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| 1 | Gastric cancer with peritoneal metastases: Efficiency of standard treatment methods显示文摘BACKGROUND Peritoneal metastasis(PM),arising from gastric cancer(GC),is the most common pattern of synchronous and metachronous dissemination and is generally associated with poor prognosis.New therapeutic modalities are being increasingly employed for such patients.AIM To develop more advanced methods,it becomes necessary to study the results of existing standard treatment methods in patients with PM in order to perform a comparative analysis of the strategies.METHODS A retrospective analysis of the efficiency of standard treatment methods(i.e.,palliative chemotherapy,palliative gastrectomy,and the best supportive care)was performed on 200 GC patients with synchronous PM.RESULTS The overall survival(OS)rate in 200 GC patients with PM under standard treatment was 5.4 mo.One-year survival occurred in 18.4%of patients.In multivariate analysis,the survival rate was significantly influenced by the following factors:Presence of extraperitoneal metastases,and stage of PM according to both the Japanese Gastric Cancer Association(JGCA)and the peritoneal cancer index(PCI).The median OS and 1-year survival of patients withР1,P2,and P3(JGCA)carcinomatosis were 9.8 mo,6.7 mo,and 4.0 mo,and 47.2%,18.8%,and 5.1%,respectively.The application of the palliative gastrectomy resulted in an increase in the median OS by up to 17 mo compared to the conservative approach where the value was 8.5 mo(P=0.05)in patients withР1РМ.In patients withР3,palliative chemotherapy increased the OS by up to 5.6 mo compared to the OS of 3.2 mo(P=0.0006)for best supportive care.The median OS and 1-year survival of patients withРCI of 1-6,7-12 and 13+points were 8.5 mo,4.2 mo,and 4.1 mo,and 39.8%,6.7%,and 5.5%,respectively.Palliative gastrectomy increased the median OS to 12.6 mo compared to conservative approach of 8.0 mo(P=0.03)in patients withРCI of 1-6 points.In patients withРCI 13+points,only palliative chemotherapy increased the OS to 6.0 mo compared to the OS of 3.4 mo for best supportive care(P=0.0008).CONCLUSION GC patients with PM are characterized by extremely poor prognoses.Long-term survivors were found in the group with PCI of 1-6 points,and there was no survival difference in groups with PCI 7-12 vs PCI 13+points.Palliative gastrectomy could prove effective in treating patients with early stage PM.The three standard treatment methods are equally effective for moderate stages of PM.In cases with advanced peritoneal carcinomatosis,a significant increase in prognosis was registered only after treatment with palliative chemotherapy. | Roman Yarema МyronОhorchak Petro Hyrya Yuriy Kovalchuk Victor Safiyan Ivan Karelin Severyn Ferneza Markiyan Fetsych Myron Matusyak Yuriy Oliynyk Тaras Fetsych | 2020 | World Journal of Gastrointestinal Oncology2020，12，5： | 3 |
| 2 | On the road to standardization of D2 lymph node dissection in a European population of patients with gastric cancer显示文摘The amount of lymph node dissection(LD) required during surgical treatment of gastric cancer surgery has been quite controversial.In the 1970 s and 1980 s,Japanese surgeons developed a doctrine of aggressive preventive gastric cancer surgery that was based on extended(D2) LD volumes.The West has relatively lower incidence rates of gastric cancer,and in Europe and the United States the most common LD volume was D0-1.This eventually caused a scientific conflict between the Eastern and Western schools of surgical thought.:Japanese surgeons determinedly used D2 LD in surgical practice,whereas European surgeons insisted on repetitive clinical trials in the European patient population.Today,however,one can observe the results of this complex evolution of views.The D2 LD is regarded as an unambiguous standard of gastric cancer surgical treatment in specialized European centers.Such a consensus of the Eastern and Western surgical schools became possible due to the longstanding scientific and practical search for methods that would help improve the results of gastric cancer surgeries using evidence-based medicine.Today,we can claim that D2 LD could improve the prognosis in European populations of patients with gastric cancer,but only when the surgical quality of LD execution is adequate. | Roman Yarema Giovanni de Manzoni Taras Fetsych Myron Ohorchak Mykhailo Pliatsko Maria Bencivenga | 2016 | World Journal of Gastrointestinal Oncology2016，8，6： | 1 |
| 3 | Hyperthermic intraperitoneal chemoperfusion in combined treatment of locally advanced and disseminated gastric cancer: Results of a single-centre retrospective study显示文摘 | Roman Romanovych Yarema Myron A. Ohorchak Gennadyi P. Zubarev Yuriy P. Mylyan Yuriy Y. Oliynyk Mykola G. Zubarev Petro I. Gyrya Yuriy J. Kovalchuk Victor I. Safiyan Taras G. Fetsych | 2014 | International Journal of Hyperthermia2014，，3： | 1 |
| 4 | Histological differentiation impacts the tumor immune microenvironment in gastric carcinoma:Relation to the immune cycle显示文摘BACKGROUND Various histological types of gastric carcinomas(GCs)differ in terms of their pathogenesis and their preexisting background,both of which could impact the tumor immune microenvironment(TIME).However,the current understanding of the immune contexture of GC is far from complete.AIM To clarify the tumor-host immune interplay through histopathological features and the tumor immune cycle concept.METHODS In total,50 GC cases were examined(15 cases of diffuse GC,31 patients with intestinal-type GC and 4 cases of mucinous GC).The immunophenotype of GC was assessed and classified as immune desert(ID),immune excluded(IE)or inflamed(Inf)according to CD8+cell count and spatial pattern.In addition,CD68+and CD163+macrophages and programmed death-ligand 1(PD-L1)expression were estimated.RESULTS We found that GCs with different histological differentiation demonstrated distinct immune contexture.Most intestinal-type GCs had inflamed TIMEs rich in both CD8+cells and macrophages.In contrast,more aggressive diffuse-type GC more often possessed ID characteristics with few CD8+lymphocytes but abundant CD68+macrophages,while mucinous GC had an IE-TIME with a prevalence of CD68+macrophages and CD8+lymphocytes in the peritumor stroma.PD-L1 expression prevailed mostly in intestinal-type Inf-GC,with numerous CD163+cells observed.Therefore,GCs of different histological patterns have specific mechanisms of immune escape.While intestinal-type GC was more often related to PD-L1 expression,diffuse and mucinous GCs possessing more aggressive behavior demonstrated low immunogenicity and a lack of tumor antigen recognition or immune cell recruitment into the tumor clusters.CONCLUSION These data help to clarify the links between tumor histogenesis and immunogenicity for a better understanding of GC biology and more tailored patient management. | Artem Mashukov Dmytro Shapochka Oleksii Seleznov Nazarii Kobyliak Tetyana Falalyeyeva Stanislav Kirkilevsky Roman Yarema Oksana Sulaieva | 2021 | World Journal of Gastroenterology2021，27，31： | 0 |
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