Chen GY, Ren P, Gao Z, Yang HM, Jiao Y. Analysis of vascular thrombus and clinicopathological factors in prognosis of gastric cancer: A retrospective cohort study. World J Gastrointest Oncol 2024; 16(8): 3436-3444 [PMID: 39171182 DOI: 10.4251/wjgo.v16.i8.3436]
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05750635
Submitted on:
August 18, 2024, 18:15
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Reader Comments:
There are some methodological concerns that we would highlight. In their exclusion criteria, we note that the authors excluded patients with serious underlying disease, The extent of severity of comorbidities to warrant exclusion was not defined. Furthermore, patients with immediate postoperative complications were also excluded from final analysis. These exclusions may introduce an element of selection bias into the analysis, as only the fittest patients who had an uneventful postoperative course were included in the final analysis.
It is also concerning that there is no mention of provision of neoadjuvant or perioperative systemic therapy for these gastric cancer patients, as is the standard of care in locally advanced gastric cancer throughout the world. It would have been interesting to know if there was an association between receiving perioperative chemotherapy, such as FLOT, and survival outcomes, or with the presence of vascular tumour thrombosis. There would have been a subset of patients with early gastric cancer that would have had upfront surgery as well, which would have opened the door to a subgroup analysis of patients that received neoadjuvant therapy vs. those that didn’t.
The completeness of this study would have benefited from reporting mean or median follow up durations, as well completeness of follow up. There was no discussion regarding recurrence or disease-free intervals.
Ultimately, this study adds to an already sizeable pool of knowledge that suggests that the presence of microvascular invasion in gastric cancer is associated with poorer survival outcomes.
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