Four Hundred Consecutive Total Gastrectomies for Gastric Cancer

Pacelli, Fabio; Papa, Valerio; Rosa, Fausto; Tortorelli, Antonio Pio; Sánchez, Alejandro Martín; Covino, Marcello; Bossola, Maurizio; Doglietto, Giovanni Battista

doi:10.1001/archsurg.143.8.769

Cited by 28 publications

(26 citation statements)

References 35 publications

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“…''Non-curative,'' ''advanced'' and ''palliative'' are dissimilar groups of patients that cannot be combined to assess outcomes for interventions. Re-defining the studies in this review left only five as being truly palliative [14,26,39,46,56]. When the intent of surgery is unclear, the results are not easily analyzed.…”

Section: Discussionmentioning

confidence: 99%

“…Intent of surgery for studies reporting outcomes for gastrectomy was re-defined according to the review criteria (Appendix Table 10). Only 9% of the studies reporting outcomes performed a truly palliative (PAL) resection per the definition that surgery was performed specifically for relief of symptoms [14,26,39,46,56] The correct definition for the intent of surgery for the rest of the articles was either non-curative (NC) [11, 12, 14, 19, 21, 23, 27, 32, 35-38, 40, 42, 47, 49, 51, 54, 57, 58, 61, 63, 66-68, 70, 71] or not otherwise specified (NOS) [13, 17, 18, 20, 24, 25, 28-31, 33, 39, 41, 43, 48, 50, 52, 53, 55, 59, 60, 69]. Mean patient age ranged from 51 to 76.4 years.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…Stage distribution was rarely reported by palliative or non-curative treatment strategy. Studies reporting outcomes for palliative resection documented gastrointestinal bleeding, pain, obstruction and weight-loss as the most common symptoms at presentation [14,26,39,46,56].…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…Authors recorded procedure-related morbidity in 12 articles (Table 1) [12,13,18,26,27,31,45,[56][57][58][65][66][67]. Morbidity was generally defined as those complications, excluding death, occurring during the hospital stay that related to the operation performed.…”

Section: Procedure-related Morbidity and Mortalitymentioning

confidence: 99%

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A systematic review of surgery for non-curative gastric cancer

et al. 2011

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Background Most gastric cancer patients present with advanced stage disease precluding curative surgical treatment. These patients may be considered for palliative resection or bypass in the presence of major symptoms; however, the utility of surgery for non-curative, asymptomatic advanced disease is debated and the appropriate treatment strategy unclear. Purpose To evaluate the non-curative surgical literature to better understand the limitations and benefits of noncurative surgery for advanced gastric cancer.Methods A literature search for non-curative surgical interventions in gastric cancer was conducted using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases from 1 January 1985 to 1 December 2009. All abstracts were independently rated for relevance by a minimum of two reviewers. Outcomes of interest were procedure-related morbidity, mortality, and survival. Results Fifty-nine articles were included; the majority were retrospective, single institution case series. Definitions describing the treatment intent for gastrectomy were incomplete in most studies. Only five were truly performed with relief of symptoms as the primary indication for surgery, while the majority were considered non-curative or not otherwise specified. High rates of procedure-related morbidity and mortality were demonstrated for all surgeries across the majority of studies and treatment-intent categories. Median and 1-year survival were poor, and values ranged widely within surgical approaches and across studies. Conclusions A lack of transparent documentation of disease burden and symptoms limits the surgical literature in non-curative gastric cancer. Improved survival is not evident for all patients receiving non-curative gastrectomy. Further prospective research is required to determine the optimal intervention for palliative gastric cancer patients.

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Section: Discussionmentioning

confidence: 99%

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Section: Procedure-related Morbidity and Mortalitymentioning

confidence: 99%

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A systematic review of surgery for non-curative gastric cancer

et al. 2011

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“…In addition, a distinct and advanced metastatic tumor growth into or within lymph nodes can lead to a palliative approach. Comparability becomes more difficult if the above-mentioned factors simultaneously occur in the case of a palliative resection [23,34].…”

Section: Introductionmentioning

confidence: 99%

Gastric carcinoma: when is palliative gastrectomy justified?

2010

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Gastric carcinoma is frequently diagnosed with an advanced stage of non-curable tumor growth characterized by infiltration of the gastric serosa, peritoneal tumor spread and/or metastases within lymph nodes and liver. Currently, there is a controversy on the value of palliative resection with regard to the safety and benefit to the patient outcome. Based on the available literature, this overview summarizes the various aspects and interprets the limited data on the palliative resection of gastric carcinoma. It turns out that the available study results may indicate potential for an improved quality of life and a prolongation of survival if an acceptable morbidity and mortality are present.

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Hereditary Diffuse Gastric Cancer

Schrader

Huntsman

2010

Cancer Treatment and Research

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Gastric cancer is one of the world's leading causes of cancer mortality. A small percentage of cases can be attributed to heritable mutations in highly penetrant cancer susceptibility genes. In this chapter we will focus on the genetic cause of hereditary diffuse gastric cancer (HDGC). Until 10 years ago, individuals from these families lived with the uncertainty of developing lethal gastric cancer. Today, HDGC families can be identified, tested for causative mutations in CDH1, and for those families where a pathogenic mutation can be identified, prophylactic total gastrectomy can be implemented in asymptomatic mutation carriers who elect to virtually eliminate their risk of developing this lethal disease.

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Four Hundred Consecutive Total Gastrectomies for Gastric Cancer

Cited by 28 publications

References 35 publications

A systematic review of surgery for non-curative gastric cancer

A systematic review of surgery for non-curative gastric cancer

Gastric carcinoma: when is palliative gastrectomy justified?

Hereditary Diffuse Gastric Cancer

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