A population-based study of tumor-node relationship, resection margins, and surgeon volume on gastric cancer survival

Gara, Christopher J. de; Hanson, John; Hamilton, Stewart M.

doi:10.1016/s0002-9610(03)00116-8

Cited by 52 publications

(45 citation statements)

References 19 publications

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“…A population-based Canadian study showed that over 60% of patients taken to the operating theater for the purpose of resection had stage III or IV disease, with median survivals of 12 or 3 months, respectively [2]. Similar survival data have subsequently been reported from the United States [3][4][5].…”

Section: Introductionmentioning

confidence: 56%

“…As in much of North America and Europe, gastric cancer in Canada often presents at an advanced stage [2,21]. As a result, trying to choose the best treatment/ palliation for patients with incurable disease is a common and diffi cult dilemma faced by general surgeons.…”

Section: Palliative Therapymentioning

confidence: 99%

“…There are many proposed explanations for the poor quality of gastric cancer surgery recently documented in North America. These include a low volume of cases per surgeon [2,18], inadequate operative exposure during residency, late presentation typically seen in a nonscreened population [10], a nihilistic approach to patients with gastric cancer, and published evidence that the extent of surgery does not correlate with survival [8,19]. We speculated that many surgeons are unaware of the quality indicators for gastric cancer surgery.…”

Section: Introductionmentioning

confidence: 99%

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Surgeons' knowledge of quality indicators for gastric cancer surgery

et al. 2007

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Section: Introductionmentioning

confidence: 56%

Section: Palliative Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgeons' knowledge of quality indicators for gastric cancer surgery

et al. 2007

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“…Em um estudo a incidência foi de 8,2% em 572 operações.9 Outro estudo detectou acometimento da margem proximal em 1% das 2740 gastrectomias subtotais avaliadas 4 . De Gara et al 5 demonstraram margem comprometida em 6% dos 121 pacientes estádio 1 e 2 da classificação TNM; 22% dos 132 pacientes com estádio 3 e 25% dos 60 pacientes com 4. Os autores incluíram nessa análise tanto a margem proximal quanto a distal em pacientes submetidos a gastrectomia subtotal e total.…”

Section: Discussionunclassified

Análise da margem cirúrgica proximal do estômago em pacientes submetidos à gastrectomia subtotal por adenocarcinoma

Freitas¹,

Dias²,

Okawa³

et al. 2008

ABCD, arq. bras. cir. dig.

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RACIONAL: A gastrectomia subtotal atualmente é considerada padrão ouro no tratamento da neoplasia gástrica do terço médio e distal. No entanto, foi demonstrado que a ocorrência de neoplasia residual na margem cirúrgica proximal está associada à redução da sobrevida. OBJETIVOS: analisar a margem cirúrgica proximal no exame anátomo-patológico de pacientes submetidos à gastrectomia subtotal por adenocarcinoma gástrico e identificar os fatores relacionados com o acometimento neoplásico dessa margem. MÉTODOS: No período entre janeiro de 1998 e dezembro de 2007 foram revisados os prontuários dos pacientes submetidos à gastrectomia subtotal devido a adenocarcinoma gástrico do terço médio e distal. Os pacientes foram analisados quanto à idade, sexo, classificação de Lauren, classificação de Borrmann, maior diâmetro da lesão, localização da lesão no estômago, clínico e presença de invasão angiolinfática. Foi realizada análise univariada desses dados em relação ao acometimento da margem proximal do estômago no exame anátomo-patológico. RESULTADOS: Foram analisados 104 casos: 34 do sexo feminino e 70 do sexo masculino com idade média de 57±13 anos. Doze pacientes (12,3%) apresentaram acometimento da margem proximal. A análise univariada entre os fatores analisados e o acometimento neoplásico da margem proximal demonstrou associação somente em relação à classificação de Borrmann. CONCLUSÃO: A classificação macroscópica de Borrmann, especialmente nos estágios III e IV, está relacionada à presença de acometimento da margem proximal nos casos de adenocarcinoma gástrico dos terços médio e distal submetidos a tratamento com gastrectomia subtotal.

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“…In North America and Europe, gastric cancer commonly presents at a late stage with frequent involvement of surrounding organs, and is generally associated with poor outcomes [1,2]. The pancreas is involved in up to 50% of advanced cases; often it is the only organ involved [3,4].…”

Section: Introductionmentioning

confidence: 99%

Systematic review of pancreaticoduodenectomy for locally advanced gastric cancer

et al. 2011

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Background The purpose of this study was to identify and synthesize findings from all articles on surgical and longterm outcomes in patients with gastric cancer undergoing gastrectomy combined with pancreaticoduodenectomy (PD). Methods Electronic literature searches were conducted using Medline, EMBASE, and Cochrane databases from January 1, 1985, to December 31, 2009. Results Eight retrospective case series were included, with 132 patients having PD combined with gastrectomy. PD was combined with total gastrectomy in 27 patients, and subtotal gastrectomy in 81 patients; 24 patients had undocumented gastric resection type. Clinical stage was available for 92 patients (4 stage I, 7 stage II, 26 stage III, and 55 stage IV). Five studies (98 patients having PD combined with gastrectomy) compared PD and gastrectomy to gastrectomy alone. In the four studies reporting morbidity, PD had a higher morbidity. The pooled pancreatic anastomotic leak rate was 24.5% for the seven studies in which complications were reported; however, there were no peri-operative deaths. Long-term survival (37.3% at 5 years) in gastric cancer patients with PD combined with gastrectomy was described; however, survival was poor in the setting of incurable factors. Due to heterogeneity of patients and staging techniques in the case series no recommendations can be made on the appropriate selection criteria for patients undergoing PD and gastrectomy. Conclusion PD for gastric cancer invading the pancreas is associated with a higher morbidity; given the heterogeneous data, defining exact selection criteria is difficult.

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A population-based study of tumor-node relationship, resection margins, and surgeon volume on gastric cancer survival

Cited by 52 publications

References 19 publications

Surgeons' knowledge of quality indicators for gastric cancer surgery

Surgeons' knowledge of quality indicators for gastric cancer surgery

Análise da margem cirúrgica proximal do estômago em pacientes submetidos à gastrectomia subtotal por adenocarcinoma

Systematic review of pancreaticoduodenectomy for locally advanced gastric cancer

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