Results of specialization in the surgical treatment of gastric cancer in Peru

Portanova, Michel; Vargas, Fernando; Lombardi, Emilio; Mena, Víctor; Carbajal, Ramiro; Palacios, Néstor; Orrego, Jorge

doi:10.1007/s10120-007-0413-z

Cited by 10 publications

(12 citation statements)

References 29 publications

(45 reference statements)

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“…Several studies suggested that GC surgery should be performed in specialized centers as they found the rate of mortality and morbidity was significantly lower if GC patients were operated on by surgeons with high caseloads or coming from specialized units [15][16][17]. Our result was different from these studies.…”

Section: Discussioncontrasting

confidence: 95%

The positive impact of surgeon specialization on survival for gastric cancer patients after surgery with curative intent

Liang

Wang

et al. 2014

Gastric Cancer

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Background Many studies have affirmed the survival benefit for cancer patients treated by specialized surgeons. Methods A total of 967 patients with gastric cancer (GC) who underwent gastrectomy with curative intent in our center were enrolled. Patients were categorized into two groups based on surgeon specialization: the specialized group (SG) and nonspecialized group (NSG). To overcome bias due to the different distribution of covariates for the two groups, a one-to-one match was applied using propensity score analysis. After matching, prognosis and recurrence data were analyzed. Results After one-to-one matching, 261 patients in the SG and 261 patients in the NSG had the same characteristics excluding factors associated with surgery. In multivariate analysis for the whole study series, surgeon specialization was an independent prognostic factor for GC patients after surgery. Patients in the SG demonstrated a significantly higher 5-year overall survival than those in the NSG (50.7 vs. 37.2 %, p = 0.001). With the strata analysis, significant prognostic differences between the two groups were only observed in patients at stage IIIa-b or N1-2. The proportion of locoregional recurrence was greater in the NSG than in the SG. Conclusion GC patients treated by specialized surgeons tended to have a better prognosis and lower locoregional recurrence rate. Surgeon specialization was an independent prognostic factor for GC patients after surgery. GC should be treated by specialized surgeons in large-volume centers.

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Section: Discussioncontrasting

confidence: 95%

The positive impact of surgeon specialization on survival for gastric cancer patients after surgery with curative intent

Liang

Wang

et al. 2014

Gastric Cancer

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“…La posibilidad de sobrevivir a la enfermedad está directamente relacionada al estadío, así en los casos de cáncer temprano las sobrevida luego de tratamiento quirúrgico o inclusive endoscópico está por encima del 90% 10,11 , sin embargo, sólo en países orientales como Korea y Japón las tasas de detección de cáncer temprano se mueven por encima del 35 y 50% respectivamente 12,13 , entre otros, debido a políticas gubernamentales agresivas. Sin embargo, en occidente ocurre todo lo contrario porque la norma sigue siendo detectar la enfermedad en estadíos avanzados 14 , lo que disminuye la efectividad del tratamiento.…”

Section: Discussionunclassified

Respuesta histológica completa a la neoadyuvancia en cáncer gástrico avanzado

2013

Rev Chil Cir

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Histological complete response after neoadjuvant therapy in advanced gastric cancer Introduction: This article describes the first case in Peru where a patient with an advanced gastric cancer showed pathologic complete response to neoadjuvance indicated due an extensive involvement of paraaortic and celiac trunk lymph nodes. Clinical case: 51 year old female patient, after 4 cycles of chemotherapy, the former with epirubicin, cisplatin and capecitabine and the remaining three with epirubicin, cisplatin and 5-fluorouracil, a complete response was obtained from the tomographic point of view. Later patient underwent total gastrectomy with D2 lymphadenectomy. Microscopic examination of the surgical specimen verified only scar tissue without evidence of malignancy in both, the stomach and the lymph nodes removed. Further we present a review of the relevant medical literature to date.

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“…This is a relatively new challenging experience that aims to provide the best standard of care available to this patients and as a result, it is expected to obtain short and long-term outcomes comparable with international standards (12,13).…”

Section: Management and Outcomesmentioning

confidence: 99%

“…Since then, several centers had been reported an improvement in morbidity and mortality rates, as well as an increment in the retrieval of lymph nodes. For example, one center reported a morbidity of 22.7% and hospital mortality of 2.8% in 243 consecutive gastric cancer surgery patients and the mean number of resected lymph nodes was 37.3±12.4 for distal gastrectomy and 45.3±14.5 for total gastrectomy (12,15).…”

Section: Management and Outcomesmentioning

confidence: 99%

“…Additionally, according to several studies, the high mortality rate among Peruvian population is due to a lack of available screening methods, lack of an appropriate number and/or training of the required specialists including oncologists, gastric surgeons, surgical oncologists, gastroenterologists, among others; and due to high costs of performing upper gastrointestinal endoscopy (3,12,15). Such issues should be addressed in order to get better outcomes in the treatment of gastric cancer patients.…”

Section: Management and Outcomesmentioning

confidence: 99%

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