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Updated: Aug 7, 2026
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Genome-Wide Analysis of DNA Methylation in Gastrointestinal Cancer
Published on: September 18, 2020
Primary Tumor Genomics and Patterns of Distant Recurrence in Resected Gastric Cancer
Max R Coffey1, Jierui Xu2, Pranita Atri2
1Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
JAMA Surgery
|August 5, 2026
Summary
Genomic profiling of gastric tumors reveals key alterations like KRAS and PIK3CA linked to recurrence. Understanding these genetic markers can personalize post-surgery care for gastric cancer patients.
Area of Science:
- Oncology
- Genomics
- Cancer Research
Background:
- Gastric cancer recurrence post-surgery poses a significant risk.
- Molecular profiling of primary tumors can enhance risk stratification for better postoperative management.
Purpose of the Study:
- To identify genomic features in primary gastric tumors associated with disease recurrence.
- To understand genomic patterns linked to specific metastatic spread (hematogenous, peritoneal, lymphatic).
Main Methods:
- A single-center cohort study included 377 patients with gastric adenocarcinoma undergoing curative resection (stages I-III) from 2010-2024.
- Primary tumor genomic sequencing was performed using a targeted cancer-associated gene panel (MSK-IMPACT).
- Disease-free survival and metastatic patterns were correlated with primary tumor genomic profiles.
Main Results:
- KRAS and PIK3CA alterations were independently associated with worse disease-free survival.
- Hematogenous recurrence was linked to higher chromosomal instability and cell cycle gene alterations compared to peritoneal recurrence.
- Bone metastasis originated from more genomically stable tumors with Lauren diffuse-type histology.
Conclusions:
- Genomic alterations in primary gastric tumors are associated with disease-free survival and recurrence patterns.
- Identified clinicogenomic factors may enable personalized postoperative surveillance.
- Findings can inform perioperative treatment decisions for gastric cancer patients.
