Retrospective Analysis of HER-2 as A Prognostic Factor in Locally Advanced & Metastatic Gastric or Gastroeosphageal Cancer

Abstract

Gastric cancer is the third leading cause of cancer death worldwide, with the highest rates reported in East Asia, South America and Eastern Europe. The lowest reported incidence is in North America. It is relatively uncommon in the United States, causing an estimated 10,000 deaths per year (Siegel et al., 2015). In our study, 81 patients with locally advanced & metastatic gastric cancer were reviewed from medical records of Ain Shams University Hospital from 2011-2014 including their clinicoepidemiological data e.g.: age- sex- PS- operative details- pathological information & other data about their treatment course were collected. Additionaly, patients with available paraffin blocks (38 patients) were collected to do IHC of HER-2 on it to correlate between HER-2 status & prognosis in patients who didn't receive trastuzumab. Our sample was divided into 3 groups: Gasteosphageal group (9 patients)- locally advanced group (34 patients)- metastatic group (39 patients). 65% of the studied population age >45 years & 55% were males. 56.8% of them were smokers .Most common site of 1ry tumour was the antrum representing 33%. Patients commonly clinically presented with vomiting 40.7% & with PS at presentation Summary 177 ECOG2 48.1% .Patients were stage IV at presentation mostly representing 33.3%, mainly to liver 39.5%. The main clinical benefit from chemotherapy was SD .Median OS was 16 months among locally advanced group & 6 months among metastatic group. Improved survival significantly for those patients received more than one line of chemotherapy in comparison to one line & to no treatment Her-2 neu positive gastric cancer patients have poor prognosis with significant deterioration in OS & PFS to be of 6, 3 months respectively in comparison to negative patients 10 ,6 months respectively.