Background

Metabolic rearrangement has been shown to be an important characteristic for stomach adenocarcinomas. Here we aimed to improve our understanding of the tumorigenesis of gastric cancer by means of gene and protein expression profile analysis with a focus on metabolic genes and pathways.

Methods

Array-based gene expression profiling of fresh frozen cancer tissues and adjacent normal tissues were obtained from 8 patients with gastric cancer at early stage by using Affymetrix oligonucleotide microarray. Assays targeted 179 unique genes related to cancer metabolism. The raw expression data were normalized using nSolver Analysis Software 3.0 and a dataset of gene expression ratios for GC vs. controls was generated. The p values were calculated using a paired t-test, and the threshold for up- and down-regulated genes was set at p value < 0.05. The protein expression of the dysregualted genes were detected by immunohistochemistry (IHC) in the formalin fixed paraffin embedded tissue blocks. The signal was quantified by the Allred score system which represented the estimated intensity and proportion of positive-staining cells.

Results

Our microarray results showed increased expression of 20 metabolic genes and decreased expression of 6 metabolic genes in all cases of gastric cancer at early stage. Besides of the undetected NOX4, the protein levels of all the others dysregualted genes, detected by IHC, showed consistently results. Half of all dysregulated genes (AKT2, EGLN3, G6PD, GLS, HIF1A, HK2, HRAS, MAP2K1, NTRK3, PGK1, PLCG1, RET and RPS6KB1) are implicated in Carbon Metabolism, a pivotal metabolic approach involving in nucleic acid biosynthesis. Five genes (ARNT, EGLN1, EGLN3, HIF1A and NOX4) are molecules implicated in hypoxia signaling. Besides, the upregulated HIF1A is a cancer metabolism driver, which means that HIF1A may induce the oncogenesis of gastric cancer.

Conclusions

The gastric mucosa in gastric cancer at early stage is characterized by dysregulated expression of a limited repertoire of metabolic genes. The nature of the corresponding metabolic rearrangement and pathways may help guide further investigations into its etiology.

Legal entity responsible for the study

Fudan University Shanghai Cancer Center.

Funding

National Human Genetic Resources Sharing Service Platform (2005DKA21300), National Natural Science Foundation of China (81602078),.

Disclosure

All authors have declared no conflicts of interest.

Background

The incidence of gastric cancer is particularly high in Iran, where it remains a leading cause of cancer-related death, and it is the most common cancer among Iranian men, with an ASR of 21.6 per 100,000 men (GLOBO2018). By contrast the incidence and mortalityof gastric cancer rank fifth and third respectively worldwide. The aim of this study was to evaluate the epidemiologic profile of gastric cancer in East Azerbaijan, Iran.

Methods

In total, 2 years of cancer registry data were collected from different sources in East Azerbaijan (EA-PBCR), and a data quality check was performed to ensure clean data. Using the 2000 World Health Organization standard population, we then generated age-standardized incidence rates (ASRs) for different cancers, with data were generated for each year from 1394 to 1395 of the Persian calendar (i.e., 19 March 2015 to 20 March 2016).

Results

In total we registered 1700 gastric cancer in two years; 918 cases in 2015 and 712 cases in 2016. From these, 1181 cases were male and 519 cases were female, and the male to female ratio was 2.28. The mean age of the patients was 68.45 (±12.97) years, with age range of 21-99 years old. The most common age group was 7th decade with 531 (31.2%) gastric cancer cases. The most common morphological types were adenocarcinoma (n = 667, 39.2%), and intestinal type carcinoma (n = 421, 24.8%), and signet ring cell carcinoma (n = 119, 7%). The age standardized incidence rate (ASR) was 29.65 and 13.30 in males and females per 100,000, in 2015. The ASR was 26.48 and 9.91 in males and females per 100,000, in 2016. Gastric Cancer account for 12.4% of all cancers in both sexes, and the odds for men was 1.50, compared with women (OR 1.50; 95% CI = 1.33 – 1.71). After rigorous attempts, 63.5 % of the cases had microscopic verification (MV), and we collected 3.3 % of reports based on clinical data. The remaining data were collected from the cause of death registry or autopsy records, producing a final DCO% of 27.4%.

Conclusions

The ASR was decreased from 29.7 to 26.48 in men, and decreased from 13.3 to 9.91 in female. However gastric cancer is the most common cancer in terms of incidence and mortality in East Azerbaijan, according to last results of EA-PBCR.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Nutritional status and proper dietary intake have a vital role in cancer prognosis and progression. Alterations in metabolic system due to chemotherapy and cancer can lead to high prevalence of malnutrition. It can be attributable to cancer, therapy effect and decreased food intake. Malnutrition has negative impact on patients treatment, side effects, immunity, Quality of life (QOL) and prolonged hospital stay and expense. Our study aims to assess the nutritional status, timely intervention and QOL in cancer patients undergoing chemotherapy.

Methods

A prospective hospital-based multidisciplinary interventional study was conducted in 97 patients with known histological malignancies who had received chemotherapy as inpatients in oncology wards at Ramaiah hospital in Bangalore for a period of six months. Detailed interview of patients and their care-takers were analysed in structured formats. Malnutrition and QOL were assessed using PG-SGA scale and EORTC QLQ C-30 questionnaire respectively. QOL was assessed at the beginning and at the end of the chemotherapy whereas PG-SGA scale was done for all the cycles and dietary intervention was given to patients who were moderately and severely malnourished. Follow up was done for all the patients till the end of the therapy.

Results

Out of 97 patients 61% were females and 36% were males. During the chemotherapy third cycle 19.5% patients were found to be well nourished (stage A) 63% were moderately malnourished (stage B) and 17.5% were severely malnourished (stage C). After the chemotherapy sixth cycle 60% were in stage A and 34% were in stage B and 6% were in stage C. Qol was also assessed and the total score before and after the chemotherapy was found to be 54.2 + 11.46 and 46.16 + 9.77 respectively Whereas 23% of the patients showed higher score (9.8 + 3.6) in physical domain before the treatment and at the end of the treatment the score increased (22 + 4.1). Emotional domain before treatment (5.9 + 2.5) and after treatment (5.3 + 2.3) social (3.6 + 1.4 and 3.5 + 1.4) cognitive (2.04 + 0.31 and 2.04 + 0.30) and role (5.9 + 1.5 and 3.9 + 1.4).

Conclusions

Pre-emptive assessment of nutritional status and prompt dietary guidance and intervention can improve patient’s nutritional status and QOL.

Legal entity responsible for the study

Sri Prathima.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Radical radiotherapy is the mainstay of bladder preservation treatment for muscle-invasive bladder cancer (MIBC) patients. The concurrent use of radiosensitisers improves patient outcome (Caffo et al., 2016, Hoskin et al., 2010). However, different factors may preclude patients from receiving radiosensitisers. This retrospective study evaluates the survival and toxicity outcomes of bladder preservation treatment in a tertiary cancer centre.

Methods

Patients treated with radical radiotherapy from 2010 to 2017 were divided into two groups depending on whether they received radiosensitisers in addition to radiotherapy. The primary outcome was overall survival (OS) and the secondary outcome was rate of late toxicities. Kaplan-Meier analyses were used to analyse OS. Late genitourinary (GU) and gastrointestinal (GI) toxicities were defined as treatment-related toxicities at 1-year post-treatment, assessed on the LENT/SOMA scale.

Results

A total of 428 patients were included in the survival analysis. 303 patients had combination treatment while 125 patients had radiotherapy alone. Patients in the combination group were younger (median age 72 vs 81, p < 0.001), have better performance status (PS 0-2 298 (95%) vs 115 (92%), p < 0.001), and fewer comorbidities compared to patients in radiotherapy alone group. The median follow-up for this study was 56 months. The median OS was 76 months (95% CI: 66-NA) in radiosensitiser group compared to 13 months in radiotherapy only group (95% CI: 13-21) (p < 0.001, HR = 3.09 (95% CI: 2.32-4.12)). As shown in the table, the incidence of late toxicity was low in both groups and formal analysis could not be carried out.

Table: 219P Rates of late toxicities following radical radiotherapy

Conclusions

The survival outcome with radiosensitisation in this real-world retrospective study is in keeping with published data. Bladder preservation is effective with minimal long-term toxicities. Patients with localised MIBC should be offered the option of bladder preservation treatment.

Legal entity responsible for the study

Radiotherapy-Related Research Group, The Christie Hospital NHS Foundation Trust.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.