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[Background]: Helicobacter pylori (H. pylori) uses various strategies that attenuate mucosal immunity to ensure its persistence in the stomach. We recently found evidence that H. pylori might modulate the natural killer group 2, member 2 (NKG2D) system. The NKG2D receptor and its ligands are a major activation system of natural killer and cytotoxic T cells, which are important for mucosal immunity and tumor immunosurveillance. The NKG2D system allows recognition and elimination of infected and transformed cells, however viruses and cancers often subvert its activation. Here we aimed to identify a potential evasion of the NKG2D system in H. pylori infection., [Methods]: We analyzed expression of NKG2D system genes in gastric tissues of H. pylori gastritis and gastric cancer patients, and performed cell-culture based infection experiments using H. pylori isogenic mutants and epithelial and NK cell lines., [Results]: In biopsies of H. pylori gastritis patients, NKG2D receptor expression was reduced while NKG2D ligands accumulated in the lamina propria, suggesting NKG2D evasion. In vitro, H. pylori induced the transcription and proteolytic shedding of NKG2D ligands in stomach epithelial cells, and these effects were associated with specific H. pylori virulence factors. The H. pylori-driven release of soluble NKG2D ligands reduced the immunogenic visibility of infected cells and attenuated the cytotoxic activity of effector immune cells, specifically the anti-tumor activity of NK cells., [Conclusion]: H. pylori manipulates the NKG2D system. This so far unrecognized strategy of immune evasion by H. pylori could potentially facilitate chronic bacterial persistence and might also promote stomach cancer development by allowing transformed cells to escape immune recognition and grow unimpeded to overt malignancy.

This study aims at providing an accurate and up-to-date quantification of the dose–response association between cigarette smoking and gastric cancer (GC) risk, overall and by subsite. We conducted a systematic review and meta-analysis of case–control and cohort studies on the association between cigarette smoking and GC risk published up to January 2023. We estimated pooled relative risks (RR) of GC and its subsites according to smoking status, intensity, duration, and time since quitting. Among 271 eligible articles, 205 original studies were included in this meta-analysis. Compared with never smokers, the pooled RR for GC was 1.53 (95% confidence interval; CI 1.44–1.62; n = 92) for current and 1.30 (95% CI 1.23–1.37; n = 82) for former smokers. The RR for current compared with never smokers was 2.08 (95% CI 1.66–2.61; n = 21) for gastric cardia and 1.48 (95% CI 1.33–1.66; n = 8) for distal stomach cancer. GC risk nonlinearly increased with smoking intensity up to 20 cigarettes/day (RR:1.69; 95% CI 1.55–1.84) and levelled thereafter. GC risk significantly increased linearly with increasing smoking duration (RR: 1.31; 95% CI 1.25–1.37 for 20 years) and significantly decreased linearly with increasing time since quitting (RR: 0.65; 95% CI 0.44–0.95 for 30 years since cessation). The present meta-analysis confirms that cigarette smoking is an independent risk factor for GC, particularly for gastric cardia. GC risk increases with a low number of cigarettes up to 20 cigarettes/day and increases in a dose-dependent manner with smoking duration.

Gastric cancer is a leading cause of cancer mortality and health disparities in Latinos. We evaluated gastric intratumoral heterogeneity using multiregional sequencing of >700 cancer genes in 115 tumor biopsies from 32 patients, 29 who were Latinos. Analyses focused on comparisons with The Cancer Genome Atlas (TCGA) and on mutation clonality, druggability, and signatures. We found that only approximately 30% of all mutations were clonal and that only 61% of the known TCGA gastric cancer drivers harbored clonal mutations. Multiple clonal mutations were found in new candidate gastric cancer drivers such as EYS, FAT4, PCDHA1, RAD50, EXO1, RECQL4, and FSIP2. The genomically stable (GS) molecular subtype, which has the worse prognosis, was identified in 48% of our Latino patients, a fraction that was >2.3-fold higher than in TCGA Asian and White patients. Only a third of all tumors harbored clonal pathogenic mutations in druggable genes, with most (93%) GS tumors lacking actionable clonal mutations. Mutation signature analyses revealed that, in microsatellite-stable (MSS) tumors, DNA repair mutations were common for both tumor initiation and progression, while tobacco, POLE, and inflammation signatures likely initiate carcinogenesis. MSS tumor progression was likely driven by aging- and aflatoxin-associated mutations, as these latter changes were usually nonclonal. In microsatellite-unstable tumors, nonclonal tobacco-associated mutations were common. Our study, therefore, contributed to advancing gastric cancer molecular diagnostics and suggests clonal status is important to understanding gastric tumorigenesis. Our findings of a higher frequency of a poor prognosis associated molecular subtype in Latinos and a possible new aflatoxin gastric cancer etiology also advance cancer disparities research.SignificanceOur study contributes to advancing our knowledge of gastric carcinogenesis, diagnostics, and cancer health disparities.

There has been no major change of practice in gastrointestinal oncology at the European Society for Medical Oncology (ESMO) symposium 2021, but confirmation that immunotherapy in combination with chemotherapy has become standard of care in several indications. The European Organisation for Research and Treatment of Cancer (EORTC) Gastrointestinal Track Cancer Group has selected important phase II and III trials presented during the symposium across all gastrointestinal cancers as well as early reports on new drugs or new combinations that may change practice in the future., SCOPUS: re.j, info:eu-repo/semantics/published

Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long-term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491 714 participants in the European Prospective Investigation into Cancer and Nutrition and the Melbourne Collaborative Cohort Study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for incident stomach cancer in relation to lifetime alcohol intake and group-based life course intake trajectories, adjusted for potential confounders including Helicobacter pylori infection. In all, 1225 incident stomach cancers (78% noncardia) were diagnosed over 7 094 637 person-years; 984 in 382 957 study participants with lifetime alcohol intake data (5 455 507 person-years). Although lifetime alcohol intake was not associated with overall stomach cancer risk, we observed a weak positive association with noncardia cancer (HR = 1.03, 95% CI: 1.00-1.06 per 10 g/d increment), with a HR of 1.50 (95% CI: 1.08-2.09) for ≥60 g/d compared to 0.1 to 4.9 g/d. A weak inverse association with cardia cancer (HR = 0.93, 95% CI: 0.87-1.00) was also observed. HRs of 1.48 (95% CI: 1.10-1.99) for noncardia and 0.51 (95% CI: 0.26-1.03) for cardia cancer were observed for a life course trajectory characterized by heavy decreasing intake compared to light stable intake (Phomogeneity = .02). These associations did not differ appreciably by smoking or H pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent noncardia stomach cancer. Heterogeneous associations observed for cardia and noncardia cancers may indicate etiologic differences.

Importance: The limited data on cancer phenotypes in men with germline BRCA1 and BRCA2 pathogenic variants (PVs) have hampered the development of evidence-based recommendations for early cancer detection and risk reduction in this population. Objective(s): To compare the cancer spectrum and frequencies between male BRCA1 and BRCA2 PV carriers. Design, Setting, and Participant(s): Retrospective cohort study of 6902 men, including 3651 BRCA1 and 3251 BRCA2 PV carriers, older than 18 years recruited from cancer genetics clinics from 1966 to 2017 by 53 study groups in 33 countries worldwide collaborating through the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA). Clinical data and pathologic characteristics were collected. Main Outcomes and Measures: BRCA1/2 status was the outcome in a logistic regression, and cancer diagnoses were the independent predictors. All odds ratios (ORs) were adjusted for age, country of origin, and calendar year of the first interview. Result(s): Among the 6902 men in the study (median [range] age, 51.6 [18-100] years), 1634 cancers were diagnosed in 1376 men (19.9%), the majority (922 of 1,376 [67%]) being BRCA2 PV carriers. Being affected by any cancer was associated with a higher probability of being a BRCA2, rather than a BRCA1, PV carrier (OR, 3.23; 95% CI, 2.81-3.70; P <.001), as well as developing 2 (OR, 7.97; 95% CI, 5.47-11.60; P <.001) and 3 (OR, 19.60; 95% CI, 4.64-82.89; P <.001) primary tumors. A higher frequency of breast (OR, 5.47; 95% CI, 4.06-7.37; P <.001) and prostate (OR, 1.39; 95% CI, 1.09-1.78; P =.008) cancers was associated with a higher probability of being a BRCA2 PV carrier. Among cancers other than breast and prostate, pancreatic cancer was associated with a higher probability (OR, 3.00; 95% CI, 1.55-5.81; P =.001) and colorectal cancer with a lower probability (OR, 0.47; 95% CI, 0.29-0.78; P =.003) of being a BRCA2 PV carrier. Conclusions and Relevance: Significant differences in the cancer spectrum w

DNA methylation in peripheral blood is a potential biomarker of gastric cancer risk which could be used for early detection. We conducted a prospective case-control study nested within the Melbourne Collaborative Cohort Study. Genomic DNA was prepared from blood samples collected a median of 12 years before diagnosis for cases (N = 168). Controls (N = 163) were matched to cases on sex, year of birth, country of birth, and blood sample type using incidence density sampling. Genome-wide DNA methylation was measured using the Infinium Human Methylation450K Beadchip. Global measures of DNA methylation were defined as the median methylation M value, calculated for each of 13CpGsubsets representing genomic function, mean methylation and location, and reliability of measurement. Conditional logistic regression was conducted to assess associations between these global measures of methylation and gastric cancer risk, adjusting for Helicobacter pylori and other potential confounders. We tested nonlinear associations using quintiles of the global measure distribution. A genome-wide association study of DNA methylation and gastric cancer risk was also conducted (N = 484,989 CpGs) using conditional logistic regression, adjusting for potential confounders. Differentially methylated regions (DMR) were investigated using the R package DMRcate. We found no evidence of associations with gastric cancer risk for individual CpGs or DMRs (P > 7.6 x 10-6). No evidence of association was observed with global measures of methylation (OR 1.07 per SD of overall median methylation; 95% confidence interval, 0.80-1.44; P = 0.65). We found no evidence that blood DNA methylation is prospectively associated with gastric cancer risk. Copyright © 2020 American Association for Cancer Research.

The study aims to provide an insight into the global research productivity in stomach cancer with an in-depth analysis of the growth & development of India and Iran. The study focuses on the authorship collaborative patterns among Indian and Iranian medical scientists as well. The study was conceived with the selection of terms on “Stomach cancer”. The terms- “Stomach Cancer, Stomach Neoplasm, Gastric Cancer, and Gastric Neoplasm” were selected from the Medical Subject Headings (MeSH) to retrieve the data from the Web of Science (WoS). The Boolean Operator “OR” was executed to retrieve the records. The data was retrieved from 1989-2017 and downloaded in the excel file after restricting the country to India and Iran. Later, Microsoft Excel and STATA software were used to analyze the data. Three important means- annual growth rate (AGR), relative growth rate (RGR), and Doubling Time (DT) have been used to trace the development of literature. Further, authorship patterns were analyzed using the authorship collaboration and collaborative coefficient methods. The findings of the study show that Japan has the highest contribution (16,616; 19.89%) followed by the USA (16,195; 19.38%) and China (15,683; 18.768%) respectively in the field of Stomach Cancer research. India stands at 15th position and Iran at 22thposition with 1104 (1.32%) and 718 (0.86%) publications respectively. The annual growth rate of India and Iran is slow in the onset as compared to the later years, which is a positive sign of the improvement in the research productivity. The collaborative patterns show that medical scientists prefer to work in collaboration.

Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long-term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491 714 participants in the European Prospective Investigation into Cancer and Nutrition and the Melbourne Collaborative Cohort Study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for incident stomach cancer in relation to lifetime alcohol intake and group-based life course intake trajectories, adjusted for potential confounders including Helicobacter pylori infection. In all, 1225 incident stomach cancers (78% noncardia) were diagnosed over 7 094 637 person-years; 984 in 382 957 study participants with lifetime alcohol intake data (5 455 507 person-years). Although lifetime alcohol intake was not associated with overall stomach cancer risk, we observed a weak positive association with noncardia cancer (HR = 1.03, 95% CI: 1.00-1.06 per 10 g/d increment), with a HR of 1.50 (95% CI: 1.08-2.09) for >= 60 g/d compared to 0.1 to 4.9 g/d. A weak inverse association with cardia cancer (HR = 0.93, 95% CI: 0.87-1.00) was also observed. HRs of 1.48 (95% CI: 1.10-1.99) for noncardia and 0.51 (95% CI: 0.26-1.03) for cardia cancer were observed for a life course trajectory characterized by heavy decreasing intake compared to light stable intake (P-homogeneity = .02). These associations did not differ appreciably by smoking or H pylori infection status. Limiting alcohol use during lifetime, particularly avoiding heavy use during early adulthood, might help prevent noncardia stomach cancer. Heterogeneous associations observed for cardia and noncardia cancers may indicate etiologic differences.

Purpose: Cancer survival is generally lower for rural compared with urban residents, but findings have been inconsistent. We aimed to assess inequalities in cancer survival by remoteness of residence in Victoria, Australia. Method(s): Incident cancer cases diagnosed in 2001-2015 with 30 cancer types (n = 331,302) were identified through the Victorian Cancer Registry and followed to the end of 2015 through death registries. Five-year net survival was estimated using the Pohar-Perme method and differences assessed by excess mortality rate ratios (EMRRs) using Poisson regression, adjusting for sex, age and year of diagnosis. EMRRs adjusted for socio-economic disadvantage were also estimated. Result(s): People living outside major cities had lower survival for 11 cancers: esophagus, stomach, colorectum, liver, gallbladder/biliary tract, pancreas, lung, connective/soft tissue, ovary, prostate, kidney. No differences in survival were found for cancers of uterus, small intestine and mesothelioma. After adjusting for socio-economic disadvantage, the observed differences in survival decreased for most cancers and disappeared for colorectal cancer, but they remained largely unchanged for cancers of esophagus, stomach, liver, pancreas, lung, connective/soft tissue, ovary and kidney. Conclusion(s): People with cancer residing outside major cities had lower survival from some cancers, which is partly due to the greater socio-economic disadvantage of rural residents.Copyright © 2020, Springer Nature Switzerland AG.

Background & aimsThere are racial and ethnic differences in the incidence of gastric adenocarcinoma worldwide and in the US. Based on a decision analysis, screening for noncardia gastric adenocarcinoma might be cost-effective for non-White individuals 50 years or older. However, a lack of precise, contemporary information on gastric adenocarcinoma incidence in specific anatomic sites for this age group has impeded prevention and early detection programs in the US. We aimed to estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals 50 years or older.MethodsWe analyzed California Cancer Registry data from 2011 through 2015 to estimate incidences of gastric adenocarcinoma in specific anatomic sites for non-Hispanic White (NHW), non-Hispanic Black, Hispanic, and the 7 largest Asian American populations. We calculated the differential incidence between non-White groups and NHW using incidence rate ratios and 95% confidence intervals (CIs).ResultsCompared with NHW subjects, all non-White groups had significantly higher incidences of noncardia gastric adenocarcinoma; the incidence was highest among Korean American men 50 years and older (70 cases per 100,000). Compared with NHW subjects 50 years and older, the risk of noncardia gastric adenocarcinoma was 1.8-fold (95% CI, 1.37-2.31) to 7.3-fold (95% CI, 5.73-9.19) higher in most non-White groups and 12.0-fold (95% CI, 9.96-14.6) to 14.5-fold (95% CI, 12.5-16.9) higher among Korean American men and women 50 years and older, respectively. Compared with NHW men 50 years and older, all non-White men, except Japanese and Korean American men, had a significantly lower risk of cardia gastric adenocarcinoma.ConclusionsWe identified several-fold differences in incidences of gastric adenocarcinoma in specific anatomic sites among racial and ethnic groups, with significant age and sex differences. These findings can be used to develop targeted risk reducti

Проведено інтелектуальний аналіз мюллер-матричних зображень плівок плазми крові людини на основі статистичного, кореляційного та спектрального підходів для здорової та хворої на рак шлунку людини. На цій основі встановлено інформативні параметри для ідентифікації раку шлунку в системі мюллер-матричного картографування плазми крові людини., Проведен интеллектуальный анализ мюллер-матричных изображений пленок плазмы крови человека на основе статистического, корреляционного и спектрального подходов для здорового и больного раком желудка человека. На этой основе установлены информативные параметры для идентификации рака желудка в системе мюллер матричного картографирования плазмы крови человека., The intellectual analysis of mueller-matrix images of blood plasma films of human on the basis of statistical, correlation and spectral approaches for healthy and patient with human stomach cancer is carried out. On this basis, informative parameters for the identification of stomach cancer in the system of the muiller-matrix mapping of human plasma are established.

To investigate the associations between dietary fatty acids and cholesterol consumption and stomach cancer (SC), we analyzed data from a population-based case-control study with a total of 1900 SC cases and 6532 controls. Dietary data and other risk or protective factors were collected by face-to-face interviews in Jiangsu Province, China, from 2003 to 2010. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple unconditional logistic regression models and an energy-adjusted method. The joint associations between dietary factors and known risk factors on SC were examined. We observed positive associations between dietary saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and total cholesterol and the development of SC, comparing the highest versus lowest quarters. Increased intakes of dietary SFAs (p-trend = 0.005; aOR, 1.11; 95% CI, 1.01-1.22 with a 7 g/day increase as a continuous variable) and total cholesterol (p-trend < 0.001; aOR, 1.13; 95% CI, 1.06-1.22 with a 250 mg/day increase as a continuous variable) were monotonically associated with elevated odds of developing SC. Our results indicate that dietary SFAs, MUFAs, and total cholesterol are associated with stomach cancer, which might provide a potential dietary intervention for stomach cancer prevention.

Background AK104 is a tetrameric PD-1/CTLA-4 bispecific antibody, based on the Akeso Tetrabody platform [1]. A number of studies have shown that combined PD-1 and CTLA-4 blockade is associated with a higher response rate in multiple tumor types. Toxicity associated with anti- CTLA-4 agents in particular is dose limiting, thereby limiting full potential for PD-1 and CTLA-4 combination therapy. AK104 introduces novel T cell targeting mechanisms of action that may provide an improved therapeutic index and a favorable toxicity profile compared to PD-1 and CTLA-4 combination therapy. Methods A multicenter, Phase I, open-label dose escalation and expansion study in solid tumors (NCT03261011) began in Oct 2017, evaluating the safety, efficacy and recommended phase 2 dose of AK104 administered IV every 2 weeks (q2w). For dose escalation, pts were enrolled at dose cohorts of 0.2, 0.5, 1.0, 2.0, 4.0, 6.0 and 10.0 mg/kg. Pharmacodynamic studies examined Ki67 expression on peripheral T-cells and receptor occupancy (RO). Results As of 8 July 2019, 40 pts, median age 66.5 years [31-85], have received AK104 at doses of 0.2 mg/kg (n = 1), 0.5 mg/kg (n = 3), 1.0 mg/kg (n = 6), 2.0 mg/kg (n = 3), 4.0 mg/kg (n = 3), 6.0 mg/kg (n = 21) and 10.0 mg/kg q2w (n = 3). Median number of doses was 4 (1- 26). Treatment-related adverse events (TRAEs) occurred in 62.5% of pts. G3 TRAEs occurred in 10% [4/40], there were no G4 TRAEs. TRAEs leading to treatment discontinuation occurred in 7.5% [3/40]). Most frequent TRAEs were rash (23%), infusion reaction (15%), fatigue (15%), nausea (13%), and pruritus (10%)(Figure 1). Of 21 evaluable pts treated at doses >= 2 mg/kg, ORR was 28.6% (6/21) and disease control rate (DCR) was 47.6% (10/21) (Figure 2). Six responders remain on treatment (Gastric cancer, TNBC, mesothelioma, and largecell neuroendocrine carcinoma each and 2 MSI-H CRC). Peripheral CD4+ T-cells demonstrated dose dependent increases in Ki-67 expression at D8. Conclusions AK104 can be given

Background: Endoscopic submucosal dissection (ESD) for early esophageal and stomach cancer is usually performed under general anesthesia. However, propofol sedation without endotracheal intubation has been suggested as a viable alternative. Objective: The objective of this study was to evaluate the safety of propofol sedation without endotracheal intubation during ESD in the upper gastrointestinal tract. Methods: We performed a retrospective cohort study of patients who underwent ESD for upper gastrointestinal tumors with propofol-remifentanil analgosedation in a tertiary referral center in the Netherlands between O

The standard treatment of patients with stomach or gullet cancer is chemotherapy alone or followed by surgery. However, despite all the discoveries that have been made in the last decade, there is currently no test available in the clinic to find out what approach is best for an individual patient. Our research tried to fill this knowledge gap. We found out that the presence of immune cells within the tumour can indicate whether a patient will benefit from chemotherapy after surgery. Furthermore, we discovered that the distribution of the tumour cells e.g. whether they are evenly distributed in the tissue or not, can predict whether chemotherapy will work or not. We think that these markers will significantly improve patient treatment decisions in the near future.

In Ecuador, the risk of developing cancer before age 75 is 20%. In 2012, 2,401 people with stomach cancer were diagnosed nationwide. That year, this neoplasm ranked second in men, second only to prostate cancer and third in women, surpassed only by breast and cervical cancers. With this background and before the need to propose new strategies to promote comprehensive health, it was decided to carry out a bibliographical essay, in order to disseminate the importance of educational work and the participation of the student sector, in activities aimed at preventing gastric cancer. It was learned that this disease is susceptible to comprehensive educational actions, starting from early ages and developing them from all levels of education, to encourage the participation of the student sector in its prevention through actions that promote healthy lifestyles and with the decrease or control of specific risk factors. In order to achieve control of this neoplasm at a national level and thereby reduce the costs generated by comprehensive care for sick people, it is necessary to promote compliance with policies for tobacco control and abusive alcohol consumption, adopt healthier diets, systematically practice physical exercises, improve protection against environmental carcinogens, increase screening for early detection, as well as to encourage early diagnosis and appropriate treatments., En el Ecuador, el riesgo de desarrollar cáncer antes de los 75 años es del 20% . En el año 2012, se diagnosticaron a nivel nacional 2,401 personas con cáncer de estómago. Ese año esta neoplasia ocupó el segundo lugar en hombres, solo superado por el cáncer de próstata y el tercer lugar en la mujer, solo superado por los cánceres de mama y de cuello uterino. Con estos antecedentes y ante la necesidad de proponer nuevas estrategias para promocionar la salud integral, se decidió realizar un ensayo bibliográfico, con el fin de divulgar la importancia de la labor educativa y la participación del sector estudiantil en las actividades dirigidas a la prevención del cáncer de gástrico. Se pudo conocer que esta enfermedad es susceptible de acciones educativas integrales, partiendo desde edades tempranas y desarrollándolas desde todos los niveles de enseñanza, para favorecer la participación del sector estudiantil en su prevención, mediante acciones que promocionen estilos de vida saludables y la disminución o control de factores de riesgos específicos. Para poder alcanzar el control de esta neoplasia a nivel nacional y con ello disminuir los costos generados por la atención integral a las personas enfermas, se hace necesario fomentar el cumplimiento de las políticas para el control del tabaco y el consumo abusivo de alcohol, adoptar dietas más saludables, practicar sistemáticamente ejercicios físicos, mejorar la protección frente a carcinógenos medioambientales, aumentar el tamizaje para la detección temprana, así como propiciar su diagnóstico temprano y los tratamientos adecuados.

Objective: To determine the perceived burden and functional status of gastric cancer patients with gastrectomy in a center of cancer in Bogota (Colombia) between 2013 and 2016. Materials and methods: Retrospective description of patients intervened by gastrectomy distributed in three groups: Patients with gastrectomy from 1 to 12 months of surgical intervention, 13 to 14 months and 25 to 36 months. For this, it was used the disease burden perception instrument and the Karnofsky scale. Results: 127 patients were included. 63 from 1 to 12 months, 43 from 13 to 24 months, and 21 from 25 to 36 months of intervention. Gastric adenocarcinoma of intestinal pattern stage III and II predominate. More than 50 % of the patients required total gastrectomy and received adjuvant chemotherapy. The majority of par-ticipants performed regular activities with mild signs and symptoms, presented low overall perceived burden and functional performance without statistically significant differences between groups. Patients from 1 to 12 months of intervention reported greater levels of physi-cal discomfort. Conclusions: In patients with gastrectomy for gastric cancer, physical symptoms persist such as emotional disturbances, economic difficulties and limitations in the work role, findings to be included in follow-up programs., Objetivo: Avaliar o seguimento de pacientes gastrectomizados emum centro de referêncianacidade de Bogotá entre 2013 e 2016, determinando o status funcional e a percepção da carga da doença. Material e métodos: Descriçãoretrospropectiva dos pacientes inter-vencionados por gastrectomiadistribuídosemtrês grupos, que têm entre 1 a 12 meses de intervençãocirúrgica, 13 a 14 meses e 25 a 36 meses. Utilizamos o instrumento de percepção da carga de doençascrônicas, desenhado, avaliado e a escala de Karnofsky. Resultados: 127 pacientes foramacompanhados por gastrectomia por câncer gástrico; 63 emum ano, 43 em 2 anos e 21em 36 meses. Do ponto de vista histopatológico, predomina o adenocarcinoma gástrico intestinal. Mais de 50% necessitaram de gastrectomia total, além de quimioterapia adjuvante e corresponderamaosestágios II e III. A maioria dos pacientes commonitorizaçãoactividade normal realizada sinais e sinto-mas leves comumabaixa carga global percebida e um estado funcional, semdiferenças significativas entre os grupos namonitorização de doentesacompanhados durante 1 a 12 meses relatados maisdesconforto físico. Conclusões: Nos pacientes gastrectomizados por câncer gástrico, a percepção de sobrecarga da doença é baixa. Alguns sintomas físicos persistem, disturbios emocionais e dificuldades econô-micas, bem como limitação no papel do trabalho, achados a serem considerados no desenvolvimento de programas de acompanhamento., Objetivo: evaluar el seguimiento de pacientes gastrectomizados por cáncer gástrico en un centro de oncología en Bogotá, entre 2013 y 2016, y determinar el estado funcional y la percepción de la carga de enfermedad. Material y métodos: descripción retrospectiva de pacientes intervenidos por gastrectomía, distribuidos en tres grupos: de 1 a 12 meses de seguimiento luego de la intervención, de 13 a 14 meses, y de 25 a 36 meses. Se utilizó un instrumento de percepción de carga de enfermedad crónica validado y la escala de Karnofsky. Resultados: se incluyeron 127 pacientes: 63 a un año, 43 a 2 años y 21 a 3 años. Predomina el adenocarcinoma gástrico de patrón intes-tinal. Más del 50% requirió gastrectomía total, más quimioterapia adyuvante, y estaba en estadios II y III. La mayoría realiza actividad normal con signos y síntomas leves, con una carga de enfermedad percibida global baja y un estado funcional sin diferencias significati-vas entre los grupos. Los pacientes con seguimiento de 1 a 12 meses reportaron un mayor malestar físico. Conclusiones: en pacientes gastrectomizados por cáncer gástrico, persisten síntomas físicos, alteraciones emocionales, dificultades económicas y limitación en el rol laboral, hallazgos por ser incluidos en los programas de seguimiento.

Introduction: Gastric cancer (GC) is one of the deadliest diseases as most of the cases are diagnosed at late stages, thereby making treatment almost impossible. GC incidence in North America has been reported to be decreasing over the years. Nevertheless, the primary concern is whether the decrease is valid for all communities? Purpose and Objectives: The purpose of this study is to identify high-risk GC hotspots in Manitoba and investigate factors associated with GC in Manitoba. The objectives were to (1) describe and investigate the geographical variation of GC incidence in Manitoba; (2) explore factors influencing the geographic change of GC incidence in Manitoba, and (3) investigate the geographical variation of GC incidence over time in Manitoba. Methods: This research study adopted an ecological design. A spatial Poisson regression model was used to address research objectives (1) and (2), and a Spatio-temporal Poisson regression model was used to address research objective 3. Results: SESI was significantly associated with cardia gastric cancer (CGC) and marginally associated with non-cardia gastric cancer (NCGC), while the Indigenous population proportion was marginally associated with CGC. In specific, 1 unit increase in SESI reduces the risk of CGC by 14% (IRR= 0.859; 95% CI: 0.780 - 0.947) and the risk of NCGC by approximately 10% (IRR = 0.898; 95% CI: 0.812 – 0.995); 1% increase in regional Indigenous population proportion reduces the risk of CGC by 1.4% (IRR = 0.986; 95% CI: 0.978 – 0.994). Also, 1 unit increase in SESI reduces the risk of CGC among women by 26.2% (IRR = 0.738; 95% CI: 0.618 – 0.879), and a 1% increase in Indigenous population proportion reduces the risk of CGC among women by 1.9% (IRR = 0.981; 95% CI: 0.966 – 0.996). Conclusion: This study has demonstrated the existence of regional variation of GC incidence risk with temporal pattern in Manitoba.

Introduction: ATAD2 protein is an emerging oncogene that has strongly been linked to the etiology of multiple advanced human cancers. Therapeutically, despite the fact that genetic suppression/knockdown studies have validated it as a compelling drug target for future therapeutic development, recent druggability assessment data suggest that direct targeting of ATAD2’s bromodomain (BRD) may be a very challenging task. ATAD2’s BRD has been predicted as a ‘difficult to drug’ or ‘least druggable’ target due to the concern that its binding pocket, and the areas around it, seem to be unfeasible for ligand binding. Areas covered: In this review, after shedding light on the multifaceted roles of ATAD2 in normal physiology as well as in cancer-etiology, we discuss technical challenges rendered by ATAD2’s BRD active site and the recent drug discovery efforts to find small molecule inhibitors against it. Expert opinion: The identification of a novel low-nanomolar semi-permeable chemical probe against ATAD2’s BRD by recent drug discovery campaign has demonstrated it to be a pharmacologically tractable target. Nevertheless, the development of high quality bioavailable inhibitors against ATAD2 is still a pending task. Moreover, ATAD2 may also potentially be utilized as a promising target for future development of RNAi-based therapy to treat cancers., Export Date: 13 February 2018; Review; CODEN: EOTTA; Correspondence Address: Zhang, J.; Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, 190 Kaiyuan Avenue, Science Park, China; email: zhang_jiancun@gibh.ac.cn. QC 20180228

Background: Cancers of the upper gastrointestinal tract commonly result in malnutrition, which increases morbidity and mortality. Current nutrition best practice lacks a mechanism to provide early and intensive nutrition support to these patients. A 3-arm parallel randomised controlled trial is testing the provision of a tailored, nutritional counselling intervention delivered using a synchronous, telephone-based approach or an asynchronous, mobile application-based approach to address this problem. This protocol outlines the design and methods that will be used to undertake an evaluation of the implementation process, which is imperative for successful replication and dissemination. Method(s): A concurrent triangulation mixed methods comparative analysis will be undertaken. The nutrition intervention will be provided using best practice behaviour change techniques and communicated either via telephone or via mHealth. The implementation outcomes that will be measured are: fidelity to the nutrition intervention protocol and to the delivery approach; engagement; acceptability and contextual factors. Qualitative data from recorded telephone consultations and written messages will be analysed through a coding matrix against the behaviour change techniques outlined in the standard operating procedure, and also thematically to determine barriers and enablers. Negative binomial regression will be used to test for predictive relationships between intervention components with health-related quality of life and nutrition outcomes. Post-intervention interviews with participants and health professionals will be thematically analysed to determine the acceptability of delivery approaches. NVivo 11 Pro software will be used to code for thematic analysis. STATA version 15 will be used to perform quantitative analysis. Discussion(s): The findings of this process evaluation will provide evidence of the core active ingredients that enable the implementation of best practice nutrition

Резюме. За останні 5 років відзначено значне зниження (майже втричі) кількості хворих, які одержували променеву терапію раку шлунка. Цілковито не проводилось опромінення шлунка в неоад’ювантному та ад’ювантному режимах. Основними показаннями до терапії був рак кардіального відділу шлунка з порушенням прохідності, больовий синдром.Паліативний ефект терапії досягнуто у 60% випадків. Застосування променевої терапії раку шлунка гальмує відсутність сучасних плануючих систем. Виявлені групи хворих, яким доцільне проведення променевої терапії раку шлунка. Плануючи терапію, доцільно орієнтуватись на відомі дані з орієнтирами на кісткові утворення епігастральної ділянки.Мета роботи – оцінити ефективність та показання до променевої терапії раку шлунка за два періоди – 1997-2003 роки та 2016-2017 роки; виявити тенденції в показаннях до променевої терапії раку шлунка; обґрунтувати можливість розширення показань до променевої терапії на основі попереднього досвіду та теперішнього стану хірургічного лікування.Матеріали та методи. У процесі дослідження проведено ретроспективний аналіз історій захворювань пацієнтів із раком шлунка після комплексного та паліативного лікування.Результати. Проаналізовані результати променевої терапії раку шлунка у 1997-2003 роках у неоад’ювантному та ад’ювантному режимах, за результатами яких встановлено, що суттєвого продовження життя оперованих хворих не досягнуто. У 2015-2107 роках променева терапія виконувалась винятково з паліативною метою і у 60% хворих досягнуто покращення стану (зменшення больового синдрому та обструкції).Висновки. Променева терапія раку шлунка показана з паліативною метою. Існують можливості і показання до ад’ювантної променевої терапії раку шлунка., Резюме. За последние 5 лет отмечено значительное снижение (почти в три раза) количества больных, которые получали лучевую терапию рака желудка. Совершенно не проводилось облучение желудка в неоадювантном и адювантном режимах. Основными показаниями к терапии был рак кардиального отдела желудка с нарушениями проходимости, болевой синдром.Паллиативный эффект терапии достигнут в 60% случаев. Применение лучевой терапии рака желудка тормозит отсутствие современных планирующих систем. Выявлены группы больных, которым целесообразно проведение лучевой терапии рака желудка. При планировании терапии целесообразно использовать известные данные с ориентирами на костные образования эпигастральной области.Целью данной работы является оценка эффективности и показаний к лучевой терапии рака желудка в два пери ода – 1997-2003 годы и 2016-2017 годы. Выявление тенденций в показаниях к лучевой терапии рака желудка. Возможность расширения показаний к лучевой терапии на основании предыдущего опыта и нынешнего состояния хирургического лечения.Материалы и методы. В ходе исследования проведен ретроспективный анализ историй заболеваний пациентов с раком желудка после комплексного и паллиативного лечения.Результаты. Проанализированные результаты лучевой терапии рака желудка в 1997-2003 годах в неоадювантному и адювантному режимах, по результатам которых установлено, что существенного продолжения жизни оперируемых больных не достигнуто. В 2015-2107 годах лучевая терапия выполнялась исключительно с паллиативной целью и у 60% больных достигнуто улучшения состояния (уменьшение болевого синдрома и обструкции).Выводы. Лучевая терапия рака желудка показана с паллиативной целью. Существуют возможности и показания к адювантной лучевой терапии рака желудка., Significant decrease (almost thrice) of the quantity of patients, who received radiation therapy, was noted for the last 5 years. Radiation of the stomach was not absolutely performed in neoadjuvant and adjuvant regimes. The main indications to therapy were cancer of the cardiac portion of the stomach with patency disturbances and pain syndrome.Effect of palliative treatment was achieved in 60 % of cases. Absence of modern planning systems inhibitsadministration of the stomach cancer radiation therapy. Groups of patients with evident indications to radiation therapy of the gastric cancer were identified. When planning therapy it is advisable to use well-known data with the landmarks regionto bone formations in epigastric region.The purpose of this work is to estimate efficiency and indications to radiation therapy of the stomach cancer in two periods – 1997-2003 and 2016-2017 years; to detect tendencies in radiation therapy indications on the basis of the previous experience and present state of surgery.Material and methods. In the course of study a retrospective analysis of the patients’ case historiessuffering fromgastric cancer aftera complex treatment was conducted.Results.Having analyzed radiotherapy results of the gastric carcinoma during 1997-2003 years in neoadjuvant and adjuvant regimes, it has been established that a significant life extension of theoperated patients was not achieved. In2015-2107, radiotherapy was performed exceptionally for the purpose of palliative care, and improvement was achieved (reduction of pain syndrome and obstruction) in 60% pf patients.Conclusions. Radiotherapy of the stomach cancer is indicated with palliative purpose. There are possibilities and indications for adjuvant radiation therapy of the stomach cancer.

Introduction: In general, ulcers are more frequently observed in the duodenum than in the stomach. However, in areas with a high incidence of gastric cancer, peptic ulcers seem to have a different anatomical distribution, predominantly gastric localization.Objective: To perform a narrative literature review about the anatomical distribution of peptic ulcers in areas with high and low incidence of gastric cancer.Materials and methods: A structured literature search was performed in the ProQuest, EBSCO, ScienceDirect, PubMed, LILACS, Embase, Trip, SciELO and Cochrane Library databases using the terms “Peptic ulcer” AND “Stomach Neoplasm”. The search was done in English with its equivalents in Spanish and was limited to observational studies, cohorts and cases and controls.Results: About 50 articles with relevant information for this review were retrieved.Conclusion: The available literature suggests that peptic ulcers predominate in areas where gastric cancer has a high incidence, while duodenal localization predominates in areas where the incidence of neoplasms is low., Introducción. Por lo general, se ha descrito que la localización duodenal de la úlcera es más frecuente que la localización gástrica; sin embargo, en áreas con alta incidencia de cáncer gástrico la úlcera péptica parece tener una distribución anatómica distinta, existiendo predominio de la localización gástrica.Objetivo. Realizar una revisión narrativa de la literatura acerca de la distribución anatómica de la úlcera péptica en áreas con alta y baja incidencia de cáncer gástrico.Materiales y métodos. Se realizó una búsqueda estructurada de la literatura en las bases de datos ProQuest, EBSCO, ScienceDirect, PubMed, LILACS, Embase, Trip, SciELO y Cochrane Library con los términos “Peptic ulcer” AND “stomach neoplasm”; la búsqueda se hizo en inglés con sus equivalentes en español y se limitó a estudios observacionales, cohortes y casos y controles.Resultados. Se encontraron alrededor de 50 artículos con información relevante para la presente revisión.Conclusión. La literatura disponible sugiere que la úlcera péptica predomina en áreas donde el cáncer gástrico tiene alta incidencia, mientras que en zonas donde la incidencia de la neoplasia es baja predomina la localización duodenal.

Background: ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific type of cancer. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. Oesophageal and gastric: essential requirements for quality care: • Oesophageal and gastric (OG) cancers are a challenging tumour group with a poor prognosis and wide variation in outcomes among European countries. Increasing numbers of older people are contracting the diseases, and treatments and care pathways are becoming more complex in both curative and palliative settings.• High-quality care can only be a carried out in specialised OG cancer units or centres which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Such units or centres are far from universal in all European countries.• It is essential that, to meet European aspirations for comprehensive cancer control, healthcare organisations implement the essential requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship. Conclusion: Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality OG cancer service. The ERQCC expert group is aware that it is not possible to propose a ‘one size fits all’ system for all countries, but urges that access to multidisciplinary units or centres must be guaranteed for all those w

BACKGROUND & AIMS: Gastrointestinal (GI) bleeding in patients receiving anticoagulation agents can be caused by occult malignancies. We investigated the proportions and features of major GI bleeding (MGIB) events related to occult GI cancers in patients receiving anticoagulation therapy. METHODS: We analyzed data from the Randomized Evaluation of Long Term Anticoagulant Therapy study (conducted between December 2005 and March 2009 in 951 clinical centers in 44 countries worldwide), which compared the abilities of dabigatran vs warfarin to prevent stroke and systemic embolism in 18,113 patients with atrial fibrillation. Two blinded gastroenterologists independently reviewed source documents of MGIB events (n = 595) that occurred during the study period. We collected data on MGIB events caused by previously unidentified GI malignancies, and compared characteristics of MGIB events in patients who received dabigatran vs warfarin (primary end point), and in patients with bleeding from cancer, vs patients bleeding from a nonmalignant or unidentified source. RESULTS: Of 546 unique MGIB events, 44 (8.1%) were found to be from GI cancers (34 of 398 MGIB events in dabigatran users and 10 of 148 MGIB events in warfarin users; P = .60). Colorectal cancer accounted for 35 of 44 of all cancers identified. There were more colorectal cancer-associated MGIB events in the dabigatran group (30 of 34) than in the warfarin group (5 of 10) (P = .02), but more gastric cancer-associated MGIB events in the warfarin group (5 of 10) than in the dabigatran group (1 of 34) (P = .001). There were no differences in the short-term outcomes of cancer-related MGIB events in the dabigatran vs the warfarin group, but 75% of all cancer-related MGIB events required at least 1 blood transfusion and the mean hospital stay was 10.1 days. Compared with MGIB events from a nonmalignant or unidentified source, MGIB from cancer occurred sooner (343.0 vs 223.1 d; P = .003), but the bleeding was more likely t

Cancer is a major public health burden both globally and in China. The most common cancer-related deaths in China are attributable to cancers of the lung, liver, stomach, and esophagus. Previous epidemiologic studies on cancer in China have often been limited by small sample sizes, inconsistent measurements, and lack of precise and accurate data. The Jiangsu Four Cancers (JFC) Study is a population-based case-control study carried out in an effort to obtain consistent and high-quality data to investigate the life style, behavioral, environmental, and genetic factors associated with the four major cancers in China. The aim of this paper is to describe the overall design of the JFC Study and report selected findings on the major risk factors for cancers. Epidemiologic data were collected from 2003 to 2010 through in-person interviews using a structured questionnaire and blood samples were drawn. Unconditional logistic regression was used to estimate the associations of putative risk factors with risks of cancers of the lung, liver, stomach, and esophagus. The study included 2871 lung cancer cases, 2018 liver cancer cases, 2969 esophageal cancer cases, 2216 stomach cancer cases, and 8019 community controls. Low educational level, low income level, tobacco smoking, alcohol drinking, and family history of cancer were confirmed as risk factors for these major cancers. The JFC Study is one of the largest case-control studies of cancers in the Chinese population and will serve as a rich resource for future research on the four major cancers in China.

Objective: to determine the inequalities in mortality due to specific causes related to socioeconomic characteristics in the municipalities of the Huila department, Colombia between 2009 and 2013. Methodology: an ecological study comparing mortality rates due to acute respiratory infection, stomach cancer, hypertensive and cerebrovascular disease, traffic accidents, homicide, diabetes and childhood mortality based on socioeconomic status according to the following socioeconomic variables: secondary education coverage, unsatisfied basic needs, rurality, economic sufficiency, municipality’s added value and water quality index. The study included the 37 municipalities of the Huila department. Age-adjusted rates were calculated using the direct method and the inequalities were measured by comparing against the described variables using rank, regression and disproportionality based measures. The Epidat 4.0 software was used for this purpose. Results: child mortality and mortality due to gastric cancer and hypertensive disease showed constant inequality regarding the assessed socioeconomic variables in the less favored municipalities. As for mortality due to acute respiratory infections and homicides, higher rates were observed in municipalities with better socioeconomic conditions. Conclusions: there is great variability in the socioeconomic conditions of the municipalities and the mortality rates due to the assessed events. The authors observed an acceptable correlation between the different measures of inequality used in the study., Objetivo: determinar as desigualdades na mortalidade por causas específicas relacionadas a características socioeconômicas nos municípios de Huila entre os anos de 2009 e 2013. Metodologia: estudo ecológico que comparou as mortalidades por infecção respiratória aguda, câncer de estômago, doenças hipertensivas e acidentes vasculares cerebrais, acidentes de trânsito, homicídio, diabetes e mortalidade na infância com base na situação socioeconômica segundo as variáveis socioeconômicas cobertura do ensino médio, NBI, Ruralidade, Suficiência Econômica; Valor Agregado Municipal e o Índice de Qualidade da Água nos 37 municípios de Huila. Foram calculadas as taxas ajustadas por idade com o método direto e a medição de desigualdades, confrontando-as com as variáveis descritas, a partir da utilização de medidas baseadas no intervalo, em regressão e em desproporcionalidade, utilizando-se o software Epidat 4.0. Resultados: na mortalidade por câncer gástrico, por doenças hipertensivas e na mortalidade na infância foram identificadas constantes desigualdades em relação às variáveis socioeconômicas avaliadas contrárias aos municípios menos favorecidos. Para a mortalidade por infecções respiratórias agudas e homicídios, foram observadas maiores taxas nos municípios com melhores condições socioeconômicas. Conclusões: existe uma grande variedade entre as condições socioeconômicas dos municípios e entre as mortalidades para os eventos avaliados, observando-se uma correlação aceitável entre as diferentes medidas de desigualdade utilizadas., Introducción: Las condiciones en que la gente nace, vive, trabaja y envejece se relacionan con la situación de salud. La cuantificación de diferencias en estas condiciones confrontadas con variables sanitarias es medición de desigualdades.Objetivo: Determinar las desigualdades en la mortalidad por causas específicas relacionadas con características socioeconómicas en municipios del Huila 2009-2013.Materiales y métodos: Estudio ecológico que comparó las mortalidades por infección respiratoria aguda, cáncer de estómago, enfermedades hipertensivas y cerebrovasculares, accidentes de tránsito, homicidio, diabetes y mortalidad en niñez con base en su situación socioeconómica según las variables socioeconómicas cobertura de educación media, NBI, Ruralidad, Suficiencia Económica; Valor Agregado Municipal y el Índice de Calidad del Agua en los 37 municipios del Huila. Se calcularon tasas ajustadas por edad con el método directo y medición de desigualdades confrontando las variables descritas, usando medidas basadas en rango, en regresión y en desproporcionalidad, usando el software Epidat 4.0. Resultados: En la mortalidad por cáncer gástrico, por enfermedades hipertensivas y la mortalidad en niñez se identificó constante desigualdad frente a las variables socioeconómicas evaluadas en contra de los municipios menos favorecidos. En la mortalidad por infecciones respiratorias agudas y homicidios se observaron mayores tasas en los municipios con mejores condiciones socioeconómicas. Conclusiones: Existe gran variabilidad entre los condiciones socioeconómicas de los municipios y entre las mortalidades por los eventos evaluados, observando aceptable correlación entre las diferentes medidas de desigualdades utilizadas.

Introduction: Upper gastrointestinal cancer patients are a unique population as their illness predisposes them to multiple nutritional co-morbidities. Specific nutritional interventions are often not sought until severe malnutrition is evident thus limiting the patient's response to therapy, diminishing their Quality of Life (QOL) and overall survival. Objective(s): This pilot study compared early and intensive nutrition intervention (INI) to standard nutrition care (SNC) for improving health outcomes amongst patients with primary oesophageal or stomach cancer. Method(s): Patients were randomised to either INI or SNC. INI commenced within 1 week of diagnosis, continued weekly for 18 weeks and was delivered via telephone or face-to-face. SNC involved no dietetic intervention until admission for treatment. Outcome measures were collected at baseline, during the intervention period and at week 26. The primary outcome was Health-Related Quality of Life (HR-QOL) using the global EQ-5D, and the cancer specific EORTC QLQ-C30 tools. Nutritional status a secondary outcome was evaluated using the Patient Generated-Subjective Global Assessment (PG-SGA). Result(s): At baseline the prevalence of malnutrition was similar between groups (90 %). Five deaths occurred in the SNC group and one in the INI group (p=0.06). At week 26, HR-QOL scores (baseline-adjusted) were higher in the INI group (n=10) compared with SNC group (n=11) (EQ-5D p<0.001;EORTC QLQ-C30p<0.001). Overall the INI group had greater weight gain (regression coefficient 6.46, 95 % CI 3.01, 9.92, p<0.001) and lower nutritional risk (PG-SGA score -10, -12.8, -7.2, p<0.001), compared with SNC. Conclusion(s): This study demonstrates the potential of a novel nutrition care model in benefiting health outcomes in newly diagnosed upper gastrointestinal cancer patients.

в данной работе проведена оценка распространенности рака желудка в Приморском крае. В качестве математического инструмента обработки базы данных использован информационно-энтропийный анализ. Авторами установлено, что уровень распространения заболеваемости рака желудка в Приморском крае имеет экологическую и социальную обусловленность с некоторым преимуществом техногенного воздействия, в особенности общего загрязнения среды и снижением качества жизни населения., The estimation of the prevalence of gastric cancer in the Primorsky Territory. As a mathematical tool used by database processing information and entropy analysis. It was found that the incidence of gastric cancer incidence in the Primorye Territory has environmental and social conditioning, with some advantage anthropogenic impacts, especially pollution of the environment and the general decline in the quality of life of the population.

We previously reported real-time monitoring of cell cycle dynamics of cancer cells throughout a live tumor intravitally using a fluorescence ubiquitination cell cycle indicator (FUCCI). Approximately 90% of cancer cells in the center and 80% of total cells of an established tumor are in G0/G1 phase. Longitudinal real-time FUCCI imaging demonstrated that cytotoxic agents killed only proliferating cancer cells at the surface and, in contrast, and had little effect on the quiescent cancer cells. Resistant quiescent cancer cells restarted cycling after the cessation of chemotherapy. Thus cytotoxic chemotherapy which targets cells in S/G2/M, is mostly ineffective on solid tumors, but causes toxic side effects on tissues with high fractions of cycling cells, such as hair follicles, bone marrow and the intestinal lining. We have termed this phenomenon tumor intrinsic chemoresistance (TIC). We previously demonstrated that tumor-targeting Salmonella typhimurium A1-R (S. typhimurium A1-R) decoyed quiescent cancer cells in tumors to cycle from G0/G1 to S/G2/M demonstrated by FUCCI imaging. We have also previously shown that when cancer cells were treated with recombinant methioninase (rMETase), the cancer cells were selectively trapped in S/G2, shown by cell sorting as well as by FUCCI. In the present study, we show that sequential treatment of FUCCI-expressing stomach cancer MKN45 in vivo with S. typhimurium A1-R to decoy quiescent cancer cells to cycle, with subsequent rMETase to selectively trap the decoyed cancer cells in S/G2 phase, followed by cisplatinum (CDDP) or paclitaxel (PTX) chemotherapy to kill the decoyed and trapped cancer cells completely prevented or regressed tumor growth. These results demonstrate the effectiveness of the praradigm of "decoy, trap and shoot" chemotherapy.

Gastric cancer (GC) is the second most lethal cancer world-wide, and represents a growing number of cancers, including those of the colon, lung, liver and prostate, that are associated with inflammation. Although the molecular mechanisms underlying the pathogenesis of these cancers remain unclear, a causal correlation has been established between inflammation triggered by microbes and gastro-intestinal cancers, as evidenced by the strong link between Helicobacter pylori infection and the development of chronic gastritis and GC. Notably, a significant number (20-25%) of human GC cases also develop in the absence of H. pylori, albeit by poorly understood mechanisms. Deregulated activation of cytokine signaling pathways, especially the latent transcription factor signal transducer and activator of transcription (STAT) 3, is implicated in various inflammation-associated cancers, including up to 50% of human GCs. However, the downstream molecular consequences of aberrant STAT3 activation in promoting carcinogenesis remain to be fully elucidated. To provide novel molecular insights into such pathological mechanisms in vivo, we have reported that a mouse strain (gp130F/F) carrying a specific "knock-in" mutation in the interleukin-6 cytokine family co-receptor gp130, which abolishes negative regulation of gp130-dependent signalling, spontaneously develops chronic gastritis and gastric tumors driven by IL-11-dependant STAT3 hyper-activation. Deregulated gp130-dependent STAT3 signaling in the gastric compartment causes increased expression of Toll-like receptor (TLR)2, a receptor responsible for recognising a diverse array of bacterial ligands and triggering inflammatory responses. Genetic targeting of TLR2 inhibited gastric tumorigenesis, but not inflammation, characterized by reduced cellular proliferation and survival in the gastric epithelium. Furthermore, bone marrow chimeras revealed that TLR2-expressing immune/inflammatory cells are dispensable for gastric tumorigenesi

Pre-cancerous inflammation is well established in the pathogenesis of gastric cancer, however the individual molecular pathways involved in this process are yet to be fully elucidated. Individually, both the potent pro-inflammatory cytokine IL-1beta and the oncogenic latent transcription factor STAT3 are known to play a role in the development of gastric cancer. Using a STAT3-driven preclinical mouse model for gastric tumourigenesis (gp130F/F), human gastric cancer specimens and in vitro techniques, we have established a link between STAT3-driven tumour burden and the inflammasome, the latter representing a multi-protein inflammatory complex that controls the production of mature, biologically-active forms of IL-1beta (and IL-18). The effector molecules of inflammasome activation, namely activated caspase-1, IL-1beta and IL-18 proteins, are upregulated in STAT3-driven gastric tumours. Genetic ablation of the inflammasome adaptor ASC reduced tumour burden by up to 50%, independent of inflammation and tumour cell proliferation. Rather, we have determined that the suppressed tumourigenesis is associated with increased tumour (epithelial) cell apoptosis in gp130[F/F] mice null for the Asc gene. Furthermore, using bone marrow chimeras we have shown that the reliance on ASC for gastric tumourigenesis is independent of bone marrowderived hematopoietic (immune) cells expressing ASC. Finally, in tumours from gp130[F/F] mice, as well as in human gastric tumour biopsies, the expression of specific inflammasome-activating pattern recognition receptors are elevated. Overall, our results uncover a role for the inflammasome in the development of gastric cancer.

The phase of the cell cycle can determine whether a cancer cell can respond to a given drug. We previously reported monitoring of real-time cell cycle dynamics of cancer cells throughout a live tumor, intravitally in live mice, using a fluorescence ubiquitination-based cell-cycle indicator (FUCCI). Approximately 90% of cancer cells in the center and 80% of total cells of an established tumor are in G0/G1 phase. Longitudinal real-time imaging demonstrated that cytotoxic agents killed only proliferating cancer cells at the surface and, in contrast, had little effect on quiescent cancer cells, which are the vast majority of an established tumor. Moreover, resistant quiescent cancer cells restarted cycling after cessation of chemotherapy. These results suggested why most drugs currently in clinical use, which target cancer cells in S/G2/M, are mostly ineffective on solid tumors. In the present report, we used FUCCI imaging and Gelfoam® collagen-sponge-gel histoculture, to demonstrate in real time, that the cell-cycle phase distribution of cancer cells in Gelfoam® and in vivo tumors is highly similar, whereby only the surface cells proliferate and interior cells are quiescent in G0/G1. This is in contrast to 2D culture where most cancer cells cycle. Similarly, the cancer cells responded similarly to toxic chemotherapy in Gelfoam® culture as in vivo, and very differently than cancer cells in 2D culture which were much more chemosensitive. Gelfoam® culture of FUCCI-expressing cancer cells offers the opportunity to image the cell cycle of cancer cells continuously and to screen for novel effective therapies to target quiescent cells, which are the majority in a tumor and which would have a strong probability to be effective in vivo.

Issue/problem Decision-making in hospitals is evolving from being opinionbased to being evidence-based. Whilst clinical guidelines provide evidence-based recommendations, evidence-based practice needs to address the local structure, systems and time-frames. Clinical pathways are document-based tools that provide a link between the best available evidence and clinical practice. Problem During a meeting with the professional from all ‘A. Gemelli’ teaching hospital units involved in the care of stomach cancer patients as well as primary care representatives, the Clinical Governance Unit presented the project of developing a clinical pathway for the care of stomach cancer patients. Professionals were divided in three groups: a first group analyzed the specific epidemiological context of stomach cancer patients attending the hospital, a second group designed on the basis of evidence and current practice the pathway flowchart in a diagram that shows on vertical axis stages of care and on orizonal axis the places of care and a third group selected quality indicators useful for future audits. After joint debates, the complete clinical pathway was reviewed by the whole group of involved professionals. Results A report including the pathway flowchart of activities articulated in clinical episodes and 28 indicators covering 5 quality dimensions was approved. Multidisciplinary team meetings as well as joint surgeon/medical oncologist examinations were introduced in hospital practice. Case management and cooperation between hospital and primary care were enhanced. The use of hospital resource and the timing between the different care stages as well as patients’ satisfaction resulted improved. Preliminary results show also improvements in clinical outcome measured. Lessons Clinical pathways are an effective instrument to decrease undesired practice variability and improve clinician performance. The early involvement of all professionals in the development of clinical pathways is

INTRODUCTION: The South American country Chile now boasts a life expectancy of over 80 years. As a consequence, Chile now faces the increasing social and economic burden of cancer and must implement political policy to deliver equitable cancer care. Hindering the development of a national cancer policy is the lack of comprehensive analysis of cancer infrastructure and economic impact. OBJECTIVES: Evaluate existing cancer policy, the extent of national investigation and the socio-economic impact of cancer to deliver guidelines for the framing of an equitable national cancer policy. METHODS: Burden, research and care-policy systems were assessed by triangulating objective system metrics -epidemiological, economic, etc. - with political and policy analysis. Analysis of the literature and governmental databases was performed. The oncology community was interviewed and surveyed. RESULTS: Chile utilizes 1% of its gross domestic product on cancer care and treatment. We estimate that the economic impact as measured in Disability Adjusted Life Years to be US$ 3.5 billion. Persistent inequalities still occur in cancer distribution and treatment. A high quality cancer research community is expanding, however, insufficient funding is directed towards disproportionally prevalent stomach, lung and gallbladder cancers. CONCLUSIONS: Chile has a rapidly ageing population wherein 40% smoke, 67% are overweight and 18% abuse alcohol, and thus the corresponding burden of cancer will have a negative impact on an affordable health care system. We conclude that the Chilean government must develop a national cancer strategy, which the authors outline herein and believe is essential to permit equitable cancer care for the country.

[Background & Aims]Helicobacter pylori infection is a risk factor for gastric cancer. To explore the genetic basis of gastric cancer that develops in inflamed gastric mucosa, we investigated genetic aberrations that latently accumulate in nontumorous gastric epithelium with H pylori infection. [Methods]We performed whole-exome sequencing of gastric tumors, noncancerous tissues with gastritis, and peripheral lymphocytes from 5 patients. We performed additional deep-sequencing analyses of selected tumor-related genes using 34 gastritis mucosal samples from patients with or without gastric cancer. We also performed deep sequencing analyses of gastric mucosal tissues from mice that express transgenic human TP53 and constitutively express activation-induced cytidine deaminase (AICDA or AID) (humanTP53 knock-in/AID-transgenic mice). [Results]Whole-exome sequencing revealed that somatic mutations accumulated in various genes in inflamed gastric tissues. Additional deep-sequencing analyses of tissues from regions of gastritis confirmed nonsynonymous low-abundance mutations in TP53 in 15 cases (44.1%) and ARID1A in 5 cases (14.7%). The mutations that accumulated in gastric mucosal tissues with H pylori–induced gastritis, as well as gastric tumors, were predominantly C:G>T:A transitions in GpCpX motifs—a marker of cytidine deamination induced by AID. Constitutive expression of AID in the gastric mucosa of mice led to mutations in the human TP53, at amino acid coding positions identical to those detected in human gastric cancers. [Conclusions]Studies of gastric tumors and tissues from humans and mice indicate that somatic mutations accumulate in various genes in gastric mucosal tissues with H pylori infection. Increased cytidine deaminase activity in these tissues appears to promote the accumulation of these mutations and might promote gastric carcinogenesis in patients with H pylori infection.

Goal: To noninvasively detect H. pylori infections in patients within one hour for under $10. Background:•H. pylori infects the Upper Gastrointestinal Tract and causes:•Peptic Ulcers•Stomach Cancer•Dyspepsia•Heartburn•Abdominal Pain•Early Satiety & Bloating•70% of Developing World’s Population•30-40% of Developed Nation’s PopulationAdvisor(s): Prof. Bruce Tromberg; Dr. Albert Cerussi;Dr. Thomas O’Sullivan; Beckman Laser Institute. UCI Dean's Choice Award

The evidence for an association between occupational asbestos exposure and esophageal, gastric and colorectal cancer is limited. We studied this association specifically addressing risk differences between relatively low and high exposure, risk associated with cancer subtypes, the influence of potential confounders and the interaction between asbestos and smoking in relation to cancer risk. Using the Netherlands Cohort Study (n = 58,279 men, aged 55-69 years at baseline), asbestos exposure was estimated by linkage to a job-exposure matrix. After 17.3 years of follow-up, 187 esophageal, 486 gastric and 1,724 colorectal cancer cases were available for analysis. The models adjusted for age and family history of cancer showed that mainly (prolonged) exposure to high levels of asbestos was statistically significantly associated with risk of esophageal adenocarcinoma (EAC), total and distal colon cancer and rectal cancer. For overall gastric cancer and gastric non-cardia adenocarcinoma (GNCA), also exposure to lower levels of asbestos was associated. Additional adjustment for lifestyle confounders, especially smoking status, yielded non-significant associations with overall gastric cancer and GNCA in the multivariable-adjusted model, except for the prolonged highly exposed subjects (tertile 3 vs. never: HR 2.67, 95% CI: 1.11-6.44 and HR 3.35, 95% CI: 1.33-8.44, respectively). No statistically significant additive or multiplicative interaction between asbestos and smoking was observed for any of the studied cancers. This prospective population-based study showed that (prolonged) high asbestos exposure was associated with overall gastric cancer, EAC, GNCA, total and distal colon cancer and rectal cancer. © 2014 UICC.

Objectives: The objective of the study was to conduct a within-cohort assessment of risk factors for incident AIDS-defining cancers (ADCs) and non-ADCs (NADCs) within the Australian HIV Observational Database (AHOD). Method(s): A total of 2181 AHOD registrants were linked to the National AIDS Registry/National HIV Database (NAR/NHD) and the Australian Cancer Registry to identify those with a notified cancer diagnosis. Included in the current analyses were cancers diagnosed after HIV infection. Risk factors for cancers were also assessed using logistic regression methods. Result(s): One hundred and thirty-nine cancer cases were diagnosed after HIV infection among 129 patients. More than half the diagnoses (n=68; 60%) were ADCs, of which 69% were Kaposi's sarcoma and 31% non-Hodgkin's lymphoma. Among the NADCs, the most common cancers were melanoma (n=10), lung cancer (n=6), Hodgkin's lymphoma (n=5) and anal cancer (n=5). Over a total of 21021 person-years (PY) of follow-up since HIV diagnosis, the overall crude cancer incidence rate for any cancer was 5.09/1000 PY. The overall rate of cancers decreased from 15.9/1000 PY [95% confidence interval (CI) 9.25-25.40/1000 PY] for CD4 counts <100 cells/muL to 2.4/1000 PY (95% CI 1.62-3.39/1000 PY) for CD4 counts >350 cells/muL. Lower CD4 cell count and prior AIDS diagnoses were significant predictors for both ADCs and NADCs. Conclusion(s): ADCs remain the predominant cancers in this population, although NADC rates have increased in the more recent time period. Immune deficiency is a risk factor for both ADCs and NADCs. © 2012 British HIV Association.

Despite evidence of nutritional deficiency, specific nutritional interventions are often not sought until severe malnutrition is evident in the upper gastrointestinal cancer population. This may limit patient response to therapy, and diminish their Quality of Life (QOL) and overall survival. This study evaluated the efficacy of early and intensive nutrition intervention (INI), compared to standard nutrition care (SNC) for improving health outcomes amongst patients with primary oesophageal or stomach cancer. Patients were randomised and stratified by diagnosis to receive early and intensive nutrition intervention or standard nutrition care. SNC involved no dietetic intervention until the patient was admitted for treatment. INI were consulted weekly for 18 weeks, which covered time of diagnosis and the patient's treatment journey, and then at week 26. Behaviour change techniques were categorised (Abraham & Michie's Taxonomy of Behaviour Change Techniques). Outcome measures were collected at several time points.The primary outcome measure was Health-Related Quality of Life (HR-QOL) using the global EQ-5D, and the cancer specific EORTC QLQ-C30. Scores were linearly transformed to obtain quantified scores. Nutritional status was the secondary outcome measure and evaluated using the PG-SGA. Dietetic interaction time and participants' perceptions of nutrition counselling were measured. The effect of the intervention on outcomes was examined using linear mixed model analysis. At baseline (diagnosis) the prevalence of malnutrition was similar between the groups (90%). Six deaths occurred, five in the SNC group and one in the INI group (p = 0.06). At week 26, HR-QOL scores were significantly higher in the INI group (n = 10) compared with SNC group (n = 11) (EQ-5D p < 0.001; EORTC QLQ-C30 p < 0.001). Weight on average was 6 kilograms greater (p < 0.001) and nutritional risk lower (PG-SGA score 10 points lower, p < 0.001) in the INI group compared to the SNC group. This study d

Background: In order to effectively target and provide individualised patient support strategies it is crucial to have a comprehensive picture of those presenting for services. The purpose of this study was to determine the characteristics and patient rated outcomes of individuals presenting to SolarisCare cancer support centres and their choices regarding complementary and integrated therapies (CIT).Methods: A cohort with a current or previous cancer diagnosis aged 18 - 87 years presenting to a SolarisCare centre during a 5-day period completed a questionnaire. Four SolarisCare centres participated in the trial including regional and metropolitan locations. Outcomes included medical and demographic characteristics, CIT variables and patient rated outcomes (PROs) including quality of life (QoL).Results: Of the 95 participants (70.3%) who completed the survey, the mean age was 60.5 years with 62% currently receiving treatment. Eighty percent of the sample had at least one other comorbid condition, with the most popular CIT being relaxation massage. Of the PROs, QoL was significantly lower than norms for the Australian population and other mixed cancer populations. No notable differences were seen between genders, however significantly poorer outcomes were found for the younger age group. Fifty percent of the population did not meet physical activity recommendations, and musculoskeletal symptoms explained between 25-27% of variance in QoL.Conclusions: A greater understanding of the health profiles of patients presenting to supportive care centres and their use of CIT, provides Western Australian health professionals with key information to ensure the safety of supportive care practices, as well as fosters optimal patient outcomes and enhances the integration of supportive care strategies within mainstream medical care.

Background: In the Bagnardi et al. (2001) meta-analysis, it was found that alcohol consumption increases the risk of stomach cancer (OR = 1.32 for heavy drinkers). However, it is unknown if drinking cessation reverses this alcohol-elevated risk. Methods: A systematic literature review was performed to provide the information for a meta-analysis where the dose-risk trend was estimated for years since drinking cessation and the risk of stomach cancer. A random effect generalised least squares model for trend estimation was used, employing study characteristics to control for heterogeneity. Results: Nineteen observational studies were identified in the literature review, of which five studies quantified duration of cessation and risk of stomach cancer, giving a total of 1947 cancer cases. No significant effect of drinking cessation on the risk of stomach cancer could be found (OR = 0.99 CI: 0.97-1.02). Conclusions: This result should be interpreted with caution due to the limited number of studies in this area. Recent findings suggest a link between heavy drinking and stomach cancer, especially gastric noncardia, but not for moderate drinking. Since all but one of the included studies in this meta-analysis failed to control for consumption level, the current study could not test if the risk decline following drinking cessation differs between moderate and high consumers.

A high intake of dietary antioxidant compounds has been hypothesized to be an appropriate strategy to reduce gastric cancer (GC) development. We investigated the effect of dietary total antioxidant capacity (TAC) in relation to GC in the European Prospective Investigation into Cancer (EPIC) study including 23 centers in 10 European countries. A total of 521,457 subjects (153,447 men) aged mostly 3570 years old, were recruited largely between 1992 and 1998. Ferric reducing antioxidant potential (FRAP) and total radical-trapping antioxidant parameter (TRAP), measuring reducing and chain-breaking antioxidant capacity were used to measure dietary TAC from plant foods. Dietary antioxidant intake is associated with a reduction in the risk of GC for both FRAP (adjusted HR 0.66; 95%CI (0.460.95) and TRAP (adjusted HR 0.61; 95%CI (0.430.87) (highest vs. lowest quintile). The association was observed for both cardia and noncardia cancers. A clear effect was observed in smokers with a significant reduction in GC risk for the fifth quintile of intake for both assays (highest vs. lowest quintile: adjusted HR 0.41; 95%CI (0.220.76) p for trend <0.001 for FRAP; adjusted HR 0.52; 95%CI (0.280.97) p for trend <0.001 for TRAP) but not in nonsmokers. In former smokers, the association with FRAP intake was statistically significant (highest vs. lowest quintile: adjusted HR 0.4; 95%CI (0.210.75) p < 0.05); no association was observed for TRAP. Dietary antioxidant capacity intake from different sources of plant foods is associated with a reduction in the risk of GC.

Introduction An aging Australian population means that clinicians who initiate long term treatment of chronic liver disease, including chronic hepatitis B, must account for an increasing number of comorbidities and altered pharmacokinetics as patients age. Limited safety and efficacy data exist regarding HBV nucleos(t)ide analogue therapy in patients >=50 years of age. We analysed safety and efficacy outcomes in this population from global entecavir (ETV) registration trials. Methods The analysis included 48 week data from the subset of nucleoside naive patients >=50 years of age in the phase III studies 022/027; patients received ETV 0.5 mg once daily. Endpoints including safety, efficacy and tolerability were assessed. Results 147 patients out of 679 in total were assessed. Baseline characteristicsmean age 58 years (range 51 to 76), 75% male, 69% Caucasian, 29% Asian, 69% HBeAg(-). Most (90%) had at least one comorbid illness; the most common were cardiovascular (22% hypertension), gastrointestinal, musculoskeletal and endocrine (20% diabetes). At 48 weeks 69% HBeAg(+) &94% HBeAg(-) had HBV DNA < 300 copies/mL. ALT <=1 x ULN occurred in 69% HBeAg(+) patients and 80% HBeAg(-) patients. Histologicial improvement occurred in 83% HBeAg(+) patients and 72% HBeAg(-) patients. The most frequent adverse events (AE) were headache, upper respiratory tract infection, arthralgia and fatigue. Serious AE occurred in 14%. One patient discontinued treatment due to gastric cancer. No grade 3/4 changes in serum creatinine occurred. Conclusions In patients >=50 years of age who may present with comorbidities, ETV was well tolerated and efficacious through 48 weeks of treatment. These results are consistent with ETV registration trials.

Background & Aims: CD46 is a C3b/C4b binding complement regulator and a receptor for several human pathogens. We examined the interaction between CD46 and Helicobacter pylori (a bacterium that colonizes the human gastric mucosa and causes gastritis), peptic ulcers, and cancer. Methods: Using gastric epithelial cells, we analyzed a set of H pylori strains and mutants for their ability to interact with CD46 and/or influence CD46 expression. Bacterial interaction with full-length CD46 and small CD46 peptides was evaluated by flow cytometry, fluorescence microscopy, enzyme-linked immunosorbent assay, and bacterial survival analyses. Results: H pylori infection caused shedding of CD46 into the extracellular environment. A soluble form of CD46 bound to H pylori and inhibited growth, in a dose- and time-dependent manner, by interacting with urease and alkyl hydroperoxide reductase, which are essential bacterial pathogenicity-associated factors. Binding of CD46 or CD46-derived synthetic peptides blocked theurease activity and ability of bacteria to survive in acidic environments. Oral administration of one CD46 peptide eradicated H pylori from infected mice. Conclusions: CD46 is an antimicrobial agent that can eradicate H pylori. CD46 peptides might be developed to treat H pylori infection.