Comparisons of perioperative and survival outcomes of laparoscopic versus open gastrectomy for serosa-positive (pT4a) gastric cancer patients: a propensity score matched analysis

2021 ◽  
Author(s):  
Hua-Yang Pang ◽  
Lin-Yong Zhao ◽  
Zi-Qi Zhang ◽  
Danil Galiullin ◽  
Xiao-Long Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Open Gastrectomy ◽  
Survival Outcomes ◽  
Gastric Cancer Patients

scholarly journals Application of clockwise modularized laparoscopic lymphadenectomy in the suprapancreatic area, a propensity score matching study and comparison with open gastrectomy

2020 ◽  
Author(s):  
Hua Yang ◽  
Wei-Han Zhang ◽  
Kai Liu ◽  
Yu-Qing Dan ◽  
Xin-Zu Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Final Analysis ◽  
Cancer Surgery ◽  
Open Gastrectomy ◽  
Gastric Cancer Surgery ◽  
Gastric Cancer Patients

Abstract Background Suprapancreatic lymphadenectomy is the essence of D2 radical gastric cancer surgery. The present study aimed to describe clockwise modularized laparoscopic lymphadenectomy in the suprapancreatic area. Methods The data from gastric cancer patients who underwent surgical treatment from September 2016 to December 2018 were collected. Patients were divided into clockwise modularized lymphadenectomy (CML) and traditional open gastrectomy (OG) groups according to the surgical treatment strategy. The propensity score matching method was utilized to balance the baseline characteristics between the two groups. Results Finally, 551 gastric cancer patients were included in the present study. Following propensity score matching, 106 pairs of patients in the CML group and OG group were included in the final analysis. The CML group had more total examined lymph nodes (36, IQR 28–44.74 vs. 29, IQR 29–39.5, p = 0.002) and no. 9 station nodes (2, IQR 1–5 vs. 2, IQR 1–3, p = 0.007) than the OG group. There was less intraoperative blood loss (30, IQR 20–80 ml vs. 80, IQR 50–80 ml, p < 0.001) and a longer surgical duration (262.5 min, IQR 220–303.25 min vs. 232, IQR 220–255 min, p < 0.001) in the CML group than in the OG group. The incidence of postoperative complications (19.8% vs. 16.0%, p = 0.591) and postoperative hospital stay (8, IQR 7–9 days vs. 8, IQR 7–9 days, p = 0.452) were comparable between the CML and OG groups. Conclusion Laparoscopic lymphadenectomy for gastric cancer surgery is technically demanding. Clockwise modularized laparoscopic lymphadenectomy in the suprapancreatic area can attain similar effects as traditional open surgery and without an increase in postoperative adverse events.

scholarly journals Laparoscopic gastrectomy for elderly gastric-cancer patients: comparisons with laparoscopic gastrectomy in non-elderly patients and open gastrectomy in the elderly

2020 ◽  
Author(s):  
Zheng-Yan Li ◽  
Jie Chen ◽  
Bin Bai ◽  
Shuai Xu ◽  
Dan Song ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Laparoscopic Gastrectomy ◽  
Open Gastrectomy ◽  
Survival Outcomes ◽  
Short Term ◽  
Term Survival ◽  
Gastric Cancer Patients

Abstract Background The benefits of laparoscopic gastrectomy (LG) in elderly gastric-cancer patients still remain unclear. The purpose of this study was to evaluate the feasibility and safety of LG in elderly gastric-cancer patients. Methods We retrospectively evaluated patients who underwent LG or open gastrectomy (OG) between June 2009 and July 2015 in a single high-volume center. We compared surgical, short-term, and long-term survival outcomes among an elderly (≥70 years old) LG (ELG) group (n = 114), a non-elderly (&lt;70 years old) LG (NLG) group (n = 740), and an elderly OG (EOG) group (n = 383). Results Except for extended time to first flatus, the surgical and short-term outcomes of the ELG group were similar to those of the NLG group. The ELG group revealed comparable disease-specific survival (DSS) rates to the NLG group (64.9% vs 66.2%, P = 0.476), although the overall survival (OS) rate was lower (57.0% vs 65.5%, P &lt; 0.001) in the ELG group than in the NLG group. The ELG group showed longer operation time than the EOG group (236.4 ± 77.3 vs 179 ± 52.2 min, P &lt; 0.001). The ELG group had less estimated blood loss (174.0 ± 88.4 vs 209.3 ± 133.8, P = 0.008) and shorter post-operative hospital stay (8.3 ± 2.5 vs 9.2 ± 4.5, P = 0.048) than the EOG group. The severity of complications was similar between the ELG and NLG groups. Multivariate analysis confirmed that LG was not a risk factor for post-operative complications. Conclusions LG is a feasible and safe procedure for elderly patients with acceptable short- and long-term survival outcomes.

scholarly journals Is Preoperative Fibrinogen Associated with the Survival Prognosis of Gastric Cancer Patients? A Multi-centered, Propensity Score-Matched Retrospective Study

2019 ◽  
Vol 44 (1) ◽  
pp. 213-222
Author(s):  
Lin-Yong Zhao ◽  
Yong-Liang Zhao ◽  
Jun-Jiang Wang ◽  
Qi-Di Zhao ◽  
Wen-Qi Yi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Prognostic Significance ◽  
Staging System ◽  
Tnm Staging ◽  
Plasma Fibrinogen ◽  
Tnm Staging System ◽  
N Stage ◽  
Gastric Cancer Patients

Abstract Background The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy. Methods A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X-tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system. Results Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C-index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy. Conclusions Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction.

Impact of adjuvant chemotherapy with S-1 on survival in patients with type 4 and large type 3 gastric cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 98-98
Author(s):  
Hayato Omori ◽  
Sanae Kaji ◽  
Rie Makuuchi ◽  
Tomoyuki Irino ◽  
Yutaka Tanizawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Strong Impact ◽  
Large Type ◽  
Gastric Cancer Patients ◽  
Type 3 ◽  
The Impact

98 Background: The prognosis of patients with linitis plastica (type 4) and large ulcero-invasive-type (type 3) gastric cancer is reported to be extremely poor. In stage II/III gastric cancer, adjuvant chemotherapy with S-1 is a standard treatment in Japan. However, the efficacy of postoperative chemotherapy with S-1 in these types of patients with dismal prognosis is unknown. The aim of this study is to evaluate the impact of adjuvant chemotherapy with S-1 on survival in type 4 and large type 3 gastric cancer patients. Methods: A total of 152 patients with clinically resectable type 4 and large type 3 gastric cancer who underwent R0 or R1 surgery from 2002 to 2014 were included. The survival outcome between patents with surgery alone and patients who received adjuvant S-1 was compared using a 1:1 propensity score matching method. Results: Patients with adjuvant S-1 were significantly younger (67 vs 74 y, p = 0.009), had higher incidence of T4 (90 vs 62%, p < 0.001), N2-3 (84 vs 63%, p = 0.008), and cytology positive (52 vs 29%, p = 0.006) than in surgery alone patients. Before matching, median survival time (MST) was not different in surgery alone (n = 52) and adjuvant S-1 (n = 100) (31.3 vs 35.8 months, p = 0.41). Propensity score matching yielded 48 patients (24 patients in each group). After matching, baseline characteristics were well balanced between the two groups. Survival in patients with adjuvant S-1 was significantly better than in surgery alone patients (MST: 50.3 vs 15.4 months, p = 0.002). Cox proportional hazard analysis revealed adjuvant S-1 treatment was selected as independent prognostic factor (HR: 0.38, 95%CI: 0.18-0.76, p = 0.006), as well as lavage cytology (HR: 3.9, 95%CI: 1.8-8.9, p < 0.001). Conclusions: Adjuvant chemotherapy with S-1 may have a strong impact on survival in type 4 and large type 3 gastric cancer patients. The efficacy of this treatment will be further demonstrated in the future clinical trials.

scholarly journals DNA damage repair and survival outcomes in advanced gastric cancer patients treated with first-line chemotherapy

2017 ◽  
Vol 140 (11) ◽  
pp. 2587-2595 ◽  
Author(s):  
Livia Ronchetti ◽  
Elisa Melucci ◽  
Francesca De Nicola ◽  
Frauke Goeman ◽  
Beatrice Casini ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Dna Damage ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Dna Damage Repair ◽  
Survival Outcomes ◽  
First Line ◽  
Damage Repair ◽  
Gastric Cancer Patients ◽  
Line Chemotherapy
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