scholarly journals O-OGC02 Stage Migration in Newly Diagnosed Oesophago-gastric Cancer during the first wave of COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Khurram Khan ◽  
Lewis Gall ◽  
Rongkagorn Chuntamongkol ◽  
Catherine McCollum ◽  
Stephan Dreyer ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Emergency Admission ◽  
Stage Migration ◽  
Newly Diagnosed ◽  
Gastric Cancers ◽  
Negative Effect ◽  
Gastric Cancer Patients ◽  
The Uk ◽  
Treatment Intent ◽  
The Impact

Abstract Background Covid-19 has significantly disrupted elective and emergency health care provision including cancer care within the UK. The aim of the study was to investigate the impact of the pandemic on the staging of oesophago-gastric cancers at presentation, determine the time delay in performing gastroscopy and the multidisciplinary team (MDT) treatment outcomes. Methods A retrospective cohort study of all newly diagnosed oesophago-gastric cancers (adenocarcinoma and squamous cell carcinoma) in a single regional MDT was performed between 1st October 2019 and 30th September 2020. Electronic records were interrogated and patients dichotomised into two groups with those presenting before the introduction of the UK national lockdown of 23rd March 2020 compared to those presenting post-lockdown. Results 349 new oesophago-gastric cancer patients were discussed in the MDT (192 pre-lockdown versus 157 post-lockdown). Demographics were evenly matched between the two groups. More patients presented as an emergency admission post-lockdown (28.0% vs 12.5%, p < 0.001). Median waiting time for gastroscopy was longer post-lockdown (23 vs 14 days, p = 0.035). Metastatic disease at presentation was more frequent post-lockdown (47.8% vs 33.3%, p = 0.008). Overall, more patients had a palliative rather than curative treatment intent post-lockdown (71.3% vs 57.8%, p = 0.005). Conclusions The Covid-19 pandemic has had a significant negative effect on the stage of oesophago-gastric cancers at presentation. This has translated into more patients receiving palliative treatment and ultimately having a poorer prognosis. This study highlights the importance of maintaining cancer services during the Covid-19 pandemic.

scholarly journals 964 Stage Migration in Newly Diagnosed Oesophago-Gastric Cancer During the First Wave Of COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Khan ◽  
R Chuntamongkol ◽  
C McCollum ◽  
L Gall ◽  
M Forshaw
Keyword(s):  
Gastric Cancer ◽  
Emergency Admission ◽  
Stage Migration ◽  
Newly Diagnosed ◽  
Gastric Cancers ◽  
Negative Effect ◽  
Gastric Cancer Patients ◽  
The Uk ◽  
Treatment Intent ◽  
The Impact

Abstract Aim Covid-19 has significantly disrupted elective and emergency health care provision including cancer care within the UK. The aim of the study was to investigate the impact of the pandemic on the staging of oesophago-gastric cancers at presentation, determine the time delay in performing gastroscopy and the multidisciplinary team (MDT) treatment outcomes. Method A retrospective cohort study of all newly diagnosed oesophago-gastric cancers (adenocarcinoma and squamous cell carcinoma) in a single regional MDT was performed between 1st October 2019 and 30th September 2020. Electronic records were interrogated and patients dichotomised into two groups with those presenting before the introduction of the UK national lockdown of 23rd March 2020 compared to those presenting post-lockdown. Results 349 new oesophago-gastric cancer patients were discussed in the MDT (192 pre-lockdown versus 157 post-lockdown). Demographics were evenly matched between the two groups. More patients presented as an emergency admission post-lockdown (28.0% vs 12.5%, p < 0.001). Median waiting time for gastroscopy was longer post-lockdown (23 vs 14 days, p = 0.035). Metastatic disease at presentation was more frequent post-lockdown (47.8% vs 33.3%, p = 0.008). Overall, more patients had a palliative rather than curative treatment intent post-lockdown (71.3% vs 57.8%, p = 0.005). Conclusions The Covid-19 pandemic has had a significant negative effect on the stage of oesophago-gastric cancers at presentation. This has translated into more patients receiving palliative treatment and ultimately having a poorer prognosis. This study highlights the importance of maintaining cancer services during Covid-19 pandemic.

scholarly journals BJS.05Stage Migration in Newly Diagnosed Oesophago-gastric Cancer during the first wave of COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Khurram Khan ◽  
Rongkagorn Chuntamongkol ◽  
Catherine McCollum ◽  
Lewis Gall ◽  
Matthew Forshaw
Keyword(s):  
Gastric Cancer ◽  
Emergency Admission ◽  
Newly Diagnosed ◽  
Gastric Cancers ◽  
Cancer Services ◽  
Negative Effect ◽  
Gastric Cancer Patients ◽  
The Uk ◽  
Treatment Intent ◽  
The Impact

Abstract Aims Covid-19 has significantly disrupted elective and emergency health care provision including cancer care within the UK. The aim of the study was to investigate the impact of the pandemic on the staging of oesophago-gastric cancers at presentation, determine the time delay in performing gastroscopy and the multidisciplinary team (MDT) treatment outcomes. Methods A retrospective cohort study of all newly diagnosed oesophago-gastric cancers (adenocarcinoma and squamous cell carcinoma) in a single regional MDT was performed between 1st October 2019 and 30th September 2020.  Electronic records were interrogated and patients dichotomised into two groups with those presenting before the introduction of the UK national lockdown of 23rd March 2020 compared to those presenting post-lockdown. Results 349 new oesophago-gastric cancer patients were discussed in the MDT (192 pre-lockdown versus 157 post-lockdown). Demographics were evenly matched between the two groups.  More patients presented as an emergency admission post-lockdown (28.0% vs 12.5%, p < 0.001).  Median waiting time for gastroscopy was longer post-lockdown (23 vs 14 days, p = 0.035).   Metastatic disease at presentation was more frequent post-lockdown (47.8% vs 33.3%, p = 0.008).  Overall, more patients had a palliative rather than curative treatment intent post-lockdown (71.3% vs 57.8%, p = 0.005). Conclusions The Covid-19 pandemic has had a significant negative effect on the stage of oesophago-gastric cancers at presentation. This has translated into more patients receiving palliative treatment and ultimately having a poorer prognosis. This study highlights the importance of maintaining cancer services during Covid-19 pandemic.

scholarly journals Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 198
Author(s):  
Ji Yeon Park ◽  
Byunghyuk Yu ◽  
Ki Bum Park ◽  
Oh Kyoung Kwon ◽  
Seung Soo Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Tumor Resection ◽  
Palliative Resection ◽  
Primary Tumors ◽  
Palliative Intent ◽  
Palliative Gastrectomy ◽  
Gastric Cancer Patients ◽  
The Impact

Background and Objectives: The prognosis of metastatic or unresectable gastric cancer is dismal, and the benefits of the palliative resection of primary tumors with noncurative intent remain controversial. This study aimed to evaluate the impact of palliative gastrectomy (PG) on overall survival in gastric cancer patients. Materials and Methods: One hundred forty-eight gastric cancer patients who underwent PG or a nonresection (NR) procedure between January 2011 and 2017 were retrospectively reviewed to select and analyze clinicopathological factors that affected prognosis. Results: Fifty-five patients underwent primary tumor resection with palliative intent, and 93 underwent NR procedures owing to the presence of metastatic or unresectable disease. The PG group was younger and more female dominant. In the PG group, R1 and R2 resection were performed in two patients (3.6%) and 53 patients (96.4%), respectively. The PG group had a significantly longer median overall survival than the NR group (28.4 vs. 7.7 months, p < 0.001). Multivariate analyses revealed that the overall survival was significantly better after palliative resection (hazard ratio (HR), 0.169; 95% confidence interval (CI), 0.088–0.324; p < 0.001) in patients with American Society of Anesthesiologists Physical Status (ASA) scores ≤1 (HR, 0.506; 95% CI, 0.291–0.878; p = 0.015) and those who received postoperative chemotherapy (HR, 0.487; 95% CI, 0.296–0.799; p = 0.004). Among the patients undergoing palliative resection, the presence of <15 positive lymph nodes was the only significant predictor of better overall survival (HR, 0.329; 95% CI, 0.121–0.895; p = 0.030). Conclusions: PG might lead to the prolonged survival of certain patients with incurable gastric cancer, particularly those with less-extensive lymph-node metastasis.

scholarly journals Body Composition Changes in Gastric Cancer Patients during Preoperative FLOT Therapy: Preliminary Results of an Italian Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 960
Author(s):  
Emanuele Rinninella ◽  
Antonia Strippoli ◽  
Marco Cintoni ◽  
Pauline Raoul ◽  
Raffaella Vivolo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Body Composition ◽  
Tumor Regression ◽  
Evaluation Criteria ◽  
Tumor Regression Grade ◽  
Skeletal Muscle Index ◽  
Before And After ◽  
Gastric Cancer Patients ◽  
The Impact ◽  
Composition Changes

Background: The impact of the new chemotherapy, fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) on body composition in gastric cancer (GC) patients remains unknown. We assessed body composition changes of GC patients receiving the FLOT regimen and their impact on treatment outcomes. Methods: Preoperative pre- and post-FLOT computed tomography (CT) scans of advanced GC patients were studied. Lumbar skeletal muscle index (SMI) and adipose indices were calculated before and after FLOT. Results: A total of 26 patients were identified between April 2019 and January 2020. Nineteen patients were sarcopenic at diagnosis. The mean BMI decreased (from 24.4 ± 3.7 to 22.6 ± 3.1; p < 0.0001) as well as the SMI (from 48.74 ± 9.76 to 46.52 ± 9.98; p = 0.009) and visceral adipose index (VAI) (from 49.04 ± 31.06 to 41.99 ± 23.91; p = 0.004) during preoperative FLOT therapy. BMI, SMI, and VAI variations were not associated with toxicity, Response Evaluation Criteria in Solid Tumors (RECIST), response, delay and completion of perioperative FLOT chemotherapy, and the execution of gastrectomy; a decrease of SMI ≥ 5% was associated with a higher Mandard tumor regression grade (p = 0.01). Conclusions: Almost three-quarters (73.1%) of GC patients were sarcopenic at diagnosis. Preoperative FLOT was associated with a further reduction in SMI, BMI, and VAI. These changes were not associated with short-term outcomes.

scholarly journals Clinical and Oncological Value of Preoperative BMI in Gastric Cancer Patients: A Single Center Experience

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Costantino Voglino ◽  
Giulio Di Mare ◽  
Francesco Ferrara ◽  
Lorenzo De Franco ◽  
Franco Roviello ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Blood Proteins ◽  
Term Survival ◽  
Long Term Survival ◽  
Single Center Experience ◽  
Group B ◽  
Gastric Cancer Patients ◽  
The Impact

Introduction. The impact of preoperative BMI on surgical outcomes and long-term survival of gastric cancer patients was investigated in various reports with contrasting results.Materials & Methods. A total of 378 patients who underwent a surgical resection for primary gastric cancer between 1994 and 2011 were retrospectively studied. Patients were stratified according to BMI into a normal group (<25, group A), an overweight group (25–30, group B), and an obesity group (≥30, group C). These 3 groups were compared according to clinical-pathological characteristics, surgical treatment, and long-term survival.Results. No significant correlations between BMI and TNM (2010), UICC stage (2010), Lauren’s histological type, surgical results, lymph node dissection, and postoperative morbidity and mortality were observed. Factors related to higher BMI were male genderP<0.05, diabetesP<0.001, and serum blood proteinsP<0.01. A trend to fewer lymph nodes retrieved during gastrectomy with lymphadenectomy in overweight patients (B and C groups) was observed, although not statistically significant. There was no difference in overall survival or disease-specific survival between the three groups.Conclusion. According to our data, BMI should not be considered a significant predictor of postoperative complications or long-term result in gastric cancer patients.

scholarly journals The Impact of COVID-19 on Gastric Cancer Surgery: A Single-Center Retrospective Study

2020 ◽  
Author(s):  
Yu-xuan Li ◽  
Chang-zheng He ◽  
Yi-chen Liu ◽  
Peng-yue Zhao ◽  
Xiao-lei Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Waiting Time ◽  
World Health ◽  
Abdominal Ct ◽  
Surgical Strategies ◽  
Patients With Cancer ◽  
Global Pandemic ◽  
Health Organization ◽  
Gastric Cancer Patients ◽  
The Impact

Abstract Background: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization. Patients with cancer are more likely to incur poor clinical outcomes. Due to the prevailing pandemic, we propose some surgical strategies for gastric cancer patients. Methods: The ‘COVID-19’ period was defined as occurring between 2020-01-20 and 2020-03-20. The enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. Results: The waiting time before admission increased by 4 days in the CG (PCG: 4.5 [IQR: 2, 7.8] vs. CG: 8.0 [IQR: 2,20]; p=0.006). More patients had performed chest CT scans besides abdominal CT before admission during the COVID-19 period (PCG: 22 [32%] vs. CG: 30 [73%], p=0.001). After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. CG: 7[IQR: 5,9]; p<0.001), more laparoscopic surgeries were performed (PCG: 51[75%] vs. CG: 38[92%], p=0.021), and hospital stay period after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11]; p<0.001). In addition, the total cost of hospitalization increased during this period, (PCG: 9.22[IQR:7.82,10.97] vs. CG: 10.42[IQR:8.99,12.57]; p=0.006). Conclusion: This study provides an opportunity for our surgical colleagues to reflect on their own services and any contingency plans they may have to tackle the COVID-19 crisis.

The Impact Of Health Insurance Coverage On Outcomes For U.S. Gastric Cancer Patients

2011 ◽  
Vol 165 (2) ◽  
pp. 338
Author(s):  
J.K. Smith ◽  
S. Ng ◽  
J.S. Hill ◽  
T.P. McDade ◽  
S.A. Shah ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Health Insurance ◽  
Cancer Patients ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Gastric Cancer Patients ◽  
The Impact

Impact of Total Lymph Node Count on Staging and Survival After Gastrectomy for Gastric Cancer: Data From a Large US-Population Database

2005 ◽  
Vol 23 (28) ◽  
pp. 7114-7124 ◽  
Author(s):  
David D. Smith ◽  
Rebecca R. Schwarz ◽  
Roderich E. Schwarz
Keyword(s):  
Gastric Cancer ◽  
Linear Trend ◽  
Stage Migration ◽  
Population Database ◽  
Curative Gastrectomy ◽  
Data Set ◽  
Lymph Node Count ◽  
Cancer Data ◽  
Survival Difference ◽  
The Impact

Background Prognosis of potentially curable (M0), completely resected gastric cancer is primarily determined by pathologic T and N staging criteria. The optimal regional dissection extent during gastrectomy for gastric adenocarcinoma continues to be debated. Methods A gastric cancer data set was created through structured queries to the Surveillance, Epidemiology, and End Results database (1973 to 1999). Relationships between the number of lymph nodes (LNs) examined and survival were analyzed for the stage subgroups T1/2N0, T1/2N1, T3N0, and T3N1. Results In every stage subgroup, overall survival was highly dependent on the number of LNs examined. Multivariate prognostic variables in the T1/2N0M0 subgroup were number of LNs examined, age (for both, P < .0001), race (P = .0004), sex (P = .0006), and tumor size (P = .02). A linear trend for superior survival based on more LNs examined could be confirmed for all four stage subgroups. Baseline model–predicted 5-year survival with only one LN examined was 56% (T1/2N0), 35% (T1/2N1), 29% (T3N0), or 13% (T3N1). For every 10 extra LNs dissected, survival improved by 7.6% (T1/2N0), 5.7% (T1/2N1), 11% (T3N0), or 7% (T3N1). A cut-point analysis yielded the greatest survival difference at 10 LNs examined but continued to detect significantly superior survival differences for cut points at up to 40 LNs, always in favor of more LNs examined. Conclusion Although the impact of stage migration versus improved regional disease control cannot be separated on basis of the available information, the data provide support in favor of extended lymphadenectomy during potentially curative gastrectomy for gastric cancer.

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