Lack of relationship between perioperative blood transfusion and survival time after curative resection for gastric cancer

Article Abstract:

Some researchers have suggested that the transfusion of blood during operations for cancer is associated with a poor prognosis, while other investigators have failed to confirm this finding. One group of investigators studying the outcome of stomach cancer patients has specifically implicated blood transfusion as having an adverse effect. For this reason, a year retrospective study over an 18-year period was performed with 568 patients who underwent surgery for stomach cancer. Of the 568 patients, 373 required blood transfusions during the perioperative period, while transfusions were not required in 195 cases. When the data were analyzed according to a univariate statistical model, patients who had received transfusions did indeed have a poorer outcome than those who did not. However, a univariate analysis considers only one variable at a time, and does not take into account correlations between different variables. For example, transfusions may be used more often among patients with more advanced cancers, and might therefore be expected to have a strong correlation with survival without any cause-and-effect relationship. When the patients were grouped according to stage of disease, there were no significant differences associated with transfusion within any group. When the data were analyzed in a multivariate model that took into account sex, age, and other variables, it was found that transfusions were not useful in predicting the outcome of a case. In addition to the results of curative stomach surgery, multivariate analysis revealed that the tumor size, degree of tumor invasion, and the status of the lymph nodes were important predictors of outcome. These results show no evidence of a relationship between blood transfusion and survival in stomach cancer patients undergoing curative surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Patient outcomes, Mortality, Complications and side effects, Blood transfusion

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DNA ploidy is associated with growth potential in gastric carcinoma

Article Abstract:

Stomach cancer is highly malignant and able to invade surrounding tissues. However, not all stomach cancers follow the same pattern in their growth. The authors have previously classified three patterns of growth: the funnel, column, and mountain. Stomach cancer begins in the lining of the stomach. A cancer that spreads along this lining may be wide at the top and more narrow deeper in the stomach tissue; this is the funnel. A column, as its name implies, is about the same size from top to bottom, and the mountain type of growth results in a cancer which remains small at the top, where it originated, but becomes progressively broader the further it invades the stomach. These patterns of growth may be further divided into expanding types, in which the tumor expands as a mass, and infiltrating types, in which cancer cells penetrate and intermingle with surrounding cells as the tumor grows. The authors have now used DNA measurements to learn more about the growth patterns of stomach cancers. Many researchers use flow cytometry to measure DNA in tumor specimens, but it is also possible to use a microscope equipped with a photometer; this device accurately measures the light transmitted by microscopic specimens specifically stained for DNA. Using this method, it was found that 40 of the 109 stomach cancer specimens examined contained more than 3 times the normal number of chromosomes. These cancers were more likely to be growing in the column form. Conversely, tumors that contained fewer than three times the normal number of chromosomes were more likely to have the superficial or funnel type of growth. However, the mountain type of growth was about equally likely to have either type of chromosome content. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Measurement, DNA, Cell proliferation, Chromosome abnormalities, Ploidy, Aneuploidy, Chromosome numbers

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Postgastrectomy prescription of mitomycin C and UFT for patients with stage IV gastric carcinoma

Article Abstract:

Improved survival from gastric (stomach) cancer has been achieved through early cancer detection, surgical ability to perform extensive lymph node removal, and postoperative chemotherapy. Unfortunately, patients who have undergone surgery for advanced (stage IV) gastric cancer have only a 10 percent five-year survival rate. An antitumor drug has been developed that is a combination of tegafur and uracil; known as UFT, the drug has been found to be more effective than 5-FU (fluorouracil, another antitumor medication). In a clinical trial, 46 patients with stage IV gastric cancer who had undergone gastric resection were assigned to receive either treatment with mitomycin C and tegafur (group A, 24 patients) or mitomycin C and UFT (group B, 22 patients). At the time this article was written, eight patients (17 percent) had survived for an average of 4.98 years; the other 38 patients had died. The five-year survival rate for group A was 13 percent and for group B, it was 23 percent. Thus it was found that UFT lengthened the survival of patients with stage IV gastric cancer approximately two-fold, compared with patients who were treated with tegafur. It was also determined that increasing the daily maintenance dose of UFT did not increase its side effects. UFT is selectively toxic to the tumor tissue. A further retrospective analysis showed that this chemotherapy protocol is effective for patients with the undifferentiated type of cancer, but is not effective for patients who have the differentiated type. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Chemotherapy, Chemotherapy, Combination, Combination chemotherapy, Mitomycin

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