Factors influencing survival in 242 cases of primary gastric carcinoma

Secco, G B; Fardelli, R; Campora, E; Rovida, S; Percivale, Pierluigi

doi:10.1002/jso.2930380104

Cited by 9 publications

(3 citation statements)

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“…A number of reports on the prognosis of patients with malignancies other than EGC have demonstrated that as the number of metastatic lymph nodes increases the posttreatment outcomes worsen [33][34][35][37][38][39][40][41][42]. In this study, however, the number of metastatic lymph nodes was not found to be of prognostic significance.…”

Section: Discussioncontrasting

confidence: 77%

“…Lymph node metastasis has been regarded as a prognostic factor for esophageal [32][33][34][35] and colorectal [36,37] cancer. Many studies focused on gastric cancer have revealed that node involvement is associated with worse outcomes when the analyses include advanced tumors [38][39][40][41][42][43][44]. Even if the depth of tumor invasion is limited to the submucosa, the presence of metastatic lymph nodes is observed to decrease survival rates in esophageal [45,46] and colorectal [47] cancer.…”

Section: Discussionmentioning

confidence: 99%

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Impact of lymph node metastasis on survival with early gastric cancer

1997

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The impact of lymph node metastasis on the survival of early gastric cancer (EGC) cases remains controversial. A retrospective study of 621 patients with EGC undergoing gastrectomy with lymphadenectomy during the period 1966-1993 was performed to evaluate the influence of node involvement on long-term outcomes. Lymph node metastasis was observed in 63 cases (10.1%). Two groups, EGC with and without node involvement, were compared with respect to long-term results and various clinicopathologic factors. The median observation period was 123 months. EGC cases without metastatic nodes had significantly better outcomes than those with node involvement in terms of overall survival as well as survival excluding deaths due to diseases unrelated to the primary EGC. Survival rates for EGC patients with node involvement did not, however, differ significantly according to the number of metastatic nodes. Three factors-submucosal invasion, large tumor size, and recurrence-were significantly related to lymph node metastasis. Age, sex, family history of malignancy, histologic type, and multiple occurrence of gastric cancer were unrelated to the prevalence of node involvement. The frequency of recurrence in EGC cases without node involvement was low (1.8%, 10 of 558). Recurrence was not, however, exceptional in those with metastatic nodes (9.5%, 6 of 63). EGC patients with lymph node metastasis, even with only a single positive node, constitute a high risk group for EGC recurrence.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Impact of lymph node metastasis on survival with early gastric cancer

1997

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“…Unfortu nately, the many variables that play an important role in the outcome of noncurative resection have not been well defined and there are no well-established guidelines for surgeons [3,8,11,12], Of 550 patients with primary gastric cancer present ing in an 18-year period, 274 (49.8%) underwent noncu rative surgery. This is comparable with the incidence of advanced gastric cancer reported by many other western authors [1,[3][4][5],…”

Section: Discussionmentioning

confidence: 99%

Variables Influencing the Choice and Outcome of Noncurative Surgery for Advanced Gastric Cancer

Secco¹,

Fardelli²,

Campora

et al. 1990

Dig Surg

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Of 550 patients with gastric cancer presenting in an 18-year period, 274 (49.8 %) underwent noncurative surgery. Surgery was noncurative due to invasion of adjacent organs (T4) in 19.7% of patients, extensive lymph node involvement (N₃) in 4%, unresectable distant metastases in 27.7% or a combination of all three conditions in 48.5% of cases. Resection was carried out in 41.4% of patients with primary situated in the antrum and in only 12.2.% with multicentric primary ( p < 0.001). Overall operative mortality was 29.9% in our series and did not differ significantly according to type of surgery. Mortality was 52% after total gastrectomy and 18% after subtotal gastric resection (p < 0.01). In patients undergoing resection, mortality increased significantly with age ( > 70 years old) and tumor stage. Six of the total 274 patients were alive 5 years from noncurative surgery. Subtotal gastric resection is the surgical procedure to be preferred. In the absence of distant metastases, resection should be considered in patients with primary situated in the body or antrum, with T₄N_0–2 or T₃N₃ lesions. Resection is also warranted when distant metastases can be excised.

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