The CancerWeb Report, What's New In Cancer: June, 1996
Stomach Cancer

• Blood vessel numbers as an indicator of prognosis - Stomach cancer is a decreasing clinical problem in the US and Europe, but in Japan it is the cause of a very significant fraction of all cancer deaths. Metastatic disease has a poor prognosis. Researchers at the Fukui Medical School in Japan analyzed the association between the number of tiny blood vessels - microvessels - in slides prepared from tumor specimens taken from 107 patients. They found that blood vessel counts by CD34 staining, were higher (154 and 210 per microscope field, respectively) in those who developed metastases in the abdominal cavity (41 patients) or spread by the blood to distant sites (24 patients) than in those whose tumors did not metastasize after surgery (106 per field). There was an increase in blood-spread metastases, but not in abdominal cavity metastases as the number of vessels increased. In contrast, no relationship was seen between vessel counts and lymph node metastases. Using a cut-off point of 155 vessels per field, patients receiving adjuvant chemotherapy after surgery showed 7-year survival rates of 59% for those below, and only 10% for those with higher counts. Tumor vascularization appeared to be a very good prognostic indicator for this disease. (Tanigawa, Cancer Research 56:2671, 1996)

  Editor's Comment: - See also the bladder cancer section in this month's (June 1996) Cancer Web Report, and the February 1996 Cancer Web Report on colorectal cancer and neuroblastoma.

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• Bone marrow micrometastases - A second potential prognostic indicator for stomach cancer was described by doctors at the Ludwig-Maximilians University in Munich, Germany. They examined the bone marrow of 180 newly-diagnosed stomach cancer patients for cells that stained with an antibody (CK2) to cytokeratin 18, a component of epithelial cells. Ninety-five (53%) of the patients had between one and 122 stained cells per million mononuclear bone marrow cells. Of the 109 patients who underwent curative surgery, 51% were similarly positive for CK2. Disease-free (42, 39, and 29 months) and overall (38, 31, and 25 months) survival of these patients was highly correlated with the number of CK2 positive cells in the marrow, for negative, 1-3 cells, greater than 3 cells categories, respectively. Bone-marrow micrometastases may be a valuable guide to the need for adjuvant therapy. (Jauch, J Clin Oncol 14:1810, 1996)

  Editor's Comment: - Similar results have been found with measurements of cytokeratin in breast cancer patients (See this month's Cancer Web Report Breast Cancer Section).