Surgical Outcomes and Prognostic Factors for T4 Gastric Cancers

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

doi:10.1016/s1015-9584(09)60395-x

Cited by 38 publications

(32 citation statements)

References 22 publications

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“…Survival in patients who underwent MVR without a complete resection was demonstrated to be significantly diminished compared to those who had an R0 resection [2,9,11,18]. Poor outcomes appear to be associated with both microscopic and macroscopic positive margins [12,15]. There were no 5-year survivors in three studies that reported outcomes in patients undergoing MVR with residual tumor; however, for patients in whom an R0 resection was achieved, the 5-year survival was 11.1-45.0% [2,9,18].…”

Section: Discussionmentioning

confidence: 93%

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Multivisceral resection for gastric cancer: a systematic review

et al. 2011

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Background The overall prognosis and survival of patients with advanced gastric cancer is generally poor. One of the most powerful predictors of outcomes in gastric cancer surgery is an R0 resection. However, the extent of the required surgical resection and the additional benefit of multivisceral resection (MVR) are controversial. Methods Electronic literature searches were conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from

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Section: Discussionmentioning

confidence: 93%

“…After removal of duplicates and screening for relevant titles and abstracts, a total of 142 articles were submitted for a full-text review. Seventeen studies involving 1343 patients met our inclusion criteria and were included in this review [1,2,[4][5][6][8][9][10][11][12][13][14][15][16][17][18][19][20] (Fig. 1).…”

Section: Literature Searchmentioning

confidence: 99%

Multivisceral resection for gastric cancer: a systematic review

et al. 2011

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“…también sería importante evaluar la calidad de vida de los enfermos tratados sin resección y la posibilidad que ellos tienen para lograr un tratamiento paliativo de buena calidad. Varios estudios han evaluado las complicaciones y la mortalidad de la GE al analizar aquellos enfermos tratados con una resección multi-orgánica y/o disección ganglionar extendida [6][7][8][9][10][11][12][13] . con el objetivo de obtener factores pronósticos de complicaciones postoperatorias y mortalidad, Viste y cols 17 evaluaron los resultados quirúrgicos de 1.010 enfermos sometidos a una gastrectomía y observaron 28% de morbilidad y 6% de mortalidad.…”

Section: Resultsunclassified

“…Está claramente demostrado que cuando la enfermedad está localizada, el tratamiento de elección es la resección quirúrgica 5 . Estudios recientes han confirmado que esto también sería aplicable a aquellos pacientes con tumores localmente avanzados con infiltración de órganos adyacentes 6,7 . A pesar de esto, la invasión local sería otro factor de mal pronóstico, independiente del tratamiento quirúrgico radical R0 8 .…”

Section: Instituto Oncológicounclassified

Gastrectomía extendida en cáncer gástrico: Evaluación de la morbilidad y mortalidad postoperatoria

Butte¹,

Kerrigan²,

Waugh³

et al. 2010

Rev. méd. Chile

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“…At the same time our R1 and R2 resection rates are also high (13% and 5%). In literature, there are some other studies stating that R0 resection rates of locally advanced gastric tumors, not treated with neo-adjuvant chemotherapy, are low (28). But now, there is increasing evidence that neo-adjuvant chemotherapy potentially down-stages the tumor and therefore may improve the resectability rate with negative surgical margins (29,30).…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes and Early Postoperative Complications in Locally Advanced Gastric Cancer

Doğan¹,

Karaman²,

Hüseyinova³

et al. 2011

Acta Oncol Tur.

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ÖZET Amaç: Batı ülkelerinde saptanan mide kanserlerinin %60-65'i tanı anında lokal ileri evrededirler. Bu hastalara uygulanan genişletilmiş rezeksiyonlar komplikasyon riskini arttırabilir. Bu çalışmanın amacı lokal ileri evre mide kanserlerinde rezektabilite, erken dönem mortalite ve morbidite oranlarını saptamaktır. Hastalar ve Yöntem: Ocak 2002 ile Eylül 2006 tarihleri arasında rezeksiyon uygulanan non-metastatik, lokal ileri evre mide kanserli hastalarımız geriye dönük olarak incelendi. Bulgular: Komşu organ invazyonu nedeni ile 110 hastaya (%49.8) ek organ rezeksiyonu uygulanmıştı. Yüz seksen bir hastaya (%82) R0, 29 hastaya (%13) R1 ve 11 hastaya (%5) R2 rezeksiyon yapılabilmişti. Tüm serinin morbidite ve mortalite oranları sırasıyla %21.7 ve %4.5 olarak bulundu. İkiden fazla ek organ rezeksiyonu (p=0.001), 2 üniteden fazla kan transfüzyonu (p=0.001) ve düşük protein seviyeleri (p=0.008) multivaryant analizlerde komplikasyon oranlarını arttıran parametreler olarak saptandı. İki veya daha fazla ek organ rezeksiyonu (p=0.001), kardiyovasküler ve respiratuar komorbidite (p=0.002) ve total gastrektomi uygulanması (p=0.028) mortaliteyi arttıran faktörler olarak bulundu. Sonuç: Neo-adjuvan tedavi uygulanmayan lokal ileri evre mide kanserli hastalarda ek organ rezeksiyonu oranları yüksektir ve bu durum morbidite ve mortalite oranlarını arttırır. Total gastrektomi mortaliteyi arttıran bir faktör olarak belirlenmiş ancak D2 diseksiyonun bu hastalarda güvenle uygulanabileceği sonucuna varılmıştır. Anahtar kelimeler: Komplikasyon; Lokal ileri evre mide kanseri; Morbidite; Mortalite ABSTRACT Objective: In Western world, 60 to 65% of the gastric cancer cases are in locally advanced stage at the time of diagnosis. Extended resections may increase the risk of complications in these patients. The aim of this study was to investigate the resectability, early morbidity and mortality rates for locally advanced gastric cancer. Patients and Methods: Non-metastatic locally advanced gastric cancer patients who underwent resection between January 2002 and September 2006 were analyzed retrospectively. Results: One hundred and ten patients (49.8%) had additional organ resection due to adjacent organ involvement. R0 resection was performed in 181 patients (82%), R1 resection in 29 patients (13%), and R2 resection in 11 patients (5%). The morbidity and mortality rates of the all series were 21.7% and 4.5% respectively. According to multivariate analysis more than two additional organ resections (p=0.001), erythrocyte transfusions of more than 2 units (p=0.001) and low total protein levels (p=0.008) were determined as the parameters that increase complication rates. The parameters that increase mortality rates were as follows; having two or more additional organ resections (p=0.001), cardiovascular and respiratory comorbidities (p=0.002) and total gastrectomy (p=0.028). Conclusion: Additional organ resection rate of the patients with locally advanced gastric cancers that not given neo-adjuvant treatment is high and this occurrence incr...

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Surgical Outcomes and Prognostic Factors for T4 Gastric Cancers

Abstract: In patients with T4 gastric carcinoma, an aggressive surgical approach can be beneficial when curative resection is performed. If curative resection is not possible, palliative resection can be performed for a better quality of life.

Cited by 38 publications

References 22 publications

Multivisceral resection for gastric cancer: a systematic review

Multivisceral resection for gastric cancer: a systematic review

Gastrectomía extendida en cáncer gástrico: Evaluación de la morbilidad y mortalidad postoperatoria

Surgical Outcomes and Early Postoperative Complications in Locally Advanced Gastric Cancer

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