bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic value of baseline complete blood count components in advanced gastric cancer patients: A multicenter retrospective study.
Authors: Elsamany Shereef Ahmed , Zeeneldin Ahmed , Tashkandi Emad , Rasmy Ayman Ahamd , Abozeed Waleed , Abdelfatah Gomaa , Bukhari Huda Sharif , Sulaimani Mernan , Firaq Donia Ahmed 
Published: May 2020

e16528 Background: Gastric cancer (GC) is one of the most prevalent malignant types in the world and an aggressive disease with a poor 5-year survival. Pretreatment CBC-based biomarkers, including blood neutrophil, lymphocyte, monocyte, and platelet counts; hemoglobin (Hb) levels; and their combinations, such as the neutrophil-lymphocyte ratio(NLR), lymphocyte-monocyte ratio (LMR) and platelet-lymphocyte ratio (PLR), have been reported to reflect systemic and local inflammation associated with cancer progression and prognosis. There has been growing interest in using CBC-based measures as biomarkers for GC. Methods: This chart-review study aimed to evaluate the effect of baseline levels of different components of routine CBC examination as well as other patients and disease characteristics on progression free survival (PFS) and overall survival (OS) in metastatic gastric cancer patients. Total 135 metastatic gastric cancer patients who had diagnosed and treated in three oncology centers in Saudi Arabia from 2011 to 2016 were incorporated. Various potential prognostic factors had measured in univariate and multivariate analysis. Results: After a median follow up of 21.4 months, the median OS / PFS were 11.0 and 6.1 months, respectively. Higher albumin level ( > 3g/dl), low neutrophil percentage ≤ 75%, high lymphocyte percentage > 15%, neutrophil /lymphocyte ≤ 2.5, high eosinophil count > 0.4 k/ml, and EOX/EOF chemotherapy vs. doublet chemotherapy were associated with better PFS in univariate analysis. Conversely, in multivariate analysis, only serum albumin and eosinophil levels were related to PFS. In univariate analysis, higher serum albumin (3 g/dl), low neutrophil percentage ≤ 75%, high lymphocyte percentage > 15%, neutrophil/lymphocyte ≤2.5, high eosinophil count > 0.4 k/ml, receiving 1st line chemotherapy vs. no chemotherapy, receiving > 6 cycles of chemotherapy, receiving EOX/EOF chemotherapy vs. doublet chemotherapy, platelet count ≤450 k/ml, male gender were associated with better OS. In multivariate analysis, lower neutrophil percentage, higher serum albumin, male sex and higher number of chemotherapy cycles were independently associated with OS. Conclusions: Higher eosinophil level was associated with improved PFS while lower neutrophil percentage and higher number of chemotherapy cycles were independent predictors of OS. Higher albumin levels independently predicted better OS and PFS.
The effects of combined modality therapy on stage II-III primary gastric signet ring cell carcinoma.
Authors: Li Yang , Tian Yantao , Zhu Zhikai 
Published: May 2020

e16530 Background: To date, there is no well-defined standard of care for gastric signet ring cell carcinoma (GSRC). Clinical guidelines support that combined modality therapy (CMT) on localized gastric cancer, but this may not be appropriate for GSRC as it was generally found to be chemo-resistant. We conducted a population-based study to examine the effects of therapeutic strategies on survival outcomes by using the Surveillance, Epidemiology, and End Results (SEER) data. Methods: Analyses included primary GSRC patients with stage II-III who survived more than 6 months, and were diagnosed between 2006 and 2016 from SEER data.CMT were categorized as gastrectomy group, adjuvant CT group (gastrectomy with adjuvant chemotherapy), neoadjuvant RT group (gastrectomy with neoadjuvant radiotherapy combined adjuvant chemotherapy), and adjuvant CRT group (gastrectomy with chemoradiotherapy). Survival analyses were conducted by Kaplan-Meier method and multivariate Cox proportional hazards models, adjusted for age, gender, race, marital status, histology, AJCC stage, tumor location, and lymph nodes removed. Models were stratified by gender, AJCC stage, lymph nodes removed and tumor location. Results: Of the 1,717 cases of stage II-III primary GSRC, the mean age was 66.9 (SD: 11.0) years, over a half were male (52.8%), and the majority were white (66.0%). A total of 39.9% received adjuvant CRT. The five-year overall survival (OS) rate was 34.6% for this treatment, and 29.6% for adjuvant CT group, 25.4% for adjuvant CRT group, only 23.8% for the gastrectomy group. The median OS of patients treated with adjuvant CRT was significantly longer than that of the gastrectomy group (33 vs 24 months, aHR = 0.71, 95%CI = 0.60,0.84). Although the crude model showed a significant association between adjuvant CT and total survival (cHR = 0.81, 95%CI = 0.68,0.96), the effect measure turned null in the multivariable and sub-group analysis. Independent prognostic factors were adjuvant CRT, ≥60 years old, AJCC stage, and > 20 lymoh nodes removed. Conclusions: In this study, GSRC patients with stage II-III experienced improved overall survival after receiving adjuvant CRT, which provides several treatment implications. Future clinical trials considering adjuvant CRT will be needed to verify the conclusion derived from this study.
The effect of chronic diseases on the clinical effect and survival period of patients with solid tumor treated with UMIPIC.
Authors: Cui Shanshan , Liu Yanping , Wu Yanfei , Shang Wei , Han Wei , Xu Xingyou , Yu Baofa ,   Shandong Baofa Therapeutics, Inc
Published: May 2020

e16532 Background: To observe the effect of chronic disease condition on the therapeutic effect and survival period of cancer patients treated with UMIPIC. Methods: 2594 cancer patients in our hospital from January 2011 to December 2015 who received UMIPIC for the study objects. 576 cases with chronic diseases, 2018 without chronic disease, 840 with lung cancer, 712 with esophageal cancer, 254 with liver cancer, 108 with pancreatic cancer, 93 with gastric cancer, 587 with other cancers. They signed the consent for treatment, evaluated the efficacy, followed up to the clinical effect, adverse reactions, survival data of patients. Results: The side effects of the chronic disease patients with cancer after UMIPIC therapy is fever at 26.56%, pain at 15.10%, the second was hemoglobin reduction 16.48%, leucopenia 5.27%, liver function damage 2.67%, thrombocytopenia 2.45%, nausea 2.26%, vomiting 1.39%, neurotoxicity and hair loss of less than 0.20%, while cancer patients without chronic disease after UMIPIC therapy, side effect is fever at 32.37%, pain at14.87%, hemoglobin reduction 13.26%, leucopenia 6.09%, nausea 2.73%, thrombocytopenia 2.6% 3%, liver function damage 1.77%, vomiting 1.73%, kidney function damage 0.89%, neurotoxicity and hair loss were lower than 0.20%; there is only fever difference in the two groups (P < 0.05).There was no significant difference in other adverse reactions. This may be due to the immunity of normal patients was stronger than that of chronic patients. It was found that the clinical benefit rate of 90.91% in patients with chronic diseases was significantly lower than 93.44% in patients without chronic diseases (P = 0.021); after follow-up, we found that the mean survival time of patients with chronic diseases was 22.149 months, median survival time was 10.300 months, while median survival time of patients without chronic diseases was 22.940 months, median survival time was 11.200 months, and the survival rates of patients without chronic diseases for 1, 2, 3 and 5-year were 48.94%, 29.97%, 25.19%, and 25.18% respectively, it is significantly higher than those of patients with chronic diseases (43.19%, 22.33%, 18.37% and 16.04%) (P<0.05). Conclusions: The survival time and survival rate of the patients without chronic diseases are higher than those of the patients with chronic diseases. The side effects of chronic diseases on the patients with cancer treated with UMIPIC are not significant different except for fever. The patients with chronic diseases can safely receive UMIPIC treatment.
The genomic profile and potential predictive circulating cytokines of gastric cancer combine disseminated intravascular coagulation.
Authors: Xiao Jian , Li Shanshan , Zhai Xiaohui , Liu Xinyi , Chen Yaoxu , Huang Mengli 
Published: May 2020

e16543 Background: Advanced gastric cancer (GC) combined with disseminated intravascular coagulation (DIC) is a rare clinical disease, but disease progression was rapid and the prognosis is extremely poor. Therefore, an effective whole-course treatment scheme is urgently needed, and the understanding of the molecular mechanism of the disease is still a blank. Methods: FFPE tissues were collected from 8 DIC and 62 non-DIC Chinese gastric cancers. Whole-exome sequencing (WES) by NGS technology was performed on the tissue samples. We also evaluate the protein level of circulating cytokine among 5 DIC GC and 15 non-DIC GC from the preoperative blood specimens by ELISA detection. Results: More than 700 genes related to cancer were addressed specifically. The most frequent mutated genes in DIC GC group are different from non-DIC GC group. 75% (6/8) DIC GC were detected to harbor AR gene mutations. NCOR2 (50%, 4/8) and KMT2C (37.5%, 3/8) were also most frequent mutated genes. While TP53 (72.6%, 45/62), APC (43.5%, 27/62) and KRAS (38.7%, 24/62) were the most frequent mutated genes in non-DIC gastric cancers. As an exotic comparison, the WES data from the public TCGA-STAD (n = 544) cohort was analyzed. The most frequent mutated genes turned out to be TP53 (45.1%, 205/455), LRP1B (28.6%, 130/455) and ARID1A (24.6%, 112/455). For ELISA detection, protein levels of MIP-1α (p = 0.0311)、IL-8 (p = 0.0435)、TNF-α (p = 0.0339) and MCP-1 (p = 0.0187) were significantly lower in DIC GC group, respectively, as compared to non-DIC GC group. In accordance with result of WES, 60% (12/20) samples in non-DIC GC group had more than one gene variation related to immune activation, while 25% (2/8) samples in DIC GC group had only one gene variation. Conclusions: Our study showed that DIC gastric cancers had unique molecular characteristics. Their development may be driven by malfunction in steroid hormone receptors activation other than TP53. DIC GC harbored less DNA variations than non-DIC GC. Circulating cytokine, such as MIP-1α、IL-8、TNF-α and MCP-1, may be served as potential monitoring indicators in the acute phase of DIC GC patients
Efficacy and safety of camrelizumab combined with FOLFOX as neoadjuvant therapy for patients with resectable locally advanced gastric and gastroesophageal junction adenocarcinoma who received D2 radical gastrectomy.
Authors: Zhao Yuzhou , Han Guangsen , Zhuang Jing , Li Zhimeng , Wang Gangcheng , Li Baodong , Wang Jinbang , Gu Yanhui , Ma Pengfei , Zhang Junli , Cao Yanghui , Liu Chenyu , Li Sen , Zhang Xijie 
Published: May 2020

e16549 Background: Neoadjuvant chemotherapy for patients with locally advanced gastric and gastroesophageal junction adenocarcinoma (GC/GEJC) can improve the overall survival without increasing operation risk. Nowadays, immunotherapy has become a new promising neoadjuvant treatment. Therefore, we intended to evaluate the safety and efficacy of camrelizumab (anti-PD-1 antibody) combined with FOLFOX as the neoadjuvant therapy for patients with locally advanced GC/GEJC who received D2 radical gastrectomy. Methods: Patients who were diagnosed as resectable locally advanced GC/GEJC received the neoadjuvant treatment of camrelizumab and FOLFOX every 2 weeks for 4 cycles. Imaging evaluation was performed in 2-4 weeks after neoadjuvant therapy. Patients who had no progression disease (PD) were recruited. Eligible patients underwent gastrectomy with D2 lymph node dissection through laparotomy or laparoscopic surgery. The primary end points were safety and R0 resection rate. Results: From July 24 2019 to January 31 2020, 15 patients were recruited. The mean age was 57 years. A total of 10(67%) were males and 5(33%) were females. According to AJCC 8th, cT3 and cT4 were confirmed in 7(47%) patients and 8(53%) patients, N1 and N2 in 7(47%) patients and 8(53%) patients, respectively. During operation, intraperitoneal metastases were found in 2 patients. Of the 13 surgeries, only 2 were laparoscopic and the others were laparotomy. The surgical procedures included Roux-en-Y (9, 69.2%), Billroth II (1, 7.7%) and jejunum interposition (3, 23.1%). Thirteen patients underwent gastrectomy with D2 lymph node dissection and all of them were confirmed R0 resection by postoperative pathology results. The mean lymph node yield was 44.1±13.2 nodes, positive lymph node yield was 1.8±2.8 nodes. Duration time of surgery was 186.5±45.5 minutes, mean blood loss was 219.2±109 ml during the operation. Mean hospital stays were 13.2±2.4 days. Only 1 patient experienced grade 3 pneumonia. Neither serious intraoperative complications nor immune-related adverse events both prior and post operation were observed. There was no treatment-related death. Conclusions: Camrelizumab combined with FLOFOX as neoadjuvant treatment for patients with locally advanced GC/GEJC showed acceptable toxicity and promising efficacy with low complications and mortality. Clinical trial information: NCT03939962 .
Genomics of esophageal squamous cell carcinoma in African Americans.
Authors: Wadleigh Robert George , Akula Nirmala , Lazerow Susan , Marino Gustavo , Chauhan Suman , Paal Edina , Liu Min-Ling L , Lichy Jack , Erkizan Hayriye Verda 
Published: May 2020

e16552 Background: Esophageal cancer (EC) is one of the most lethal cancers with 90% mortality rate. Uneven Worldwide geographical distribution and varying etiologic factors contribute to the heterogenic nature of EC worldwide. In the US, 75% esophageal squamous cell carcinoma (ESCC) is diagnosed in African Americans (AA). However, despite comprehensive and multi-geographical efforts to understand the genomic basis of ESCC, the knowledge of molecular and genetic mechanisms leading to genomic subtyping of AA has been limited due to the underrepresentation of AAs in these studies. We hypothesized that the differences in mutational events in AA ESCC might, in part, cause the disparity in outcome and the mutational events may determine treatment options. Methods: Whole exome sequencing (WES) of matched- tumor and normal-cell DNA from late-stage ESCC of ten AA patients were performed by using Agilent SureSelect XT Human All Exon V6+UTR. Somatic variants per tumor samples called by two or more methods (Mutect2, VarScan2, and Strelka2) were combined and used for downstream population filtering. Somatic copy number changes were determined by using CNVKit in SevenBridges Genomics. Results: Somatic variants called by two or more algorithms filtered and sorted for rare mutations (equal to or less than 1% African originated population frequency) demonstrated an average of 23 nonsynonymous mutations per MB in high mutation rate AA ESCC. The remaining four samples had two or fewer nonsynonymous mutations per MB. TP53 was one of the most frequently mutated gene with 50% of mutation frequency. ARID2 mutated in 30%, EP300 in 20%, and RB1 in 10% of our cohort. Multiple amplified and deleted regions ranging from 94 to 46 were observed in seven samples in contrast to three samples that were silent in terms of copy number variations ranging from 29 to 9. Significant CNV were mostly seen in proliferation, cell cycle and checkpoint genes, squamous cell homeostasis, epithelial to mesenchymal transition, invasion and metastasis, receptor tyrosine kinase and signaling pathways, chromatin remodeling, detoxification, RNA/DNA editing and angiogenesis. Conclusions: WES of ten AA ESCC samples demonstrated a higher mutation rate in a group of patients with many passenger mutations and complex and recurrent copy number changes that affect oncogenic driver genes, which might suggest enhanced subtyping of ESCC in AA.
An analysis of clinicopathological characteristics and prognosis on hepatoid adenocarcinoma of stomach.
Authors: Shi Juan , Chen Yanping , Liu Lin , Su Xiangyu 
Published: May 2020

e16558 Background: Hepatoid adenocarcinoma of the stomach(HAS) is a rare type of gastric adenocarcinoma(GAC). At present, histopathology is the gold standard for the diagnosis of HAS, however, HAS is easy to be missed diagnosis, and lack of a perfect diagnosis system and effective treatment strategy. In this research, clinical pathological features will be analyzed to improve the diagnostic system, judge prognosis and provide clues for exploration of pathogenesis and targeted therapy of HAS. Methods: 576 cases including 5 confirmed patients with HAS were enrolled onto this study from 1320 patients with GAC. 10 cases of HAS were diagnosed by the second histopathological examination from the other 571 enrolled cases. 30 cases from the remaining 561 enrolled patients were randomly selected as the control group. The information of the two group cases were completed by collecting the existing case data, detecting the missed immunohistochemical indicators and telephone follow-up. The clinicopathological features of the two group cases were compared, and the treatment and prognosis of 15 HAS cases were analyzed. Results: In this study, 15 cases of HAS were found in 576 patients with GAC, including 5 cases from the 1st pathological diagnosis and 10 cases from the 2nd pathological diagnosis. There was no significant difference in age, gender, HP positive rate, serum CEA or CA19-9 level, tumor size, TNM stage, tumor invasion depth, lymph node invasion, distant metastasis rate, differentiation degree, nerve/vascular invasion, and Ki-67 expression level between the two groups( P> 0.05). Compared with the control group, the serum AFP level, and the expression level of GPC3, AFP, EGFR and VEGF protein of patients in HAS group were significantly high, as well as the patients in the HAS group were more likely to develop liver metastasis( P< 0.05). The mOS was 12 mo vs 42 mo for HAS group vs control group( P< 0.05). Multivariate analysis showed immunohistochemical AFP staining intensity was an independent risk factor for prognosis of HAS. Conclusions: As a special type of GAC, HAS is prone to developing liver metastasis with poor prognosis. Based on the higher missed diagnosis rate of HAS, it is suggested to make 2nd cancer histopathological diagnosis including immunohistochemical detection of AFP and GPC3 for GAC patients with significantly increased serum AFP level. The intensity of immunohistochemical AFP staining is an independent risk factor for the prognosis of patients with HAS. VEGF, EGFR and PD-1 / PDL-1 may be potential therapeutic targets of HAS, which is worth further study.
Clinical outcomes of patients with gastric cancer according to pre and post-neoadjuvant chemotherapy PD-L1 immunohistochemistry (IHC) expression.
Authors: Ribeiro Heber Salvador de Castro , Costa Wilson Luiz da , Begnami Maria Dirlei de Souza , Mello Celso Abdon Lopes , Neotti Tatiane , Diniz Alessandro Landskron , Godoy André Luis , Farias Igor Correa , Melo Torres Silvio , Vaz da Silva Diego Greatti Vaz , Jesus Victor Hugo Fonseca , Riechelmann Rachel Pimenta , Dias-Neto Emmanuel , Coimbra Felipe José Fernández 
Published: May 2020

e16569 Background: The incidence, prognostic and predictive impacts of PD-L1 expression in locally advanced gastric cancer is unknown. We aimed to determine the expression of PD-L1 by CPS in the pre-treatment biopsy and surgical specimens of patients (pts) with gastric cancer who received neoadjuvant therapy and its association with pathological response and survival outcomes. Methods: Retrospective cohort of pts treated at a cancer center from 2007 to 2017. Pts with confirmed gastric or GEJ adenocarcinoma who received neoadjuvant treatment and curative-intent D2 surgery were included. Gastric stump tumors and those who had a total esophagectomy were excluded. Clinical data were obtained from medical charts. Biopsy samples and a tissue microarray with the most representative areas of the surgical specimen were used to detect PD-L1 IHC expression with 22C3 phamDx antibody. Results were analyzed using the CPS score. Overall and DFS survival included the Kaplan-Meier product-limit estimator in an ITT analysis and a Cox regression was used to obtain crude and adjusted HR for prognostic factors. Results: 270 pts were included: median age was 58.9 years, most (51.5%) had cT3-T4N+ stages, 45% had diffuse histology and 87.8% completed the preoperative regimen. 13% had a pCR, while 53% had minimal tumor regression. With a median follow-up of 60.3 months (CI 95% 54.7 – 65.8), the median OS and DFS were not reached. 11.4% of biopsies and 18.6% of surgical specimens had positive CPS, with a median score of 3 (IQR 2,0 – 7,5) and 9 (IQR 5.0 – 20.0) respectively. In 18.9% of paired samples the PD-L1 expression was found to be negative in the biopsy sample and positive in the surgical specimen. PD-L1 expression was neither associated with pathologic response after neoadjuvant chemotherapy, nor with survival outcomes. Conclusions: PD-L1 expression on the setting of locally advanced gastric cancer was low and it was different when biopsy and surgical specimens were compared. No impact on survival results could be detected. [Table: see text]
Cardiotoxicity after chemoradiation for locally advanced esophageal cancer: Contributions of substructure and whole heart dose-volume parameters to risk prediction.
Authors: Cai Guoxin , Yu Jinming , Meng Xue 
Published: May 2020

e16576 Background: To investigate the predictive value of substructure and whole heart dosimetric parameters for cardiotoxicity and overall survival (OS) in patients with esophageal cancer receiving concurrent chemoradiation (cCRT). Methods: We retrospectively reviewed the records of 125 patients with stage Ⅲ middle and lower thoracic esophageal cancer treated with cCRT from 2011 to 2015. The primary endpoint was grade ≥ 2 cardiac events and the second endpoint was OS. Dose-volume histogram parameters for whole heart, left atrium (LA), left ventricle (LV), right atrium (RA), right ventricle (RV), right coronary artery (RCA), left anterior descending (LAD), left circumflex (LCX), and pericardium were extracted. Automated multivariable logistic regression model selection using the MATLAB-based Dose Response Explorer System was performed. Models were evaluated by Spearman correlation coefficient (Rs) and ROC area. Cox regressions analysis was performed to evaluate the association between covariates and OS. Results: Median follow-up was 32 months. The prescribed dose was 60 Gy. Forty patients (32.0%) developed 44 grade ≥ 2 cardiac events, at a median of 14.5 months to first event. The most frequently observed cardiac events were pericardial effusion or pericarditis (n = 13), arrhythmia (n = 12), acute coronary syndrome (ACS, n = 10), and congestive heart failure (CHF, n = 5). Variables included in the models most frequently selected by bootstrap were age, WHO/International Society of Hypertension (ISH) risk score and mean LA dose (Rs = 0.36, AUC = 0.796, p < 0.001) for all cardiac events; age, WHO/ISH risk score and pericardium volume receiving ≥ 20 Gy (Rs = 0.33, AUC = 0.771, p < 0.001) for pericardial events; age, mean LA dose and RA volume receiving ≥ 5 Gy (Rs = 0.31, AUC = 0.754, p < 0.001) for arrhythmic events; and WHO/ISH risk score, mean LA dose and LCX volume receiving ≥ 30 Gy (Rs = 0.37, AUC = 0.812, p < 0.001) for ACS/CHF events. On multivariable analysis, disease progression, Eastern Cooperative Oncology Group (ECOG) performance status, mean LA dose, and gross tumor volume were significant predictors of OS. Conclusions: Whether for whole cardiac, pericardial, arrhythmic or ischemic events, models including corresponding substructure dose outperformed those with whole heart dose in risk prediction. High cardiac substructure dose was associated with a worse OS.