Recurrence in Pn0 Gastric Cancer: Risk Factors in the Occident

Nobre, Karolyne Ernesto Luiz; Pereira, Marina Alessandra; Ramos, Marcus Fernando Kodama Pertille; Ribeiro, Ulysses; Zilberstein, Bruno; Ivan, Cristina; Dias, André Roncon

doi:10.1590/0102-672020210001e1562

Cited by 2 publications

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References 28 publications

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“…It is estimated that more than 1 million (1,033,701) new cases of GC occurred worldwide in 2018 4 . Surgery remains the main curative treatment option, and gastrectomy with D2 lymphadenectomy is considered the standard surgical treatment for locally advanced stage 2 , 22 . Unfortunately, many patients at the time of diagnosis have already locally unresectable tumors or signs of systemic disease.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment in Clinical Stage Iv Gastric Cancer: A Comparison of Different Procedures and Survival Outcomes

Ramos

Pereira

Dias

et al. 2022

ABCD, arq. bras. cir. dig.

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- BACKGROUND: Even in clinical stage IV gastric cancer (GC), surgical procedures may be required to palliate symptoms or in an attempt to improve survival. However, the limited survival of these patients raises doubts about who really had benefits from it. AIM: This study aimed to analyze the surgical outcomes in stage IV GC treated with surgical procedures without curative intent. METHODS: Retrospective analyses of patients with stage IV GC submitted to surgical procedures including tumor resection, bypass, jejunostomy, and diagnostic laparoscopy were performed. Patients with GC undergoing curative gastrectomy served as the comparison group. RESULTS: Surgical procedures in clinical stage IV were performed in 363 patients. Compared to curative surgery (680 patients), stage IV patients had a higher rate of comorbidities and ASA III/IV classification. The surgical procedures that were performed included 107 (29.4%) bypass procedures (partitioning/gastrojejunal anastomosis), 85 (23.4%) jejunostomies, 76 (20.9%) resections, and 76 (20.9%) diagnostic laparoscopies. Regarding patients’ characteristics, resected patients had more distant metastasis (p=0.011), bypass patients were associated with disease in more than one site (p<0.001), and laparoscopy patients had more peritoneal metastasis (p<0.001). According to the type of surgery, the median overall survival was as follows: resection (13.6 months), bypass (7.8 months), jejunostomy (2.7 months), and diagnostic (7.8 months, p<0.001). On multivariate analysis, low albumin levels, in case of more than one site of disease, jejunostomy, and laparoscopy, were associated with worse survival. CONCLUSION: Stage IV resected cases have better survival, while patients submitted to jejunostomy and diagnostic laparoscopy had the worst results. The proper identification of patients who would benefit from surgical resection may improve survival and avoid futile procedures.

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Section: Introductionmentioning

confidence: 99%

Surgical Treatment in Clinical Stage Iv Gastric Cancer: A Comparison of Different Procedures and Survival Outcomes

Ramos

Pereira

Dias

et al. 2022

ABCD, arq. bras. cir. dig.

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Hospital Volume, Postoperative Mortality, and Costs After Gastrectomy for Gastric Cancer in Colombia: Is There Any Association?

Cuesta

Cruz

Buitrago

2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: There are no information in the literature associating the volume of gastrectomies with survival and costs for the health system in the treatment of patients with gastric cancer in Colombia. AIMS: The aim of this study was to analyze how gastrectomy for gastric cancer is associated with hospital volume, 30-day and 180-day postoperative mortality, and healthcare costs in Bogotá, Colombia. METHODS: A retrospective cohort study based on hospital data of all adult patients with gastric cancer who underwent gastrectomy between 2014 and 2016 using a paired propensity score. The surgical volume was identified as the average annual number of gastrectomies performed by the hospital. RESULTS: A total of 743 patients were included in the study. Hospital mortality at 30 and 180 days postoperatively was 36 (4.85%) and 127 (17.09%) patients, respectively. The average health care cost was USD 3,200. A total of 26 or more surgeries were determined to be the high surgical volume cutoff. Patients operated on in hospitals with a high surgical volume had lower 6-month mortality (HR 0.44; 95%CI 0.27–0.71; p=0.001), and no differences were found in health costs (mean difference 398.38; 95%CI–418.93–1,215.69; p=0.339). CONCLUSIONS: This study concluded that in Bogotá (Colombia), surgery in a high-volume hospital is associated with better 6-month survival and no additional costs to the health system.

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Recurrence in Pn0 Gastric Cancer: Risk Factors in the Occident

Cited by 2 publications

References 28 publications

Surgical Treatment in Clinical Stage Iv Gastric Cancer: A Comparison of Different Procedures and Survival Outcomes

Surgical Treatment in Clinical Stage Iv Gastric Cancer: A Comparison of Different Procedures and Survival Outcomes

Hospital Volume, Postoperative Mortality, and Costs After Gastrectomy for Gastric Cancer in Colombia: Is There Any Association?

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