Recent advances in surgical treatment have improved the survival of patients with gastric carcinoma

Otsuji, Eigo; Yamaguchi, Toshiharu; Sawai, Kiyoshi; Hagiwara, Akeo; Taniguchi, Hiroki; Takahashi, Toshio

doi:10.1002/(sici)1097-0142(19980401)82:7<1233::aid-cncr4>3.0.co;2-g

Cited by 41 publications

(8 citation statements)

References 14 publications

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“…21,22 However, there are studies showing that the degree of lymph node dissection was a significant factor correlated with the survival time after curative resection for gastric cancer. 6,23,24 The current study revealed that lymph node metastasis is the most important factor predicting the timing of recurrence, and patients with lymph node involvement more frequently died of recurrence within 2 years after curative gastrectomy for gastric cancer. Intergroup-0116, a prospective multi-institution phase III trial evaluating postoperative combined chemoradiation versus surgery alone in 556 patients with completely resected stage IB to stage IV M0 adenocarcinoma of the stomach and gastroesophageal junction, reported a significant survival benefit with adjuvant combined-modality therapy.…”

Section: Discussionmentioning

confidence: 99%

Timing of Death From Tumor Recurrence After Curative Gastrectomy for Gastric Cancer

Sakar

Karagöl²,

Gümüş³

et al. 2004

American Journal of Clinical Oncology

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In Western literature, there are few studies investigating the predictors of early versus late recurrence after curative gastrectomy for gastric cancer. The current study analyzed (1) patients who died of recurrent gastric cancer and (2) prognostic factors, which can be applied to timing of death from tumor recurrence. Of 492 patients who underwent curative resection (R0) for gastric cancer in the Department of Surgery, Medical Faculty of Istanbul between 1994 and 2000, 142 patients who died of recurrence were included into study. None of the patients had received postoperative adjuvant treatment. The patients were divided into 2 groups: an early recurrence group that included 102 patients who recurred and died within 2 years after surgery, and a late recurrence group, which included 40 patients who died of recurrence more than 2 years after surgery. Clinicopathologic findings were compared between the early and late recurrence groups. Multivariate analysis was performed to investigate the independent factors, which are predictive for early versus late recurrence, and prognostic factors independently associated with the survival period. In multivariate analysis, the early recurrence group, when compared with the late recurrence group, was characterized by lymph node metastasis (N1-3 versus N0; P = 0.002). Overall survival was influenced by nodal status (N1-3 versus N0; P = 0.003), type of operation performed (radical total versus radical subtotal gastrectomy; P = 0.003), Eastern Cooperative Oncology Group performance status (PS 3-4 versus PS 1-2; P = 0.004), and tumor localization (cardia versus corpus and antrum; P = 0.046). In contrast, T stage of the disease was not prognostic for survival, although it was close to statistical significance (P = 0.066). Multivariate analysis showed that poorer performance status at initial presentation (P = 0.001) and lymph node metastasis (P = 0.032) independently correlated with overall survival (P = 0.002). Lymph node status was the most important factor predictive for early versus late recurrence and patients with lymph node metastases were at more risk of death within 2 years after curative operation for gastric cancer. Postoperative chemoradiotherapy should be especially recommended for patients at high risk of recurrence of adenocarcinoma of the stomach or who have undergone curative resection.

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Section: Discussionmentioning

confidence: 99%

Timing of Death From Tumor Recurrence After Curative Gastrectomy for Gastric Cancer

Sakar

Karagöl²,

Gümüş³

et al. 2004

American Journal of Clinical Oncology

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“…In recent years, the emphasis on regular cancer screening programs and advances in diagnostic techniques has greatly improved the detection rate of early gastric cancer (EGC) [2]. In Korea, a population-based mass-screening program for GC was initiated by the Ministry of Health and Welfare in 2002.…”

Section: Introductionmentioning

confidence: 99%

“…Although this screening program does not completely cover the target population, it already has led to an increase in the detection rate of EGCs from 33% in 1999 to 60% in 2012, and has subsequently contributed to an improved clinical outcome for GC [4]. In addition, advances in surgical techniques and multimodal treatments have also improved survival [2,5,6]. Because of this prolongation in survival, GC patients live longer, but have a greater possibility of developing multiple primary cancer (MPC).…”

Section: Introductionmentioning

confidence: 99%

Prediction of metachronous multiple primary cancers following the curative resection of gastric cancer

et al. 2013

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BackgroundDue to improved survival rate, gastric cancer (GC) patients have an increased risk of developing multiple primary cancer (MPC). The purpose of this study is to evaluate the clinicopathological features of MPC and to generate useful tools for the prediction of metachronous MPC following gastrectomy.Methods3066 patients who underwent curative resection of GC were reviewed retrospectively, based on the clinical information and the medical record.ResultsThe 5-year incidence of MPC was 2.5%. Of these, 54.3% had a metachronous MPC, while 45.7% had a synchronous MPC. The most prevalent site of metachronous MPC was the colorectum (26.3%), followed by lung (23.7%) and liver (18.4%). Multivariate logistic regression analysis revealed that old age at the time of GC diagnosis (≥60 years), early stage of GC (stage I and II), and multiplicity of GC at the time of gastrectomy were independent predictive factors for metachronous MPC. GC patients with either metachronous or synchronous MPC showed poorer survival than patients without MPC. In addition, patients with a metachronous MPC showed late survival disadvantage, while patients with a synchronous MPC showed early survival disadvantage. Furthermore, we were able to develop and internally validate a nomogram to predict the metachronous MPC after curative gastrectomy (C-index = 0.72).ConclusionPatients at high risk of developing metachronous MPC after curative resection of GC were identified. Individual risk of developing metachronous MPC could be predicted by a novel nomogram. Further external validation with independent patient cohorts is required to improve the accuracy of prediction.

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“…With the increased detection of early gastric cancer and the improvement of surgical procedure during the past three decades (1-3), gastric cancer survival has improved. Long-term follow-up for recurrence has led to an increased incidence of second primary cancers (4,5).…”

Section: Introductionmentioning

confidence: 99%

Clinicopathologic Features of Metachronous or Synchronous Gastric Cancer Patients with Three or More Primary Sites

et al. 2010

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PurposeWe investigated the clinicopathologic information of patients with gastric cancer with multiple primary cancers (GC-MPC) of three or more sites.Materials and MethodsBetween 1995 and 2009, 105,908 patients were diagnosed with malignancy at Severance Hospital, Yonsei University Health System. Of these, 113 (0.1%) patients with MPC of three or more sites were registered, and 41 (36.3%) of these were GC-MPC. We retrospectively reviewed the clinical data and overall survival using the medical records of these 41 GC-MPC patients. We defined synchronous cancers as those occurring within 6 months of the first primary cancer, while metachronous cancers were defined as those occurring more than 6 months later.ResultsPatients with metachronous GC-MPC were more likely to be female (p=0.003) and young than patients with synchronous GC-MPC (p=0.013). The most common cancer sites for metachronous GC-MPC patients were the colorectum, thyroid, lung, kidney and breast, while those for synchronous GC-MPC were the head and neck, esophagus, lung, and kidney. Metachronous GC-MPC demonstrated significantly better overall survival than synchronous GC-MPC, with median overall survival durations of 4.7 and 14.8 years, respectively, and 10-year overall survival rates of 48.2% and 80.7%, respectively (p<0.001).ConclusionMultiplicity of primary malignancies itself does not seem to indicate a poor prognosis. The early detection of additional primary malignancies will enable proper management with curative intent.

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Recent advances in surgical treatment have improved the survival of patients with gastric carcinoma

Abstract: It was concluded that survival has been improved by recent advances in the surgical approach to gastric carcinoma.

Cited by 41 publications

References 14 publications

Timing of Death From Tumor Recurrence After Curative Gastrectomy for Gastric Cancer

Timing of Death From Tumor Recurrence After Curative Gastrectomy for Gastric Cancer

Prediction of metachronous multiple primary cancers following the curative resection of gastric cancer

Clinicopathologic Features of Metachronous or Synchronous Gastric Cancer Patients with Three or More Primary Sites

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