Surgical treatment of stomach cancer: possibilities of predicting survival rate at the present stage

Authors

  • S.I. Kirkilevsky National Cancer Institute, Kyiv, Ukraine,
  • A.G. Lurin Municipal Institution “Odesa Regional Oncology Center”, Odesa, Ukraine,
  • V.G. Dubinina Odesa National Medical University, Odesa, Ukraine,
  • O.V. Lukyanchuk Odesa National Medical University, Odesa, Ukraine Municipal Institution “Odesa Regional Oncology Center”, Odesa, Ukraine,
  • A.A. Mashukov National Cancer Institute, Kyiv, Ukraine Odesa National Medical University, Odesa, Ukraine Municipal Institution “Odesa Regional Oncology Center”, Odesa, Ukraine,
  • A.A. Bilenko Odesa National Medical University, Odesa, Ukraine,
  • A.N. Zgura Municipal Institution “Odesa Regional Oncology Center”, Odesa, Ukraine,
  • S.V. Mеrlich Municipal Institution “Odesa Regional Oncology Center”, Odesa, Ukraine,
  • D.V. Ratsiborsky Municipal Institution “Odesa Regional Oncology Center”, Odesa, Ukraine,
  • V.Е. Maksimovsky Odesa National Medical University, Odesa, Ukraine,
  • I.V. Shilin Municipal Institution “Odesa Regional Oncology Center”, Odesa, Ukraine,
  • D.N. Osadchy Odesa National Medical University, Odesa, Ukraine,

DOI:

https://doi.org/10.22141/1997-2938.2.33.2017.107647

Keywords:

stomach cancer, immunohistochemistry, oncoproteins

Abstract

Background. Studying the survival rate of cancer patients is the main task of the clinical and experimental oncologist. Based on the mathematical analysis of many factors at once, it is possible to predict the life expectancy of a patient with stomach cancer. Materials and methods. A total of 221 patients operated for gastric cancer in the period of 2007–2013 were included in the study conducted at the premises of the abdominal oncosurgical department of the Odessa regional oncology center. Patients underwent radical oncosurgical operations, after which the tumor tissue was examined routinely histologically and for the presence of expression of certain molecular markers, which were also prognosis markers, like the degree of differentiation, the depth of invasion to the stomach wall or the number of lymph nodes affected by metastases. Results. The worst prognosis of survival, based on the existing group of patients, was the so-called “triple negative” gastric cancer, by analogy with a similar form of breast cancer. An interesting feature revealed in the process of analyzing marker combinations was the combination of VEGFR-p53-Her2+Ki-67–: such tumors were highly differentiated forms, without invasion into neighboring structures, exophytic growth, without signs of aggressive growth. What is commonly referred to as local forms, promising in terms of long-term survival, even in the loco-regional stage. A group was found where the performance of multiorgan resections affected the survival rate of patients with gastric carcinoma at late observation periods — after 100 months. The main critical feature of the VEGFR-p53+Her2-Ki-67+ group was the absence of metastases in regional lymph nodes, even in the case of Т4 tumor. It is possible to monitor the influence of standard morphological factors and tumor cells expressed on the membranes of oncoproteins on the life expectancy of a particular patient. Survival methods can be used by surgeons and chemotherapists to personalize chemotherapy (Her2/new, VEGFR) and to individualize surgical methods of treatment: invasion into the stomach wall, patient’s age, affected lymph nodes count, tumor size, G grade and p53 bioagressivity. Conclusions. Given the increasing dependence of medical community on the availability of medical data on various topics, there is the need to create more precise gradations in the dependency of survival of cancer patients on various clinical and morphological situations.

References

Чиссов В.И., Вашакмадзе Л.А., Бутенко А.В. и др. Возможности хирургического лечения резектабельного рака желудка IV стадии // Российский онкологический журнал. — 2003. — № 6. — С. 4-7.

Добровольский Н.А., Орел Н.А., Лурин А.Г., Згура А.Н., Биленко А.А., Машуков А.А., Мерлич С.В., Рациборский Д.В., Максимовский В.Е. Изучение влияния расширенных лимфодиссекций на выживаемость больных раком желудка // Клиническая онкология. — 2013. — № 4 (12).

Amato M., Perrone G., Righi D., Pellegrini C., Rabitti C., DiMatteo F., Crucitti P., Caputo D., Coppola R., Tonini G., Santini D., Onetti Muda A. HER2 Status in Gastric Cancer: Comparison between Primary and Distant Metastatic Disease. Pathol. Oncol. Res. — 2016 Jun 30. PMID: 27363700.

Burke A.P., Yen T.S., Shekitka K.M., Sobin L.H. Lymphoepithelial carcinoma of the stomach with Epstein-Barr virus demonstrated by polymerase chain reaction // Mod. Pathol. — 1990. — 3 (3). — 377-380.

Chen T., Xu X.Y., Zhou P.H. Emerging molecular classifications and therapeutic implications for gastric cancer // Chin. J. Cancer. — 2016. — 35 (1). — 49. doi: 10.1186/s40880-016-0111-5. Review. PMID: 27233623.

Japanese Classification of Gastric Carcinoma — 2nd English Edition — Japanese Gastric Cancer Association // Gastric. Cancer. — 1998. — 1. — 10-24.

Quality of life in cancer chemotherapy randomized trials / B. Curbow, J.V. Bowie, A.C. Martin et al. // Quality of Life Research. — 1997. — Vol. 6. — P. 684.

Issue

Section

Original Researches