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The piece highlights specific genetic signals (e.g., PIK3CA amplifications and ARID1A mutations) and discusses implications for adjuvant treatment and future targeted or immunotherapeutic 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associated with recurrence patterns in diffuse-type gastric cancer?",{"text":72,"@type":64},"PIK3CA amplifications in diffuse-type gastric cancer were associated with early recurrence, while ARID1A mutations were frequently found in patients with single-site recurrence.",{"name":74,"@type":61,"acceptedAnswer":75},"Did the evaluated molecular parameters generally predict DFS and OS?",{"text":76,"@type":64},"No. Several molecular parameters, including MSI, Helicobacter pylori, EBV, and multiple genetic mutations in pathways such as PI3K/AKT and TP53, were not useful for predicting DFS and OS.","https://schema.org",{"og:url":32,"og:type":79,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":81,"canonical":32},"index,follow",{"doc_id":83,"site_id":7},436673,1791069827,{"code":4,"msg":86,"data":87},"success",[88,92,96,100,105,110,113,118,123,126,130],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Story & 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factors  \nSzu-Ting Yanga,b,c, Chia-Hao Liua,b,c, Peng-Hui Wanga,b,c,d,*  \naDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cFemale Cancer Foundation, Taipei, Taiwan, ROC; dDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC  \nMalignant diseases are the main and leading cause of death in Taiwan, contributing to an urgent need of active care for patients with malignant diseases, regardless whether the earlyor late-stage of diseases are defined.1–3 Cancer treatment can be simply grouped into two distinguished therapeutic approaches; one is the highly curative therapy applied either by surgery alone and/or radiation therapy with/without neoadjuvant therapy (NAT) or adjuvant therapy under multi-modality guidance; and the other is the palliative therapy or multidisciplinary decision-making with low possibility of curability, based on the characteristics and patterns of diseases at the initial diagnosis.4–9 Except of some specific systemic diseases, patients with an in situ or organ-limited diseases have a better chance to be cured accompanied with a long-term survival after the initial primary curative treatment.2 However, few patients with proposed curable diseases may recur later even though the initial primary active and curative treatment is given, and subsequently die of diseases, suggesting that an accurate and precise evaluation and appropriate and personalized therapeutic plan to those patients with supposedly curable diseases by far-advanced development of new technology or therapeutic strategy is critically important.10,11 All efforts make the diseases with a maximal chance for curability. The article published in the January issue of the Journal of the Chinese Medical Association entitled “The clinicopathological and genetic differences among gastric cancer patients with no recurrence, early recurrence, and late recurrence after curative surgery” attempted to explore this topic, since the authors’ enrolled subjects belonged to complete resection of tumors and all of them received the curable surgery claimed by authors.12  \nThe authors enrolled 473 patients with gastric cancer (GC) undergoing curative surgery to investigated the impact of genetic alterations and clinicopathological features on disease-free  \n*Address correspondence. Dr Peng-Hui Wang, Department of Obstetricsand Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: phwang@vghtpe.gov.tw](ROC. E-mail address: phwang@vghtpe.gov.tw);  \n[pongpongwang@gmail.com](pongpongwang@gmail.com) (P.-H. Wang).  \nConflicts of interest: Dr Peng-Hui Wang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 262-264.  \nReceived December 16, 2022; accepted December 30, 2022.  \ndoi: 10. 1097/JCMA.0000000000000872.  \nCopyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \nsurvival (DFS) and overall survival (OS) in these GC patients.12 DFS was classified as no recurrence, early recurrence (defined by \u003C 2 years) and late recurrence (defined by ≥ 2 years) .12 The authors found that PIK3CA amplifications in diffuse-type GC were associated with early recurrence and ARID1A mutations were frequently found in patients with single-site recurrence, suggesting that targeted","cbCaisMhZSojQX1V","https://ap.wps.com/l/cbCaisMhZSojQX1V","pdf",294184,"English","# Molecular pathology-integrated prognostic factors\n## Prognostic need after curative surgery\n## Genetic alterations and survival outcomes\n## Limits of evaluated molecular parameters\n## Subgroup and subtype implications\n## Future strategies: targeted therapy and immunotherapy","[{\"question\":\"Why is accurate prognostic evaluation important after curative surgery in gastric cancer?\",\"answer\":\"Because some patients with supposedly curable disease still recur later and die, requiring precise risk assessment and individualized therapeutic planning.\"},{\"question\":\"How were disease-free survival categories defined in the discussed study?\",\"answer\":\"Disease-free survival was classified into no recurrence, early recurrence (defined as less than 2 years), and late recurrence (defined as 2 years or more).\"},{\"question\":\"Which molecular findings were associated with recurrence patterns in diffuse-type gastric cancer?\",\"answer\":\"PIK3CA amplifications in diffuse-type gastric cancer were associated with early recurrence, while ARID1A mutations were frequently found in patients with single-site recurrence.\"},{\"question\":\"Did the evaluated molecular parameters generally predict DFS and OS?\",\"answer\":\"No. Several molecular parameters, including MSI, Helicobacter pylori, EBV, and multiple genetic mutations in pathways such as PI3K/AKT and TP53, were not useful for predicting DFS and OS.\"}]","Molecular pathology-integrated clinicopathological prognostic factors - editorial | PDF",1790678716]