Radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantation
BackgroundDe novo malignancies are major causes of death after organ transplantation because the recipients subsequently receive immunosuppressant drugs. When gastric cancer develops, the clinical course of the tumor may be particularly aggressive. However, there are few reliable studies of gastric...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1264628/full |
| _version_ | 1797358010052378624 |
|---|---|
| author | Jin Ah Lee So Jung Kim Ho Seok Seo Han Hong Lee Sung Geun Kim Kyong Hwa Jun Kyo Young Song Yoon Ju Jung |
| author_facet | Jin Ah Lee So Jung Kim Ho Seok Seo Han Hong Lee Sung Geun Kim Kyong Hwa Jun Kyo Young Song Yoon Ju Jung |
| author_sort | Jin Ah Lee |
| collection | DOAJ |
| description | BackgroundDe novo malignancies are major causes of death after organ transplantation because the recipients subsequently receive immunosuppressant drugs. When gastric cancer develops, the clinical course of the tumor may be particularly aggressive. However, there are few reliable studies of gastric cancer treatment after organ transplantation. This study examined the clinicopathological characteristics of gastric cancer patients after organ transplantation and evaluated treatment outcomes after gastrectomy.MethodsClinical data were collected from 54 patients who were diagnosed with gastric cancer after organ transplantation. Of these, 30 who underwent surgery for gastric cancer while on immunosuppressant medications were compared with a control group of 625 gastric cancer patients. To compensate for clinical differences between the two groups, 1:1 propensity-score matching was performed.ResultsAmong the 30 gastric cancer patients on immunosuppressants, kidney transplantation was the most common procedure (19/30, 63.3%) followed by bone marrow (6) and liver transplantation (4); among all 54 patients, 45 were on one or two immunosuppressants. Up-migration to an advanced pathological stage was more frequent in the transplant group. In multivariate analysis, transplantation was a significant risk factor for up-migration from the T, M, and final stages after surgery. When the 30 patients on immunosuppressants who underwent gastric cancer surgery were compared with the matched controls, the total incidence (30.0 vs 40.0%, P = 0.417) and the number of severe postoperative complications (16.7 vs 13.4%, P = 0.417) did not differ significantly between groups after propensity score matching. In terms of overall survival, the transplant group showed significantly worse prognosis in stages I, II, and IV (P < 0.001, P = 0.039 and 0.007, respectively).ConclusionRadical gastrectomy can be a safe oncological procedure for gastric cancer patients on immunosuppressants after transplantation. Considering their immunosuppressed condition and the possibility of underestimation of the stage of gastric cancer, early detection with endoscopic screening is needed to allow curative treatment. |
| first_indexed | 2024-03-08T14:54:32Z |
| format | Article |
| id | doaj.art-9a2b0ad0a11349bc9d99d5d4ef088699 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T14:54:32Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-9a2b0ad0a11349bc9d99d5d4ef0886992024-01-10T18:22:08ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-01-011310.3389/fonc.2023.12646281264628Radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantationJin Ah Lee0So Jung Kim1Ho Seok Seo2Han Hong Lee3Sung Geun Kim4Kyong Hwa Jun5Kyo Young Song6Yoon Ju Jung7Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastrointestinal Surgery, Department of Surgery, Yeouedo St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastrointestinal Surgery, Department of Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of KoreaDivision of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Gastrointestinal Surgery, Department of Surgery, Yeouedo St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaBackgroundDe novo malignancies are major causes of death after organ transplantation because the recipients subsequently receive immunosuppressant drugs. When gastric cancer develops, the clinical course of the tumor may be particularly aggressive. However, there are few reliable studies of gastric cancer treatment after organ transplantation. This study examined the clinicopathological characteristics of gastric cancer patients after organ transplantation and evaluated treatment outcomes after gastrectomy.MethodsClinical data were collected from 54 patients who were diagnosed with gastric cancer after organ transplantation. Of these, 30 who underwent surgery for gastric cancer while on immunosuppressant medications were compared with a control group of 625 gastric cancer patients. To compensate for clinical differences between the two groups, 1:1 propensity-score matching was performed.ResultsAmong the 30 gastric cancer patients on immunosuppressants, kidney transplantation was the most common procedure (19/30, 63.3%) followed by bone marrow (6) and liver transplantation (4); among all 54 patients, 45 were on one or two immunosuppressants. Up-migration to an advanced pathological stage was more frequent in the transplant group. In multivariate analysis, transplantation was a significant risk factor for up-migration from the T, M, and final stages after surgery. When the 30 patients on immunosuppressants who underwent gastric cancer surgery were compared with the matched controls, the total incidence (30.0 vs 40.0%, P = 0.417) and the number of severe postoperative complications (16.7 vs 13.4%, P = 0.417) did not differ significantly between groups after propensity score matching. In terms of overall survival, the transplant group showed significantly worse prognosis in stages I, II, and IV (P < 0.001, P = 0.039 and 0.007, respectively).ConclusionRadical gastrectomy can be a safe oncological procedure for gastric cancer patients on immunosuppressants after transplantation. Considering their immunosuppressed condition and the possibility of underestimation of the stage of gastric cancer, early detection with endoscopic screening is needed to allow curative treatment.https://www.frontiersin.org/articles/10.3389/fonc.2023.1264628/fullgastric cancerorgan transplantationimmunosuppressive druggastrectomydiagnosisprognosis |
| spellingShingle | Jin Ah Lee So Jung Kim Ho Seok Seo Han Hong Lee Sung Geun Kim Kyong Hwa Jun Kyo Young Song Yoon Ju Jung Radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantation Frontiers in Oncology gastric cancer organ transplantation immunosuppressive drug gastrectomy diagnosis prognosis |
| title | Radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantation |
| title_full | Radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantation |
| title_fullStr | Radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantation |
| title_full_unstemmed | Radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantation |
| title_short | Radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantation |
| title_sort | radical gastrectomy is safe for treatment of gastric cancer patients on immunosuppressive drugs after organ transplantation |
| topic | gastric cancer organ transplantation immunosuppressive drug gastrectomy diagnosis prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1264628/full |
| work_keys_str_mv | AT jinahlee radicalgastrectomyissafefortreatmentofgastriccancerpatientsonimmunosuppressivedrugsafterorgantransplantation AT sojungkim radicalgastrectomyissafefortreatmentofgastriccancerpatientsonimmunosuppressivedrugsafterorgantransplantation AT hoseokseo radicalgastrectomyissafefortreatmentofgastriccancerpatientsonimmunosuppressivedrugsafterorgantransplantation AT hanhonglee radicalgastrectomyissafefortreatmentofgastriccancerpatientsonimmunosuppressivedrugsafterorgantransplantation AT sunggeunkim radicalgastrectomyissafefortreatmentofgastriccancerpatientsonimmunosuppressivedrugsafterorgantransplantation AT kyonghwajun radicalgastrectomyissafefortreatmentofgastriccancerpatientsonimmunosuppressivedrugsafterorgantransplantation AT kyoyoungsong radicalgastrectomyissafefortreatmentofgastriccancerpatientsonimmunosuppressivedrugsafterorgantransplantation AT yoonjujung radicalgastrectomyissafefortreatmentofgastriccancerpatientsonimmunosuppressivedrugsafterorgantransplantation |