Early onset gastric cancer: distinct clinical entity with different prognosis?
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://revista.spcir.com/index.php/spcir/article/view/56 |
Resumo: | Background: This study aimed to evaluate early onset gastric cancer (EOGC), considered as gastric cancer in a patient younger than 45 years, as a distinct entity with a different prognosis. Methods: This study is related to 1256 patients admitted with gastric or gastroesophageal junction carcinoma in Department of Surgery, São João Hospital, Porto, Portugal, between January 1988 and December 2008. EOGC represented 10,6% of the gastric carcinomas treated during this period. The following clinical, pathological and staging parameters were studied: age, gender, tumor location, resectability, type of resection, type of lymphadenectomy [Siewert (GGCS 1993) and Japanese (JGCA 2nd English Edition 1998) classifications], number of lymph nodes studied, tumor dimensions, macroscopic form, histological classification (Laurén and Ming), venous invasion, lymphatic permeation, perineural invasion, depth of wall invasion (T), lymph node metastases (N) – TNM (UICC/AJCC 7th Edition 2009) and Japanese (JGCA 2nd English Edition 1998) classifications and lymph node ratio – distance metastases (M) and stage.Results: Significant diffe- rences were observed in the type of resection (p<0,001) and type of lymphadenectomy (p=0,008), with more radical surgery performed in EOGC patients. Some tumor characteristics also showed significant differences: tumor dimensions (p=0,004), with EOGC usually smaller; diffuse type according to Lauren’s classification (p<0,001); infiltrative type according to Ming’s classification (p=0,001); less venous invasion (p=0,005); less lymphatic permeation (p=0,029). There were no significant differences in the staging parameters. There were significant differences in the survival rate (p<0,001), with 5-year survival rate of 44% in patients with EOGC compared with 31% in older patients. Cox-regression analysis revealed age, wall invasion depth and lymph node ratio as independent prognostic factors.Conclusions: This study confirmed EOGC as a distinct clinical entity. Despite more aggressive pathological characteristics, there was a better survival in EOGC group, probably due to better physical status of young individuals and more aggressive surgical treatment in this subgroup of patients.Keywords: Gastric cancer; Early onset gastric cancer; Prognosis; Clinicopathological characterizationStudy partially presented at the 2011 Gastrointestinal Cancers Symposium, San Francisco, USA, 20-22 January, 2011; Abstract published in J Clin Oncol 29: 2011 (suppl 4; abstr 22). |
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Early onset gastric cancer: distinct clinical entity with different prognosis?Early onset gastric cancer: uma entidade clínica distinta com um prognóstico diferente?Background: This study aimed to evaluate early onset gastric cancer (EOGC), considered as gastric cancer in a patient younger than 45 years, as a distinct entity with a different prognosis. Methods: This study is related to 1256 patients admitted with gastric or gastroesophageal junction carcinoma in Department of Surgery, São João Hospital, Porto, Portugal, between January 1988 and December 2008. EOGC represented 10,6% of the gastric carcinomas treated during this period. The following clinical, pathological and staging parameters were studied: age, gender, tumor location, resectability, type of resection, type of lymphadenectomy [Siewert (GGCS 1993) and Japanese (JGCA 2nd English Edition 1998) classifications], number of lymph nodes studied, tumor dimensions, macroscopic form, histological classification (Laurén and Ming), venous invasion, lymphatic permeation, perineural invasion, depth of wall invasion (T), lymph node metastases (N) – TNM (UICC/AJCC 7th Edition 2009) and Japanese (JGCA 2nd English Edition 1998) classifications and lymph node ratio – distance metastases (M) and stage.Results: Significant diffe- rences were observed in the type of resection (p<0,001) and type of lymphadenectomy (p=0,008), with more radical surgery performed in EOGC patients. Some tumor characteristics also showed significant differences: tumor dimensions (p=0,004), with EOGC usually smaller; diffuse type according to Lauren’s classification (p<0,001); infiltrative type according to Ming’s classification (p=0,001); less venous invasion (p=0,005); less lymphatic permeation (p=0,029). There were no significant differences in the staging parameters. There were significant differences in the survival rate (p<0,001), with 5-year survival rate of 44% in patients with EOGC compared with 31% in older patients. Cox-regression analysis revealed age, wall invasion depth and lymph node ratio as independent prognostic factors.Conclusions: This study confirmed EOGC as a distinct clinical entity. Despite more aggressive pathological characteristics, there was a better survival in EOGC group, probably due to better physical status of young individuals and more aggressive surgical treatment in this subgroup of patients.Keywords: Gastric cancer; Early onset gastric cancer; Prognosis; Clinicopathological characterizationStudy partially presented at the 2011 Gastrointestinal Cancers Symposium, San Francisco, USA, 20-22 January, 2011; Abstract published in J Clin Oncol 29: 2011 (suppl 4; abstr 22). Introdução: O presente estudo procurou avaliar se o early onset gastric cancer (EOGC), considerado como cancro gástrico em indivíduos com menos de 45 anos, representa uma entidade clínica distinta com um prognóstico diferente. Métodos: O estudo é relativo a 1256 doentes com carcinoma do estômago e da junção esófago-gástrica admitidos no Departamento de Cirurgia Geral do Hospital São João, E.P.E. entre Janeiro de 1988 e Dezembro de 2008. Os EOGC representaram 10,6% de todos os casos de carcinoma gástrico tratados neste período. Foram avaliados os seguintes parâmetros clínico-patológicos e de estadiamento: sexo, localização tumoral, ressecabilidade, tipo de cirurgia de ressecção, tipo de ressecção, tipo de linfadenectomia [classificação de Siewert (GGCS 1993) e Japonesa (JGCA 2a Edição Versão Inglesa 1998)], número de gânglios estudados, dimensões do tumor, forma macroscópica, classificação histológica (Laurén e Ming), invasão venosa, permeação linfática, invasão perineural, progressão do tumor na parede (T), metastização ganglionar (N) – classificação TNM (UICC/AJCC 7a Edição 2009) e Japonesa (JGCA 2a Edição Versão Inglesa 1998), rácio ganglionar, metastização à distância (M) e estadio. Resultados: Nesta série, observaram-se diferenças significativas no tipo de cirurgia de ressecção (p<0,001) e no tipo de linfadenectomia (p=0,008), com cirurgias mais radicais nos doentes com EOGC. Verificaram-se também diferenças significativas em algumas características patológicas: dimensões do tumor (p=0,004), classificação de Laurén (p<0,001), classificação de Ming (p=0,001), invasão venosa (p=0,005), permeação linfática (p=0,029). Não se verificaram diferenças significativas relativamente ao estadiamento. Observaram-se diferenças significativas (p<0,001) nas curvas de sobrevida aos 5 anos dos doentes com EOGC (44%) em comparação com os pacientes mais idosos (31%). A análise multivariada pelo método da regressão de Cox identificou a idade, a progressão do tumor na parede e o rácio ganglionar como factores de prognóstico independentes. Conclusões: Este estudo confirmou o EOGC como uma entidade clínica distinta. Apesar de algumas das características patológicas deste tipo de tumores se associarem classicamente a um pior prognóstico, a sobrevida dos doentes com EOGC foi significativamente superior, devido provavelmente ao melhor estado fisiológico dos indivíduos jovens e à maior agressividade e radicalidade do tratamento cirúrgico neste subgrupo de pacientes. Palavras-chave: Cancro gástrico; Cancro gástrico em jovens; Prognóstico; Caracterização clínico-patológica. Trabalhado parcialmente apresentado no 2011 Gastrointestinal Cancers Symposium, São Francisco, EUA, 20 a 22 de Janeiro de 2011; Resumo publicado em J Clin Oncol 29: 2011 (suppl 4; abstr 22). Sociedade Portuguesa de Cirurgia2012-03-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://revista.spcir.com/index.php/spcir/article/view/56Revista Portuguesa de Cirurgia; No 20 (2012): Março 2012 - II Série; 21-30Revista Portuguesa de Cirurgia; No 20 (2012): Março 2012 - II Série; 21-302183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spcir.com/index.php/spcir/article/view/56https://revista.spcir.com/index.php/spcir/article/view/56/53Copyright (c) 2016 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessSousa, Hugo Miguel Teixeira Ferraz dos SantosMachado, Tiago de Queirós Bouça RibeirinhoSousa, João António Pinto dePreto, John RodriguesCosta, Eduardo Jorge Lima daMaia, José Eduardo Fernandes Costa2024-02-22T22:33:03Zoai:revista.spcir.com:article/56Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:10:58.472116Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Early onset gastric cancer: distinct clinical entity with different prognosis? Early onset gastric cancer: uma entidade clínica distinta com um prognóstico diferente? |
title |
Early onset gastric cancer: distinct clinical entity with different prognosis? |
spellingShingle |
Early onset gastric cancer: distinct clinical entity with different prognosis? Sousa, Hugo Miguel Teixeira Ferraz dos Santos |
title_short |
Early onset gastric cancer: distinct clinical entity with different prognosis? |
title_full |
Early onset gastric cancer: distinct clinical entity with different prognosis? |
title_fullStr |
Early onset gastric cancer: distinct clinical entity with different prognosis? |
title_full_unstemmed |
Early onset gastric cancer: distinct clinical entity with different prognosis? |
title_sort |
Early onset gastric cancer: distinct clinical entity with different prognosis? |
author |
Sousa, Hugo Miguel Teixeira Ferraz dos Santos |
author_facet |
Sousa, Hugo Miguel Teixeira Ferraz dos Santos Machado, Tiago de Queirós Bouça Ribeirinho Sousa, João António Pinto de Preto, John Rodrigues Costa, Eduardo Jorge Lima da Maia, José Eduardo Fernandes Costa |
author_role |
author |
author2 |
Machado, Tiago de Queirós Bouça Ribeirinho Sousa, João António Pinto de Preto, John Rodrigues Costa, Eduardo Jorge Lima da Maia, José Eduardo Fernandes Costa |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Sousa, Hugo Miguel Teixeira Ferraz dos Santos Machado, Tiago de Queirós Bouça Ribeirinho Sousa, João António Pinto de Preto, John Rodrigues Costa, Eduardo Jorge Lima da Maia, José Eduardo Fernandes Costa |
description |
Background: This study aimed to evaluate early onset gastric cancer (EOGC), considered as gastric cancer in a patient younger than 45 years, as a distinct entity with a different prognosis. Methods: This study is related to 1256 patients admitted with gastric or gastroesophageal junction carcinoma in Department of Surgery, São João Hospital, Porto, Portugal, between January 1988 and December 2008. EOGC represented 10,6% of the gastric carcinomas treated during this period. The following clinical, pathological and staging parameters were studied: age, gender, tumor location, resectability, type of resection, type of lymphadenectomy [Siewert (GGCS 1993) and Japanese (JGCA 2nd English Edition 1998) classifications], number of lymph nodes studied, tumor dimensions, macroscopic form, histological classification (Laurén and Ming), venous invasion, lymphatic permeation, perineural invasion, depth of wall invasion (T), lymph node metastases (N) – TNM (UICC/AJCC 7th Edition 2009) and Japanese (JGCA 2nd English Edition 1998) classifications and lymph node ratio – distance metastases (M) and stage.Results: Significant diffe- rences were observed in the type of resection (p<0,001) and type of lymphadenectomy (p=0,008), with more radical surgery performed in EOGC patients. Some tumor characteristics also showed significant differences: tumor dimensions (p=0,004), with EOGC usually smaller; diffuse type according to Lauren’s classification (p<0,001); infiltrative type according to Ming’s classification (p=0,001); less venous invasion (p=0,005); less lymphatic permeation (p=0,029). There were no significant differences in the staging parameters. There were significant differences in the survival rate (p<0,001), with 5-year survival rate of 44% in patients with EOGC compared with 31% in older patients. Cox-regression analysis revealed age, wall invasion depth and lymph node ratio as independent prognostic factors.Conclusions: This study confirmed EOGC as a distinct clinical entity. Despite more aggressive pathological characteristics, there was a better survival in EOGC group, probably due to better physical status of young individuals and more aggressive surgical treatment in this subgroup of patients.Keywords: Gastric cancer; Early onset gastric cancer; Prognosis; Clinicopathological characterizationStudy partially presented at the 2011 Gastrointestinal Cancers Symposium, San Francisco, USA, 20-22 January, 2011; Abstract published in J Clin Oncol 29: 2011 (suppl 4; abstr 22). |
publishDate |
2012 |
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2012-03-30 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://revista.spcir.com/index.php/spcir/article/view/56 |
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https://revista.spcir.com/index.php/spcir/article/view/56 |
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por |
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https://revista.spcir.com/index.php/spcir/article/view/56 https://revista.spcir.com/index.php/spcir/article/view/56/53 |
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Copyright (c) 2016 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
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Copyright (c) 2016 Revista Portuguesa de Cirurgia |
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openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
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Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 20 (2012): Março 2012 - II Série; 21-30 Revista Portuguesa de Cirurgia; No 20 (2012): Março 2012 - II Série; 21-30 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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