Gastric Linitis Plastica: Clinical Characteristics and Outcomes from the National Cancer Database.


Journal

Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988

Informations de publication

Date de publication:
Apr 2023
Historique:
received: 24 12 2022
revised: 24 01 2023
accepted: 25 01 2023
medline: 29 3 2023
entrez: 28 3 2023
pubmed: 29 3 2023
Statut: ppublish

Résumé

Gastric linitis plastica (LP) is a rare type of gastric tumor with limited data. We sought to investigate the clinical characteristics, treatment modalities, and outcomes utilizing a national database. The National Cancer Database (NCDB) was reviewed for LP of the stomach from 2004 to 2017. Kaplan-Meier analysis and Cox proportional hazards model were utilized to evaluate overall survival and predictors of survival. Out of 222,488 gastric cancer cases, 896 patients with histologically confirmed primary gastric LP were included. Patients were predominantly white (78.5%), female (51.9%) and presented at advanced stage disease (stage 4=69%). A total of 369 (41.2%) patients underwent surgical resection, 520 (58.0%) received chemotherapy and 158 (17.6%) received radiation therapy. The mean OS (overall survival) of the entire cohort was 16.9 months with 1-year and 5-year OS rates of 33% and 5%, respectively. Mean OS for the patients receiving surgery with chemotherapy and/or radiation, surgery alone, chemotherapy and/or radiotherapy alone, and no treatment was 28.4, 17.1, 12.3, and, 8.1 months, respectively (p<0.001). On multivariate cox-regression analysis, advanced-stage disease (stage IV) (p<0.001), no surgical resection (p<0.001), and no receipt of chemotherapy (p<0.001) were associated with increased hazards of death. Over time, the proportion of patients receiving surgical resection (30.7% from 48.3%) and radiation therapy decreased (13.8% from 20.6%) and the use of chemotherapy increased (63.9% from 54.8%). Gastric LP is associated with a poor prognosis. Multimodal therapy including surgical resection and systemic therapy in the neoadjuvant setting seems to provide the best long-term outcomes.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
Gastric linitis plastica (LP) is a rare type of gastric tumor with limited data. We sought to investigate the clinical characteristics, treatment modalities, and outcomes utilizing a national database.
PATIENTS AND METHODS METHODS
The National Cancer Database (NCDB) was reviewed for LP of the stomach from 2004 to 2017. Kaplan-Meier analysis and Cox proportional hazards model were utilized to evaluate overall survival and predictors of survival.
RESULTS RESULTS
Out of 222,488 gastric cancer cases, 896 patients with histologically confirmed primary gastric LP were included. Patients were predominantly white (78.5%), female (51.9%) and presented at advanced stage disease (stage 4=69%). A total of 369 (41.2%) patients underwent surgical resection, 520 (58.0%) received chemotherapy and 158 (17.6%) received radiation therapy. The mean OS (overall survival) of the entire cohort was 16.9 months with 1-year and 5-year OS rates of 33% and 5%, respectively. Mean OS for the patients receiving surgery with chemotherapy and/or radiation, surgery alone, chemotherapy and/or radiotherapy alone, and no treatment was 28.4, 17.1, 12.3, and, 8.1 months, respectively (p<0.001). On multivariate cox-regression analysis, advanced-stage disease (stage IV) (p<0.001), no surgical resection (p<0.001), and no receipt of chemotherapy (p<0.001) were associated with increased hazards of death. Over time, the proportion of patients receiving surgical resection (30.7% from 48.3%) and radiation therapy decreased (13.8% from 20.6%) and the use of chemotherapy increased (63.9% from 54.8%).
CONCLUSION CONCLUSIONS
Gastric LP is associated with a poor prognosis. Multimodal therapy including surgical resection and systemic therapy in the neoadjuvant setting seems to provide the best long-term outcomes.

Identifiants

pubmed: 36974782
pii: 43/4/1543
doi: 10.21873/anticanres.16303
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1543-1548

Informations de copyright

Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Auteurs

Adil Ayub (A)

Department of Surgery, University of Texas Medical Branch, Galveston, TX, U.S.A.; ayuba@upmc.edu.
Division of Surgical Oncology, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.

Buria Naeem (B)

Department of Pediatric Critical Care, Texas Children's Hospital, Houston, TX, U.S.A.

Alexander Perez (A)

Department of Surgery, University of Texas Medical Branch, Galveston, TX, U.S.A.

Douglas Tyler (D)

Department of Surgery, University of Texas Medical Branch, Galveston, TX, U.S.A.
Department of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A.

V Suzanne Klimberg (VS)

Department of Surgery, University of Texas Medical Branch, Galveston, TX, U.S.A.
Department of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A.

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