3Kierownik: dr n. med. r. Hansdorfer-Korzon Breast cancer often requires combined oncologic treatments, the base of which is surgery. Quality of life (QoL) after each surgical procedure may influence the process of decision making among women, who qualify for multiple oncological strategies. our knowledge about QoL in breast cancer patients is derived from comparative studies. Results may differ, depending on country, culture, and societal relations. the aim of the study was to investigate the quality of life of Polish patients treated with breastconserving therapy (BCT) or mastectomy with breast reconstruction. material and methods. The study involved women who underwent surgery for breast cancer in the Department of Surgical oncology of the Gdynia oncology Center from September 2010 to November 2013. Eighty-two breast reconstructions (in 79 patients) and 226 BCT procedures were performed. QoL was measured with the use of EoRTC QLQ-C30 and QLQ-BR23 questionnaires. Results. Global QoL was high in both groups and did not differ significantly. Body image was slightly better after BCT than after mastectomy with breast reconstruction, but sexual QoL was lower. Future perspective was quite low in both groups. Disease symptoms were not bothering. conclusions. The global QoL among Polish breast cancer patients treated with BCT or mastectomy with breast reconstruction is high and does not differ between groups. There is a need for anxiety and disease-related fear prophylaxis and for the improvement of sex life of breast cancer survivors.
IntroductionSurgical resection is the only potentially curative modality for gastric cancer and it is associated with substantial morbidity and mortality.AimTo determine risk factors for postoperative morbidity and mortality following major surgery for gastric cancer.Material and methodsBetween 1.08.2006 and 30.11.2014 in the Department of Oncological Surgery of Gdynia Oncology Centre 162 patients underwent gastric resection for adenocarcinoma. All procedures were performed by 13 surgeons. Five of them performed at least two gastrectomies per year (n = 106). The remaining 56 resections were done by eight surgeons with annual volume lower than two. Perioperative mortality was defined as every in-hospital death and death within 30 days after surgery. Causes of perioperative deaths were the matter of in-depth analysis.ResultsOverall morbidity was 23.5%, including 4.3% rate of proximal anastomosis leak. Mortality rate was 4.3%. Morbidity and mortality were not dependent on: age, gender, body mass index, tumour location, extent of surgery, splenectomy performance, or pTNM stage. The rates of morbidity (50% vs. 21.3%) and mortality (16.7% vs. 3.3%) were significantly higher in cases of tumour infiltration to adjacent organs (pT4b). Perioperative morbidity and mortality were 37.5% and 8.9% for surgeons performing less than two gastrectomies per year and 16% and 0.9% for surgeons performing more than two resections annually. The differences were statistically significant (p = 0.002, p = 0.003).ConclusionsAnnual surgeon case load and adjacent organ infiltration (pT4b) were significant risk factors for morbidity and mortality following major surgery for gastric cancer. The most common complications leading to perioperative death were cardiac failure and proximal anastomosis leak.
Age itself is not a risk factor for postoperative complications in spite of higher rate of accompanying diseases in elderly.
There is no complete coincidence in gastric cancer between the occurrence of the HER2 gene amplification and the HER2 receptor expression. The impact of the HER2 gene status and HER2 protein on prognosis in gastric cancer remains unclear. Chromosome 17 polysomy may be an important negative prognostic factor in gastric cancer.
Introduction. Gastrectomy for cancer remains a challenge for both the patient and the surgical team. It is regarded as a high-risk surgery with extensive postoperative trauma and significant morbidity and mortality. The experience in the preparation and selection for operative treatment and surgery itself are important factors affecting the outcome. The aim of the study was to analyse, on the basis of the first 6 years of departmental functioning, whether the change in surgical department profile from general to oncological surgery affects the outcome of major surgery for gastric cancer. Materials and methods. Data collected from 114 consecutive patients that underwent major surgery for gastric cancer in the first 6 years of activity of our department were retrospectively reviewed. The department was created on the basis of a previously existing general surgery unit. There were 87 radical and 27 palliative resections. Total gastrectomy was the most common procedure (84%). The material was divided into 2 groups: patients who underwent surgery during first 3 years of the department's existence (group I, n = 47) and patients who underwent surgery in the second 3-year period (group II, n = 67). Results. In the second three-year period we found: a higher mean age of patients (67.7 vs 63.1 years), a higher rate of artificial feeding applied (94% vs 66%), a higher mean number of harvested lymph nodes (21.3 vs 15.9), a lower rate of oesophageal anastomosis leak (0 vs 8.5%) and an improved 2-year survival rate (62.7% vs 44.7%). All of the mentioned differences exceeded the level of statistical significance. Postoperative mortality was 1.5% in group II and 8.5% in group I (p > 0.05). Conclusion. A surgical department profile focused on surgical oncology improves the outcome of major surgery for gastric cancer.
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