ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2018
A prospective multi-institutional validity study to evaluate the accuracy of clinical diagnosis of pathological stage III gastric cancer (JCOG1302A).
Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04440605 (A Study to Confirm the Accuracy of Locally Advanced Gastric Cancer Diagnosis), which is not on this map. Cited by 84 papers.
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The trial behind it
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A Study to Confirm the Accuracy of Locally Advanced Gastric Cancer Diagnosis: A Prospective, Multicenter, Cohort Study
Who cites it
84 citing papers in PubMed, 148 citations in OpenAlex.
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- A Phase II Study of Perioperative Capecitabine plus Oxaliplatin Therapy for Clinical SS/SE N1-3 M0 Gastric Cancer (OGSG 1601).The oncologist · 2020Trial
- Trial
- Survival Results by the Prospectively Determined Clinical Staging for Locally Advanced Gastric Cancer: A Follow-Up Study of JCOG1302A.Annals of gastroenterological surgery · 2026Article
- Risk Factors for Mediastinal Lymph-Node Metastasis in Siewert Type I/II Esophagogastric Junction Cancers.Cancers · 2026Article
- Current Status and Challenges of Local Resection for Early Gastric Cancer in East Asia.Cancers · 2026Review
- Optimal upfront surgery for gastric adenocarcinoma. Real life situation in Brazil. Results comparable to neoadjuvant treatment.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026Article
- Preoperative prediction of serosal invasion in gastric cancer using multiphase contrast-enhanced CT radiomics.Frontiers in oncology · 2026Article
- Cell-Free DNA Methylation-Based Liquid Biopsy Assay to Identify Lymph Node Metastasis in T1 Gastric Cancer.United European gastroenterology journal · 2025Article
- Asia Pacific Gastroesophageal Cancer Congress (APGCC) 2024 consensus statement on stage 2 and 3 locally advanced gastric and Siewert 3 junctional adenocarcinoma.Journal of gastroenterology · 2025Article
- Unraveling the Anti-Tumor Effects and Molecular Mechanisms of Hairyvein Agrimonia Herb in Gastric Cancer Through Network Pharmacology and Experimental Validation.Cancer reports (Hoboken, N.J.) · 2025Article
- Comparative outcomes of laparoscopic and open gastrectomy for T4b gastric cancer with transverse colon or mesentery invasion: a dual-center retrospective analysis.World journal of surgical oncology · 2025Article
- Efficacy and safety of XELOX combined with neoadjuvant radiotherapy versus neoadjuvant chemotherapy in locally advanced gastric cancer.BMC cancer · 2025Article
- Gastrectomy after neoadjuvant chemotherapy in five cases of locally advanced gastric cancer with pancreatic head invasion.International cancer conference journal · 2025Article
- Efficacy ofCancer reports (Hoboken, N.J.) · 2025Article
- Dual-phase contrast-enhanced CT-based intratumoral and peritumoral radiomics for preoperative prediction of lymph node metastasis in gastric cancer.BMC gastroenterology · 2025Article
- The role ofJournal of gastrointestinal oncology · 2025Article
- Cost-effectiveness of open vs. laparoscopic gastrectomy for locally advanced gastric cancer in China.Scientific reports · 2025Article
- Neoadjuvant therapy with immune checkpoint inhibitors in combination with chemotherapy vs . chemotherapy alone in HER2(-) locally advanced gastric cancer: A propensity score-matched cohort study.Chinese medical journal · 2025Article
24 more citing papers are in PubMed but not listed here.
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19 authors at 15 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeoadjuvant chemotherapy (NAC) followed by radical surgery is a promising strategy to improve survival of patients with stage III gastric cancer, but is associated with the risk of preoperative overdiagnosis by which patients with early disease may receive unnecessary intensive chemotherapy.
methodsWe assessed the validity of a preoperative diagnostic criterion in a prospective multicenter study. Patients with gastric cancer with a clinical diagnosis of T2/T3/T4, M0, except for diffuse large tumors and extensive bulky nodal disease, were eligible. Prospectively recorded clinical diagnoses (cT category, cN category) were compared with postoperative pathological diagnoses (pT category, pN category, and pathological stage). The primary endpoint was the proportion of pathological stage I tumors among those diagnosed as cT3/T4, which we expected to be 5% or less.
resultsData from 1260 patients enrolled from 53 institutions were analyzed. The proportion of pathological stage I tumors in those with a diagnosis of cT3/T4 (primary endpoint) was 12.3%, which was much higher than the prespecified value. The positive predictive value and the sensitivity for pathological stage III tumors were 43.6% and 87.8% respectively. The sensitivity and specificity of contrast-enhanced CT for lymph node metastasis were 62.5% and 65.7% respectively. After exploring several diagnostic criteria, we propose, for future NAC trials in Japan, a diagnosis of "cT3/T4 with cN1/N2/N3," by which inclusion of pathological stage I tumors was reduced to 6.5%, although its sensitivity for pathological stage III tumors decreased to 64.5%.
conclusionClinical diagnosis of T3/T4 tumors was not an optimal criterion to select patients for intensive NAC trials because more than 10% of patients with pathological stage I disease were included. We propose the criterion "cT3/T4 and cN1/N2/N3" instead.
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