Clinical significance of gastric outlet obstruction on the oncologic and surgical outcomes of radical surgery for carcinoma of the distal stomach

Park, Seong Heum; Mok, Young Jae; Kim, Jong Han; Kim, Seungjoo; Kim, Chong Suk

doi:10.1002/jso.21256

Cited by 12 publications

(11 citation statements)

References 28 publications

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“…Tumor size more than 5 cm [15] and pathological T4 in our series predicted increased morbidity. Gastric outlet obstruction was not reported to be associated with increased incidence of high grade postoperative complications [35]. Large tumors and presence of gastric outlet obstruction can be associated with cancer cachexia and nutritional problems which account for significant morbidity.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Morbidity and Mortality Following D2 Gastrectomy-an Audit of 456 Cases

Sunil

Seshadri

Mahajan

et al. 2015

Indian J Surg Oncol

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Section: Discussionmentioning

confidence: 99%

Postoperative Morbidity and Mortality Following D2 Gastrectomy-an Audit of 456 Cases

Sunil

Seshadri

Mahajan

et al. 2015

Indian J Surg Oncol

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“…Hu et al [30] reported a postoperative complication rate of 10.2% in 1,184 patients with advanced gastric cancer. The most common major complication in the LDG group was pancreatic fistula, which tends to reflect surgical inexperience and a learning curve [34] . Pancreatic fistulas occurred in 3 patients undergoing LDG in 2010, the year we started performing D2 lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic vs. open distal gastrectomy for advanced gastric cancer in elderly patients: a retrospective study

Yuu¹,

Tsuchihashi²,

Toyoda³

et al. 2019

MIS

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Aim: It is unclear whether elderly patients with advanced gastric cancer can benefit from laparoscopic gastrectomy. This study aimed to compare the surgical and early postoperative outcomes of laparoscopic distal gastrectomy with those of open distal gastrectomy for advanced gastric cancer in elderly patients aged 75 years or older. Methods: We retrospectively examined all elderly patients who underwent laparoscopic distal gastrectomy or open distal gastrectomy from October 2010 to October 2017 using prospectively collected data. Operative results, hospital courses, and survival rates were compared between the two groups. Results: Distal gastrectomy was performed in 60 patients, laparoscopically in 20 and through open surgery in 40. The laparoscopic group had significantly lesser intraoperative blood loss (100 mL vs. 300 mL; P < 0.001) and shorter mean postoperative hospital stays (12 days vs. 23 days; P < 0.001). The overall 3-year survival rate was 50.1% in the laparoscopic group and 41.7% in the open group (P = 0.531). Conclusion: Laparoscopic distal gastrectomy led to a faster return to a full diet and a shorter postoperative hospital stay in our study, and it was well tolerated by elderly patients with advanced gastric cancer.

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“…Whether obstruction is associated with a more advanced disease stage or impedes food intake, which may contribute to a poor outcome, remains open to question. In a retrospective study of patients who underwent radical surgery for distal cancers, gastric outlet obstructions significantly reduced the survival time from 50.8 to 30.6 months (P=0.001) [22]. …”

Section: Discussionmentioning

confidence: 99%

Perioperative Epirubicin, Oxaliplatin, and Capecitabine Chemotherapy in Locally Advanced Gastric Cancer: Safety and Feasibility in an Interim Survival Analysis

Ostwal

Sahu²,

Ramaswamy

et al. 2017

J Gastric Cancer

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PurposePerioperative chemotherapy improves survival outcomes in locally advanced (LA) gastric cancer.Materials and MethodsWe retrospectively analyzed patients with LA gastric cancer who were offered perioperative chemotherapy consisting of epirubicin, oxaliplatin, and capecitabine (EOX) from May 2013 to December 2015 at Tata Memorial Hospital in Mumbai.ResultsAmong the 268 consecutive patients in our study, 260 patients (97.0%) completed neoadjuvant chemotherapy, 200 patients (74.6%) underwent D2 lymphadenectomy, and 178 patients (66.4%) completed adjuvant chemotherapy. The median follow-up period was 17 months. For the entire cohort, the median overall survival (OS), 3-year OS rate, median progression-free survival (PFS), and 3-year PFS rate were 37 months, 64.4%, 31 months, and 40%, respectively. PFS and OS were significantly inferior in patients who presented with features of obstruction than in those who did not (P=0.0001). There was no difference in survival with respect to tumor histology (well to moderately differentiated vs. poorly differentiated, signet ring vs. non-signet ring histology) or location (proximal vs. distal). Survival was prolonged in patients with an early pathological T stage and a pathological node-negative status. In a multivariate analysis, postoperative pathological nodal status and gastric outlet obstruction on presentation significantly correlated with survival.ConclusionsEOX chemotherapy with curative resection and D2 lymphadenectomy is a suggested alternative to the existing perioperative regimens. The acceptable postoperative complication rate and relatively high resection, chemotherapy completion, and survival rates obtained in this study require further evaluation and validation in a clinical trial.

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Clinical significance of gastric outlet obstruction on the oncologic and surgical outcomes of radical surgery for carcinoma of the distal stomach

Cited by 12 publications

References 28 publications

Postoperative Morbidity and Mortality Following D2 Gastrectomy-an Audit of 456 Cases

Postoperative Morbidity and Mortality Following D2 Gastrectomy-an Audit of 456 Cases

Laparoscopic vs. open distal gastrectomy for advanced gastric cancer in elderly patients: a retrospective study

Perioperative Epirubicin, Oxaliplatin, and Capecitabine Chemotherapy in Locally Advanced Gastric Cancer: Safety and Feasibility in an Interim Survival Analysis

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