Helicobacter pylori infection may predict a good response to immunotherapy in gastric cancer

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Key clinical point: Helicobacter pylori (HP) infection is associated with the tumor expression of programmed death ligand-1 (PD-L1) in patients with gastric cancer.

Major finding: HP infection was significantly associated with the tumor expression of PD-L1 in patients with gastric cancer (odds ratio 1.90; P < .001), with the association not being significantly affected by the sample size, evaluation methods for PD-L1 expression, or quality score (all P > .05).

Study details: This meta-analysis of 10 observational studies investigated the association between HP infection and the tumor expression of PD-L1 in 1870 patients with gastric cancer.

Disclosures: This study was sponsored by the Natural Science Foundation of the Anhui Higher Education Institutions of China and others. The authors declared no conflicts of interest.

Source: Zhu Y et al. Helicobacter pylori infection and PD-L1 expression in gastric cancer: A meta-analysis. Eur J Clin Invest. 2022:e13880 (Sep 27). Doi: 10.1111/eci.13880

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Key clinical point: Helicobacter pylori (HP) infection is associated with the tumor expression of programmed death ligand-1 (PD-L1) in patients with gastric cancer.

Major finding: HP infection was significantly associated with the tumor expression of PD-L1 in patients with gastric cancer (odds ratio 1.90; P < .001), with the association not being significantly affected by the sample size, evaluation methods for PD-L1 expression, or quality score (all P > .05).

Study details: This meta-analysis of 10 observational studies investigated the association between HP infection and the tumor expression of PD-L1 in 1870 patients with gastric cancer.

Disclosures: This study was sponsored by the Natural Science Foundation of the Anhui Higher Education Institutions of China and others. The authors declared no conflicts of interest.

Source: Zhu Y et al. Helicobacter pylori infection and PD-L1 expression in gastric cancer: A meta-analysis. Eur J Clin Invest. 2022:e13880 (Sep 27). Doi: 10.1111/eci.13880

Key clinical point: Helicobacter pylori (HP) infection is associated with the tumor expression of programmed death ligand-1 (PD-L1) in patients with gastric cancer.

Major finding: HP infection was significantly associated with the tumor expression of PD-L1 in patients with gastric cancer (odds ratio 1.90; P < .001), with the association not being significantly affected by the sample size, evaluation methods for PD-L1 expression, or quality score (all P > .05).

Study details: This meta-analysis of 10 observational studies investigated the association between HP infection and the tumor expression of PD-L1 in 1870 patients with gastric cancer.

Disclosures: This study was sponsored by the Natural Science Foundation of the Anhui Higher Education Institutions of China and others. The authors declared no conflicts of interest.

Source: Zhu Y et al. Helicobacter pylori infection and PD-L1 expression in gastric cancer: A meta-analysis. Eur J Clin Invest. 2022:e13880 (Sep 27). Doi: 10.1111/eci.13880

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Early gastric cancer: Outcomes of pylorus-preserving vs conventional distal gastrectomy

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Key clinical point: In patients with early gastric cancer (EGC), pylorus-preserving gastrectomy (PPG) vs conventional distal gastrectomy (CDG) results in the harvest of fewer lymph nodes at stations 5, 6, 9, and 11p but similar survival outcomes.

Major finding: Patients who underwent PPG vs CDG had significantly lower numbers of lymph nodes harvested at stations 5, 6, 9, and 11p (weighted mean difference, −3.09; P < .001) but similar overall survival (hazard ratio [HR] 0.63; P = .852) and recurrence-free survival (HR 0.29; P = .900).

Study details: This was a meta-analysis of 16 studies including 4500 patients with EGC who had undergone PPG or CDG with lymph node dissection.

Disclosures: This study was sponsored by the Peking University People’s Hospital Research and Development Fund. The authors declared no conflicts of interest.

Source: Hou S et al. Pathological and oncological outcomes of pylorus-preserving versus conventional distal gastrectomy in early gastric cancer: A systematic review and meta-analysis. World J Surg Oncol. 2022;20:308 (Sep 24). Doi: 10.1186/s12957-022-02766-0

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Key clinical point: In patients with early gastric cancer (EGC), pylorus-preserving gastrectomy (PPG) vs conventional distal gastrectomy (CDG) results in the harvest of fewer lymph nodes at stations 5, 6, 9, and 11p but similar survival outcomes.

Major finding: Patients who underwent PPG vs CDG had significantly lower numbers of lymph nodes harvested at stations 5, 6, 9, and 11p (weighted mean difference, −3.09; P < .001) but similar overall survival (hazard ratio [HR] 0.63; P = .852) and recurrence-free survival (HR 0.29; P = .900).

Study details: This was a meta-analysis of 16 studies including 4500 patients with EGC who had undergone PPG or CDG with lymph node dissection.

Disclosures: This study was sponsored by the Peking University People’s Hospital Research and Development Fund. The authors declared no conflicts of interest.

Source: Hou S et al. Pathological and oncological outcomes of pylorus-preserving versus conventional distal gastrectomy in early gastric cancer: A systematic review and meta-analysis. World J Surg Oncol. 2022;20:308 (Sep 24). Doi: 10.1186/s12957-022-02766-0

Key clinical point: In patients with early gastric cancer (EGC), pylorus-preserving gastrectomy (PPG) vs conventional distal gastrectomy (CDG) results in the harvest of fewer lymph nodes at stations 5, 6, 9, and 11p but similar survival outcomes.

Major finding: Patients who underwent PPG vs CDG had significantly lower numbers of lymph nodes harvested at stations 5, 6, 9, and 11p (weighted mean difference, −3.09; P < .001) but similar overall survival (hazard ratio [HR] 0.63; P = .852) and recurrence-free survival (HR 0.29; P = .900).

Study details: This was a meta-analysis of 16 studies including 4500 patients with EGC who had undergone PPG or CDG with lymph node dissection.

Disclosures: This study was sponsored by the Peking University People’s Hospital Research and Development Fund. The authors declared no conflicts of interest.

Source: Hou S et al. Pathological and oncological outcomes of pylorus-preserving versus conventional distal gastrectomy in early gastric cancer: A systematic review and meta-analysis. World J Surg Oncol. 2022;20:308 (Sep 24). Doi: 10.1186/s12957-022-02766-0

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Risk factors for delayed gastric emptying following gastrectomy for gastric cancer

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Key clinical point: The female sex, distal gastric tumors, and diabetes are risk factors for delayed gastric emptying (DGE) in patients who have undergone gastrectomy for gastric cancer.

Major finding: Multivariate analysis revealed female sex (adjusted odds ratio [aOR] 2.47; P = .037), diabetes (aOR 2.44; P = .041), and distal gastric tumors (aOR 2.59; P = .033) as independent risk factors for DGE.

Study details: This retrospective study included 412 patients with gastric cancer who underwent distal gastrectomy and thereafter did (n = 27) or did not (n = 385) experience DGE.

Disclosures: No information on funding sources was provided. The author declared no conflicts of interest.

Source: Mukoyama T et al. Assessment of risk factors for delayed gastric emptying after distal gastrectomy for gastric cancer. Sci Rep. 2022;12:15903 (Sep 23). Doi: 10.1038/s41598-022-20151-5

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Key clinical point: The female sex, distal gastric tumors, and diabetes are risk factors for delayed gastric emptying (DGE) in patients who have undergone gastrectomy for gastric cancer.

Major finding: Multivariate analysis revealed female sex (adjusted odds ratio [aOR] 2.47; P = .037), diabetes (aOR 2.44; P = .041), and distal gastric tumors (aOR 2.59; P = .033) as independent risk factors for DGE.

Study details: This retrospective study included 412 patients with gastric cancer who underwent distal gastrectomy and thereafter did (n = 27) or did not (n = 385) experience DGE.

Disclosures: No information on funding sources was provided. The author declared no conflicts of interest.

Source: Mukoyama T et al. Assessment of risk factors for delayed gastric emptying after distal gastrectomy for gastric cancer. Sci Rep. 2022;12:15903 (Sep 23). Doi: 10.1038/s41598-022-20151-5

Key clinical point: The female sex, distal gastric tumors, and diabetes are risk factors for delayed gastric emptying (DGE) in patients who have undergone gastrectomy for gastric cancer.

Major finding: Multivariate analysis revealed female sex (adjusted odds ratio [aOR] 2.47; P = .037), diabetes (aOR 2.44; P = .041), and distal gastric tumors (aOR 2.59; P = .033) as independent risk factors for DGE.

Study details: This retrospective study included 412 patients with gastric cancer who underwent distal gastrectomy and thereafter did (n = 27) or did not (n = 385) experience DGE.

Disclosures: No information on funding sources was provided. The author declared no conflicts of interest.

Source: Mukoyama T et al. Assessment of risk factors for delayed gastric emptying after distal gastrectomy for gastric cancer. Sci Rep. 2022;12:15903 (Sep 23). Doi: 10.1038/s41598-022-20151-5

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Laparoscopic gastrectomy for gastric cancer: Postoperative NSAID use requires caution

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Key clinical point: Postoperative nonsteroidal anti-inflammatory drug (NSAID) use in intravenous patient-controlled analgesia (IV-PCA) is associated with an increased risk for anastomotic leakage, duodenal stump leakage, intra-abdominal bleeding, and intra-abdominal inflammation in patients who undergo laparoscopic gastrectomy for gastric cancer.

Major finding: The NSAID vs non-NSAID group had a significantly higher incidence rate of anastomotic leakage (2.4% vs 0.7%; P = .002), duodenal stump leakage (1.8% vs 0.6%; P = .007), intra-abdominal bleeding (2.1% vs 0.7%; P = .005), and intra-abdominal abscess (1.5% vs 0.4%; P = .008).

Study details: This single-center retrospective study included 2150 patients with gastric cancer who underwent went laparoscopic gastrectomy and thereafter did (n = 935) or did not (n = 1,215) receive NSAID in IV-PCA.

Disclosures: This study was sponsored by the Korean Gastric Cancer Association. The authors declared no conflicts of interest.

Source: Kim SJ et al. Impact of postoperative NSAIDs (IV-PCA) use on short-term outcomes after laparoscopic gastrectomy for the patients of gastric cancer. Surg Endosc. 2022 (Sep 21). Doi: 10.1007/s00464-022-09600-4

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Key clinical point: Postoperative nonsteroidal anti-inflammatory drug (NSAID) use in intravenous patient-controlled analgesia (IV-PCA) is associated with an increased risk for anastomotic leakage, duodenal stump leakage, intra-abdominal bleeding, and intra-abdominal inflammation in patients who undergo laparoscopic gastrectomy for gastric cancer.

Major finding: The NSAID vs non-NSAID group had a significantly higher incidence rate of anastomotic leakage (2.4% vs 0.7%; P = .002), duodenal stump leakage (1.8% vs 0.6%; P = .007), intra-abdominal bleeding (2.1% vs 0.7%; P = .005), and intra-abdominal abscess (1.5% vs 0.4%; P = .008).

Study details: This single-center retrospective study included 2150 patients with gastric cancer who underwent went laparoscopic gastrectomy and thereafter did (n = 935) or did not (n = 1,215) receive NSAID in IV-PCA.

Disclosures: This study was sponsored by the Korean Gastric Cancer Association. The authors declared no conflicts of interest.

Source: Kim SJ et al. Impact of postoperative NSAIDs (IV-PCA) use on short-term outcomes after laparoscopic gastrectomy for the patients of gastric cancer. Surg Endosc. 2022 (Sep 21). Doi: 10.1007/s00464-022-09600-4

Key clinical point: Postoperative nonsteroidal anti-inflammatory drug (NSAID) use in intravenous patient-controlled analgesia (IV-PCA) is associated with an increased risk for anastomotic leakage, duodenal stump leakage, intra-abdominal bleeding, and intra-abdominal inflammation in patients who undergo laparoscopic gastrectomy for gastric cancer.

Major finding: The NSAID vs non-NSAID group had a significantly higher incidence rate of anastomotic leakage (2.4% vs 0.7%; P = .002), duodenal stump leakage (1.8% vs 0.6%; P = .007), intra-abdominal bleeding (2.1% vs 0.7%; P = .005), and intra-abdominal abscess (1.5% vs 0.4%; P = .008).

Study details: This single-center retrospective study included 2150 patients with gastric cancer who underwent went laparoscopic gastrectomy and thereafter did (n = 935) or did not (n = 1,215) receive NSAID in IV-PCA.

Disclosures: This study was sponsored by the Korean Gastric Cancer Association. The authors declared no conflicts of interest.

Source: Kim SJ et al. Impact of postoperative NSAIDs (IV-PCA) use on short-term outcomes after laparoscopic gastrectomy for the patients of gastric cancer. Surg Endosc. 2022 (Sep 21). Doi: 10.1007/s00464-022-09600-4

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Early gastric cancer: Bleeding risk after ESD similar between patients with surgically altered and whole stomach

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Key clinical point: The risk for bleeding after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is not significantly different between patients with surgically altered stomach and whole stomach.

Major finding: Patients with surgically altered vs whole stomach did not have a significant difference in the risk for bleeding after ESD (adjusted odds ratio 1.37; 95% CI 0.87-2.17).

Study details: This subanalysis of a multicenter retrospective study included 10,765 patients who underwent ESD for EGC, of which 445 had surgically altered stomach and 10,320 had whole stomach.

Disclosures: This study was partially supported by the Japanese Foundation for Research and Promotion of Endoscopy Grant. M Fujishiro declared receiving lecture honoraria from various sources.

Source: Odagiri H et al. Bleeding following endoscopic submucosal dissection for early gastric cancer in surgically altered stomach. Digestion. 2022 (Oct 4). Doi: 10.1159/000526865

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Key clinical point: The risk for bleeding after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is not significantly different between patients with surgically altered stomach and whole stomach.

Major finding: Patients with surgically altered vs whole stomach did not have a significant difference in the risk for bleeding after ESD (adjusted odds ratio 1.37; 95% CI 0.87-2.17).

Study details: This subanalysis of a multicenter retrospective study included 10,765 patients who underwent ESD for EGC, of which 445 had surgically altered stomach and 10,320 had whole stomach.

Disclosures: This study was partially supported by the Japanese Foundation for Research and Promotion of Endoscopy Grant. M Fujishiro declared receiving lecture honoraria from various sources.

Source: Odagiri H et al. Bleeding following endoscopic submucosal dissection for early gastric cancer in surgically altered stomach. Digestion. 2022 (Oct 4). Doi: 10.1159/000526865

Key clinical point: The risk for bleeding after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is not significantly different between patients with surgically altered stomach and whole stomach.

Major finding: Patients with surgically altered vs whole stomach did not have a significant difference in the risk for bleeding after ESD (adjusted odds ratio 1.37; 95% CI 0.87-2.17).

Study details: This subanalysis of a multicenter retrospective study included 10,765 patients who underwent ESD for EGC, of which 445 had surgically altered stomach and 10,320 had whole stomach.

Disclosures: This study was partially supported by the Japanese Foundation for Research and Promotion of Endoscopy Grant. M Fujishiro declared receiving lecture honoraria from various sources.

Source: Odagiri H et al. Bleeding following endoscopic submucosal dissection for early gastric cancer in surgically altered stomach. Digestion. 2022 (Oct 4). Doi: 10.1159/000526865

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Gastric cancer: Neoadjuvant treatment status should not guide the extent of lymphadenectomy

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Key clinical point: Routine D2-lymphadenectomy should be performed during total and distal gastrectomy in patients with gastric cancer even after administering neoadjuvant chemotherapy (NAC).

Major finding: cT2, cT3, and cT4 stage tumors metastasized to all individual lymph node (LN) stations (1-9, 11, and 12a). Patients who did vs did not receive NAC had a numerically lower incidence of metastases in almost all stations (54% vs 63%) but a similar distribution of LN metastases over the different stations.

Study details: This side-study of the LOGICA trial included 212 patients with resectable gastric cancer who underwent total or distal D2-gastrectomy with en-bloc D2-lymphadenectomy combined with total omentectomy, of which 158 received NAC and 120 had LN metastases.

Disclosures: The LOGICA trial was sponsored by ZonMw (The Netherlands Organization for Health Research and Development); this side-study received no funding. Some authors declared serving as consultants or advisors for or receiving research funding and travel or accommodation fees and expenses from various sources.

Source: de Jongh C et al and the LOGICA Study Group. Pattern of lymph node metastases in gastric cancer: A side-study of the multicenter LOGICA-trial. Gastric Cancer. 2022 (Sep 14). Doi: 10.1007/s10120-022-01329-2

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Key clinical point: Routine D2-lymphadenectomy should be performed during total and distal gastrectomy in patients with gastric cancer even after administering neoadjuvant chemotherapy (NAC).

Major finding: cT2, cT3, and cT4 stage tumors metastasized to all individual lymph node (LN) stations (1-9, 11, and 12a). Patients who did vs did not receive NAC had a numerically lower incidence of metastases in almost all stations (54% vs 63%) but a similar distribution of LN metastases over the different stations.

Study details: This side-study of the LOGICA trial included 212 patients with resectable gastric cancer who underwent total or distal D2-gastrectomy with en-bloc D2-lymphadenectomy combined with total omentectomy, of which 158 received NAC and 120 had LN metastases.

Disclosures: The LOGICA trial was sponsored by ZonMw (The Netherlands Organization for Health Research and Development); this side-study received no funding. Some authors declared serving as consultants or advisors for or receiving research funding and travel or accommodation fees and expenses from various sources.

Source: de Jongh C et al and the LOGICA Study Group. Pattern of lymph node metastases in gastric cancer: A side-study of the multicenter LOGICA-trial. Gastric Cancer. 2022 (Sep 14). Doi: 10.1007/s10120-022-01329-2

Key clinical point: Routine D2-lymphadenectomy should be performed during total and distal gastrectomy in patients with gastric cancer even after administering neoadjuvant chemotherapy (NAC).

Major finding: cT2, cT3, and cT4 stage tumors metastasized to all individual lymph node (LN) stations (1-9, 11, and 12a). Patients who did vs did not receive NAC had a numerically lower incidence of metastases in almost all stations (54% vs 63%) but a similar distribution of LN metastases over the different stations.

Study details: This side-study of the LOGICA trial included 212 patients with resectable gastric cancer who underwent total or distal D2-gastrectomy with en-bloc D2-lymphadenectomy combined with total omentectomy, of which 158 received NAC and 120 had LN metastases.

Disclosures: The LOGICA trial was sponsored by ZonMw (The Netherlands Organization for Health Research and Development); this side-study received no funding. Some authors declared serving as consultants or advisors for or receiving research funding and travel or accommodation fees and expenses from various sources.

Source: de Jongh C et al and the LOGICA Study Group. Pattern of lymph node metastases in gastric cancer: A side-study of the multicenter LOGICA-trial. Gastric Cancer. 2022 (Sep 14). Doi: 10.1007/s10120-022-01329-2

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Multimodal treatment of gastric cancer affects outcomes in a stage‐specific manner

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Key clinical point: Among patients with nonmetastatic gastric cancer who received both surgery and neoadjuvant chemotherapy (neoadj) or adjuvant chemotherapy (adj), those with stage III disease benefited from neoadj, whereas those with stage I disease benefited from upfront surgery followed by adj.

Major finding: Overall survival with surgery + neoadj vs surgery + adj was worse in patients with stage I disease (hazard ratio [HR] 1.186, 95% CI 1.004-1.402), comparable in those with stage II disease (HR 0.98; 95% CI 0.91-1.07), and significantly improved in those with stage III disease (HR 0.78; 95% CI 0.69-0.90).

Study details: This retrospective study included 11,984 patients with resectable gastric cancer (stage I 15%; stage II 67%; stage III 18%) who underwent surgery and chemotherapy treatment either before or after surgery.

Disclosures: No information on funding was available. The authors declared no conflicts of interest.

Source: Ramos-Santillan V et al. The order of surgery and chemotherapy matters: Multimodality therapy and stage-specific differences in survival in gastric cancer. J Surg Oncol. 2022 (Oct 4). Doi: 10.1002/jso.27110

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Key clinical point: Among patients with nonmetastatic gastric cancer who received both surgery and neoadjuvant chemotherapy (neoadj) or adjuvant chemotherapy (adj), those with stage III disease benefited from neoadj, whereas those with stage I disease benefited from upfront surgery followed by adj.

Major finding: Overall survival with surgery + neoadj vs surgery + adj was worse in patients with stage I disease (hazard ratio [HR] 1.186, 95% CI 1.004-1.402), comparable in those with stage II disease (HR 0.98; 95% CI 0.91-1.07), and significantly improved in those with stage III disease (HR 0.78; 95% CI 0.69-0.90).

Study details: This retrospective study included 11,984 patients with resectable gastric cancer (stage I 15%; stage II 67%; stage III 18%) who underwent surgery and chemotherapy treatment either before or after surgery.

Disclosures: No information on funding was available. The authors declared no conflicts of interest.

Source: Ramos-Santillan V et al. The order of surgery and chemotherapy matters: Multimodality therapy and stage-specific differences in survival in gastric cancer. J Surg Oncol. 2022 (Oct 4). Doi: 10.1002/jso.27110

Key clinical point: Among patients with nonmetastatic gastric cancer who received both surgery and neoadjuvant chemotherapy (neoadj) or adjuvant chemotherapy (adj), those with stage III disease benefited from neoadj, whereas those with stage I disease benefited from upfront surgery followed by adj.

Major finding: Overall survival with surgery + neoadj vs surgery + adj was worse in patients with stage I disease (hazard ratio [HR] 1.186, 95% CI 1.004-1.402), comparable in those with stage II disease (HR 0.98; 95% CI 0.91-1.07), and significantly improved in those with stage III disease (HR 0.78; 95% CI 0.69-0.90).

Study details: This retrospective study included 11,984 patients with resectable gastric cancer (stage I 15%; stage II 67%; stage III 18%) who underwent surgery and chemotherapy treatment either before or after surgery.

Disclosures: No information on funding was available. The authors declared no conflicts of interest.

Source: Ramos-Santillan V et al. The order of surgery and chemotherapy matters: Multimodality therapy and stage-specific differences in survival in gastric cancer. J Surg Oncol. 2022 (Oct 4). Doi: 10.1002/jso.27110

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Robotic-assisted distal gastrectomy: A feasible treatment option for advanced gastric cancer

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Key clinical point: Compared with laparoscopic-assisted distal gastrectomy (LADG), robotic-assisted distal gastrectomy (RADG) results in less operative blood loss, more retrieved lymph nodes (LN), and similar complication rates and oncological outcomes in advanced gastric cancer.

Major finding: Patients who underwent RADG vs LADG had lower operative blood loss (139.3 ± 97.8 vs 167.3 ± 134.2 mL; P < .001); higher retrieved LN number (31.4 ± 12.1 vs 29.4 ± 12.3; P = .015); and similar overall complication rate (13.7% vs 16.6%; P = .242), 3-year overall survival rate (75.5% vs 73.1%; P = .471), and 3-year disease-free survival rate (72.9% vs 71.4%; P = .763).

Study details: Findings are from a retrospective study that propensity score-matched patients with advanced gastric cancer who underwent RADG (n = 410) with those who underwent LADG (n = 410).

Disclosures: This study was sponsored by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gao G et al. Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: A propensity score-matched analysis of 1164 patients. World J Surg Oncol. 2022;20:315 (Sep 28). Doi: 10.1186/s12957-022-02778-w

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Key clinical point: Compared with laparoscopic-assisted distal gastrectomy (LADG), robotic-assisted distal gastrectomy (RADG) results in less operative blood loss, more retrieved lymph nodes (LN), and similar complication rates and oncological outcomes in advanced gastric cancer.

Major finding: Patients who underwent RADG vs LADG had lower operative blood loss (139.3 ± 97.8 vs 167.3 ± 134.2 mL; P < .001); higher retrieved LN number (31.4 ± 12.1 vs 29.4 ± 12.3; P = .015); and similar overall complication rate (13.7% vs 16.6%; P = .242), 3-year overall survival rate (75.5% vs 73.1%; P = .471), and 3-year disease-free survival rate (72.9% vs 71.4%; P = .763).

Study details: Findings are from a retrospective study that propensity score-matched patients with advanced gastric cancer who underwent RADG (n = 410) with those who underwent LADG (n = 410).

Disclosures: This study was sponsored by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gao G et al. Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: A propensity score-matched analysis of 1164 patients. World J Surg Oncol. 2022;20:315 (Sep 28). Doi: 10.1186/s12957-022-02778-w

Key clinical point: Compared with laparoscopic-assisted distal gastrectomy (LADG), robotic-assisted distal gastrectomy (RADG) results in less operative blood loss, more retrieved lymph nodes (LN), and similar complication rates and oncological outcomes in advanced gastric cancer.

Major finding: Patients who underwent RADG vs LADG had lower operative blood loss (139.3 ± 97.8 vs 167.3 ± 134.2 mL; P < .001); higher retrieved LN number (31.4 ± 12.1 vs 29.4 ± 12.3; P = .015); and similar overall complication rate (13.7% vs 16.6%; P = .242), 3-year overall survival rate (75.5% vs 73.1%; P = .471), and 3-year disease-free survival rate (72.9% vs 71.4%; P = .763).

Study details: Findings are from a retrospective study that propensity score-matched patients with advanced gastric cancer who underwent RADG (n = 410) with those who underwent LADG (n = 410).

Disclosures: This study was sponsored by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Gao G et al. Surgical and oncological outcomes of robotic- versus laparoscopic-assisted distal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: A propensity score-matched analysis of 1164 patients. World J Surg Oncol. 2022;20:315 (Sep 28). Doi: 10.1186/s12957-022-02778-w

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Paclitaxel + carboplatin + capecitabine regimen shows promise in advanced gastric cancer

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Key clinical point: The paclitaxel, carboplatin, and capecitabine (TCX) regimen offers a good efficacy and safety profile in patients with advanced gastric cancer.

Major finding: The patients had a median progression-free survival (PFS) and overall survival (OS) of 9.3 and 17.0 months, respectively; the PFS rates were 74.6%, 32.5%, and 14.4% and OS rates were 97.5%, 68.7%, and 21.7% at 6 months, 1 year, and 2 years, respectively. Grade 3-4 neutropenia, anemia, and thrombocytopenia occurred only in 27.1%, 2.4%, and 1.2% of patients, respectively; non-hematologic and hematologic toxicities did not require intervention or treatment discontinuation.

Study details: This prospective cohort study included 83 patients with advanced gastric cancer who received the TCX regimen for ≥3 cycles.

Disclosures: No information on funding sources was provided. The author declared no conflicts of interest.

Source: Nguyen HT et al. Treatment outcome and safety of the TCX regimen for advanced gastric cancer: A prospective cohort study. Cancer Manag Res. 2022;14:2825-2837 (Sep 19). Doi: 10.2147/CMAR.S384325

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Key clinical point: The paclitaxel, carboplatin, and capecitabine (TCX) regimen offers a good efficacy and safety profile in patients with advanced gastric cancer.

Major finding: The patients had a median progression-free survival (PFS) and overall survival (OS) of 9.3 and 17.0 months, respectively; the PFS rates were 74.6%, 32.5%, and 14.4% and OS rates were 97.5%, 68.7%, and 21.7% at 6 months, 1 year, and 2 years, respectively. Grade 3-4 neutropenia, anemia, and thrombocytopenia occurred only in 27.1%, 2.4%, and 1.2% of patients, respectively; non-hematologic and hematologic toxicities did not require intervention or treatment discontinuation.

Study details: This prospective cohort study included 83 patients with advanced gastric cancer who received the TCX regimen for ≥3 cycles.

Disclosures: No information on funding sources was provided. The author declared no conflicts of interest.

Source: Nguyen HT et al. Treatment outcome and safety of the TCX regimen for advanced gastric cancer: A prospective cohort study. Cancer Manag Res. 2022;14:2825-2837 (Sep 19). Doi: 10.2147/CMAR.S384325

Key clinical point: The paclitaxel, carboplatin, and capecitabine (TCX) regimen offers a good efficacy and safety profile in patients with advanced gastric cancer.

Major finding: The patients had a median progression-free survival (PFS) and overall survival (OS) of 9.3 and 17.0 months, respectively; the PFS rates were 74.6%, 32.5%, and 14.4% and OS rates were 97.5%, 68.7%, and 21.7% at 6 months, 1 year, and 2 years, respectively. Grade 3-4 neutropenia, anemia, and thrombocytopenia occurred only in 27.1%, 2.4%, and 1.2% of patients, respectively; non-hematologic and hematologic toxicities did not require intervention or treatment discontinuation.

Study details: This prospective cohort study included 83 patients with advanced gastric cancer who received the TCX regimen for ≥3 cycles.

Disclosures: No information on funding sources was provided. The author declared no conflicts of interest.

Source: Nguyen HT et al. Treatment outcome and safety of the TCX regimen for advanced gastric cancer: A prospective cohort study. Cancer Manag Res. 2022;14:2825-2837 (Sep 19). Doi: 10.2147/CMAR.S384325

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bDMARDs, especially anti-TNF agents, reduce radiographic progression in PsA

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Key clinical point: Some biologic disease-modifying antirheumatic drugs (bDMARDs), especially anti-tumor necrosis factor (TNF) agents, may prevent radiographic progression in patients with psoriatic arthritis (PsA).

Major finding: Anti-TNF agents like infliximab (standardized mean difference [SMD], −0.59; 95% CI, −0.87 to −0.3), etanercept (SMD, −0.51; 95% CI, −0.78 to −0.23), and adalimumab (SMD, −0.45; 95% CI, −0.64 to −0.26) followed by interleukin inhibitors like ixekizumab (SMD, −0.37; 95% CI, −0.62 to −0.12) and secukinumab 300 mg (SMD, −0.33; 95% CI, −0.50 to −0.15) were more effective than placebo in reducing the total radiographic score for structural damage.

Study details: Finding are from a meta-analysis of 11 randomized controlled trials including 4,010 patients with PsA who received bDMARDs or placebo.

Disclosures: This study did not receive any external funding. CH Yang declared receiving speaking fees from several sources.

Source: Wang SH et al. Biologic disease-modifying antirheumatic drugs for preventing radiographic progression in psoriatic arthritis: A systematic review and network meta-analysis. Pharmaceutics. 2022;14(10):2140 (Oct 8). Doi: 10.3390/pharmaceutics14102140.

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Key clinical point: Some biologic disease-modifying antirheumatic drugs (bDMARDs), especially anti-tumor necrosis factor (TNF) agents, may prevent radiographic progression in patients with psoriatic arthritis (PsA).

Major finding: Anti-TNF agents like infliximab (standardized mean difference [SMD], −0.59; 95% CI, −0.87 to −0.3), etanercept (SMD, −0.51; 95% CI, −0.78 to −0.23), and adalimumab (SMD, −0.45; 95% CI, −0.64 to −0.26) followed by interleukin inhibitors like ixekizumab (SMD, −0.37; 95% CI, −0.62 to −0.12) and secukinumab 300 mg (SMD, −0.33; 95% CI, −0.50 to −0.15) were more effective than placebo in reducing the total radiographic score for structural damage.

Study details: Finding are from a meta-analysis of 11 randomized controlled trials including 4,010 patients with PsA who received bDMARDs or placebo.

Disclosures: This study did not receive any external funding. CH Yang declared receiving speaking fees from several sources.

Source: Wang SH et al. Biologic disease-modifying antirheumatic drugs for preventing radiographic progression in psoriatic arthritis: A systematic review and network meta-analysis. Pharmaceutics. 2022;14(10):2140 (Oct 8). Doi: 10.3390/pharmaceutics14102140.

Key clinical point: Some biologic disease-modifying antirheumatic drugs (bDMARDs), especially anti-tumor necrosis factor (TNF) agents, may prevent radiographic progression in patients with psoriatic arthritis (PsA).

Major finding: Anti-TNF agents like infliximab (standardized mean difference [SMD], −0.59; 95% CI, −0.87 to −0.3), etanercept (SMD, −0.51; 95% CI, −0.78 to −0.23), and adalimumab (SMD, −0.45; 95% CI, −0.64 to −0.26) followed by interleukin inhibitors like ixekizumab (SMD, −0.37; 95% CI, −0.62 to −0.12) and secukinumab 300 mg (SMD, −0.33; 95% CI, −0.50 to −0.15) were more effective than placebo in reducing the total radiographic score for structural damage.

Study details: Finding are from a meta-analysis of 11 randomized controlled trials including 4,010 patients with PsA who received bDMARDs or placebo.

Disclosures: This study did not receive any external funding. CH Yang declared receiving speaking fees from several sources.

Source: Wang SH et al. Biologic disease-modifying antirheumatic drugs for preventing radiographic progression in psoriatic arthritis: A systematic review and network meta-analysis. Pharmaceutics. 2022;14(10):2140 (Oct 8). Doi: 10.3390/pharmaceutics14102140.

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