The relationship between level of plasma D-dimer and survival time in metastatic gastric cancer patients

Objective:The principal purpose of this study was to determine the relationship between level of plasma D-dimer and survival time in metastatic gastric cancer patients.Methods:We retrospectively collected the data of plasma D-dimer in metastatic gastric cancer patients admitted in our Department (Department of Oncology,The Affiliated Changzheng Hospital,The Second Military Medical University,Shanghai,China) from October 2006 to October 2008 and analyzed the relationship between level of plasma D-dimer and survival time along with other clinicopathologic parameters.Results:A total of 82 patients were studied in our research,52 were males and 30 females,and the mean age was 57 years.The 48 cases had a normal plasma D-dimer level (<300μg/L) and 34 had a high plasma D-dimer level (≥300μg/L).In the normal and high plasma D-dimer level groups,the mean survival times were 10.9 (95% CI:9.8-12.2) months and 6.8(95% CI:4.4-7.6) months respectively,and the difference was statistically significant.Conclusion:Metastatic gastric cancer patients with high plasma D-dimer level had significantly shorter survival time than those with normal plasma D-dimer level.Level of plasma D-dimer can be referred as a potential predictor in metastatic gastric cancer patients.

Efficacy and safety of elemene combined with SOX in the treatment of advanced metastatic gastric cancer

Objective: To explore the therapeutic effect of elemene combined with S-1 / oxaliplatin (SOX) in the treatment of advanced metastatic gastric cancer, and to analyze and evaluate the safety of the chemotherapy, so as to provide new ideas for clinical treatment. Methods: 71 patients with advanced metastatic gastric cancer from April 2015 to April 2018 were randomly divided into two groups: the control group treated with SOX alone and the observation group treated with elemene combined SOX. The short-term and long-term therapeutic effects of the two groups were compared by the RECIST1.1 score and survival curve, and the differences of tumor markers, serological indicators and adverse reactions between the two groups were compared. Results: the objective remission rate (ORR) and clinical benefit rate (CBR) of the observation group were significantly higher than those of the control group (χ2=5.161, P=0.031;χ2=5.124, P=0.037);after treatment, the serum CEA, CA-199, IGF-1, MMP-9, IL-2 and IFN-γ levels of the observation group were significantly improved compared with those of the control group (P<0.05);compared with the two groups, the incidence of leucopenia, anemia, asthenia, nausea and vomiting in the observation group were significantly lower than that in the control group (P<0.05);the median tumor progression time (7.1 months, 95%CI=4.037-10.248) and median total survival time (8.8 months, 95%CI=6.634-10.907) in the observation group were significantly higher than that in the control group (4.9 months, 95%CI=2.324-6.839) and median total survival time (6.5 months, 95%CI=5.007-7.638), and the difference was statistically significant (P=0.001, P=0.026). Conclusion: elemene combined with SOX has a high short-term and long-term efficacy in patients with advanced metastatic gastric cancer, and its side effects are less, and its safety is higher, which has a certain clinical significance.

Role of immunotherapy in gastric cancer with liver metastasis

Gastric cancer continues to be a significant issue for public health,marked by its widespread occurrence and high mortality rates,even as the incidence of the disease shows a declining trend.The liver is the primary site for metastatic spread,with the peritoneum,lungs,and bones also being common targets.With the advent of biologic treatments and the introduction of immunotherapy for patients with metastatic conditions,the options to treat metastatic gastric cancer have expanded.This diversified therapeutic approach is designed to enhance patient quality of life and prolong survival,showcasing the progress in treatment modalities for individuals with gastric cancer and liver metastases.

Case Report: A Long Survivor Patient with Stage IV Gastric Adenocarcinoma

Gastric cancer (GC) is the fifth most common malignancy of the world and third leading cause of cancer death. At diagnosis, 35% of GC patients have distant metastases and in these cases the survival rate is very poor with a median overall survival (OS) inferior to 1 year. We report a case of a 67-year-old woman with gastric carcinoma initially deemed limited stage on diagnosis (cT2N0M0), treated surgically with radical subtotal gastrectomy with Billroth II reconstruction. In the staging CT scan, the patient presented a liver image that was considered benign. Three months later, due to abdominal pain, the patient performed another CT scan and the diagnostic of a large single liver metastasis was made;retrospectively it was observed that the lesion was present at diagnosis and that it had increased. A biopsy was performed which confirmed the metastatic origin. In a multidisciplinary team, the lesion was considered unresectable. She was proposed for first line (1st L) palliative chemotherapy (ChT) with FOLFIRI, with partial response as best response. After 30 cycles of FOLFIRI, bone metastases were diagnosed. The patient was submitted to a cementoplasty of D11-12 and L1-2. Afterwards, she started 2nd L ChT with mFOLFOX6 and at the same time she started zoledronic acid every 28 days. The best response to mFOLFOX6 was stable disease. Since November 2018, the patient has been treated with zoledronic acid every 28 days alone and maintains stable disease without ChT.