigate long-term survival of D1-plus lymphadenectomy.

• D1-plus
• D2
• Gastric cancer
• Lymphadenectomy
• Nodal dissection
• PSM

Background: Although the Japan Clinical Oncology Group (JCOG) 9501 trial did not find that prophylactic D3 lymphadenectomy led to any survival advantage over D2 lymphadenectomy, it did find that the prognosis of subserosal and N0 gastric cancer patients improved. The aim of this retrospective observational study was to compare survival after D2 or D3 lymphadenectomy in different patient subgroups. Methods: The study considered all of the patients who underwent D2 or D3 lymphadenectomy at a high-volume center in Verona (Italy) between 1992 and 2011. After excluding patients with Bormann IV or neuroendocrine tumors, early gastric cancers, or non-curative resections, the analysis involved 301 R0 patients: 100 who underwent D2, and 201 who underwent D3 lymphadenectomy. Post-operative deaths and deaths due to recurrences were considered as terminal events in the survival analysis. Results: The D2 patients were significantly older than the D3 patients at baseline (69.8 ± 2.3 vs. 62.2 ± 10.7 years). The median number of retrieved nodes was 29 (interquartile range: 24.5–39) after D2, and 43 (34–52) after D3. The five-year disease-related survival rate was similar after D2 (44%, 95% confidence interval (CI) 34–54%) and D3 (41%, 34–48%) (p = 0.766). A Cox model controlling for sex, age, tumor site, Laurén histology, and T and N stages showed that the risk of cancer-related death after D3 was similar to that recorded after D2 (hazard ratio 0.97, 95% CI 0.67–1.42). There was a significant interaction between the T status and the extension of the lymphadenectomy (p = 0.012), with the prognosis being better after D2 in T2 and T4b patients, and after D3 in T3 patients. Conclusions: The findings of this study suggest that D3 lymphadenectomy is not routinely indicated for patients with advanced gastric cancer, although differences in survival after D3 across T tiers deserve further consideration.

• gastric cancer
• superextended lymphadenectomy
• tailored surgery

• Adjuvant chemotherapy
• C-reactive protein–albumin ratio
• Early recurrence
• Gastric cancer
• Post-recurrence survival

• Albumins/metabolism
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Biomarkers, Tumor/metabolism
• C-Reactive Protein/metabolism
• Chemotherapy, Adjuvant/mortality
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Gastrectomy/mortality
• Humans
• Incidence
• Japan/epidemiology
• Male
• Middle Aged
• Neoplasm Recurrence, Local/diagnosis
• Neoplasm Recurrence, Local/epidemiology
• Neoplasm Recurrence, Local/metabolism
• Predictive Value of Tests
• Prospective Studies
• ROC Curve
• Stomach Neoplasms/metabolism
• Stomach Neoplasms/pathology
• Stomach Neoplasms/therapy
• Survival Rate

• 2016Y9031 the Scientific and technological innovation joint capital projects of Fujian Province
• No.81871899 National Nature Science Foundation of China
• No. [2017]171 Construction Project of Fujian Province Minimally Invasive Medical Center
• 2016B013 The second batch of special support funds for Fujian Province innovation and entrepreneurship talents
• No.2016QH025 QIHANG funds of Fujian Medical University
• 2015-CXB-16 Fujian province medical innovation project
• WKJ2016-2-27 Fujian provincial health and family planning commission joint project

Non-communicable diseases (NCDs) are the leading cause of death and disease burden globally, cardiovascular diseases (CVDs) account for the major part of death related to NCDs followed by different types of cancer, chronic obstructive pulmonary disease (COPD), and diabetes. As the World Health Organization (WHO) and the United Nations have announced a 25% reduction in mortality of NCDs by 2025, different communities need to adopt preventive strategies for achieving this goal. Personalized medicine approach as a predictive and preventive strategy aims for a better therapeutic goal to the patients to maximize benefits and reduce harms. The clinical benefits of this approach are already realized in cancer targeted therapy, and its impact on other conditions needs more studies in different societies. In this review, we essentially describe the concept of personalized (or precision) medicine in association with NCDs and the future of precision medicine in prediction, prevention, and personalized treatment.

• Precision medicine
• cancer
• cardiovascular diseases
• chronic obstructive pulmonary disease
• non-communicable diseases
• type 2 diabetes

• Gastric cancer
• Preoperative chemoradiotherapy
• Preoperative chemotherapy

Purpose: N3 gastric cancer (GC) is characterized by a heavy burden of lymph node metastasis and a high postoperative recurrence rate. The role of radiotherapy in this group of patients remains undetermined. The purpose of this study was to compare the effectiveness of adjuvant chemoradiotherapy (CRT) and adjuvant chemotherapy (ChT) for N3 GC after D2/R0 resection.

Patients and methods: From January 2004 to December 2015, patients with N3 GC in the database of Fudan University Shanghai Cancer Center were retrospectively reviewed. The eligible patients were enrolled in an adjuvant CRT group and an adjuvant ChT group. Four different methods based on a propensity score model were used to balance the baseline characteristics. Then, survival analyses between the two groups were performed in addition to patterns of recurrence and subgroup analyses.

Results: In total, 175 and 365 eligible patients were enrolled into the CRT and ChT groups, respectively. After balancing, the disease-free survival (DFS) of patients in the CRT group was significantly better than that of patients in the ChT group (p=0.021). Subgroup analyses showed that patients with N3a GC benefitted from adjuvant CRT.

Conclusion: Compared with adjuvant ChT, adjuvant CRT can further improve the DFS of patients with N3 GC after D2/R0 resection. Patients with lymph node metastases should be further stratified when selecting patients for adjuvant CRT.

• chemoradiation
• gastrectomy
• propensity score
• stomach neoplasms
• survival analysis

• chemoradiotherapy
• gastric cancer
• radiotherapy
• target definition

• Gastric cancer
• Intraperitoneal administration
• Paclitaxel
• Peritoneal metastasis

• Adjuvant
• Chemotherapy
• Concurrent chemo-radiotherapy
• Gastric cancer
• Recurrence

• Gastric cancer
• Lymphadenectomy
• Para-aortic lymphadenectomy

• Aorta
• Combined Modality Therapy
• Humans
• Lymph Node Excision/methods
• Lymphatic Metastasis
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Stomach Neoplasms/therapy

• Gastrectomy
• Latin America
• prognosis
• stomach neoplasm
• survival

• American Joint Committee on Cancer staging (AJCC)
• Surveillance, Epidemiology, and End Results (SEER)
• pancreatic ductal adenocarcinoma (PDAC)
• staging
• survival.