A matched cohort study of the failure pattern after laparoscopic and open gastrectomy for locally advanced gastric cancer: does the operative approach matter?

2021 ◽  
Author(s):  
Jun Lu ◽  
Dong Wu ◽  
Bin-Bin Xu ◽  
Zhen Xue ◽  
Hua-Long Zheng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Study ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Operative Approach ◽  
Failure Pattern ◽  
Open Gastrectomy ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Locally Advanced Gastric Cancer

Completely laparoscopic versus open gastrectomy for early and advanced gastric cancer: a matched cohort study

2011 ◽  
Vol 26 (3) ◽  
pp. 661-672 ◽  
Author(s):  
Fabrizio Moisan ◽  
Enrique Norero ◽  
Milenko Slako ◽  
Julián Varas ◽  
Gonzalo Palominos ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Study ◽  
Advanced Gastric Cancer ◽  
Open Gastrectomy ◽  
Matched Cohort ◽  
Matched Cohort Study

scholarly journals Oncological outcomes of laparoscopic versus open gastrectomy after neoadjuvant chemotherapy for locally advanced gastric cancer: a retrospective multicenter study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Islam Khaled ◽  
Pablo Priego ◽  
Hany Soliman ◽  
Mohammed Faisal ◽  
Ihab Saad Ahmed
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Disease Free Survival ◽  
Open Gastrectomy ◽  
Oncological Outcomes ◽  
Locally Advanced Gastric Cancer ◽  
The Mean

Abstract Background The oncological outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) following neoadjuvant chemotherapy have been investigated in a few studies. Our purpose was to evaluate the oncological outcomes of LG and OG after neoadjuvant chemotherapy in patients with locally advanced gastric cancer (GC) and to determine the advantages, preferences, and ease of use of the two techniques after chemotherapy. Methods We conducted a retrospective chart review of all patients who underwent either OG (n = 43) or LG (n = 41). The neoadjuvant treatment regimen consisted of capecitabine plus oxaliplatin for three cycles, which was then repeated 6 to 12 weeks after the operation for four cycles. Results The hospital stay time and intraoperative blood loss in the LG group were significantly lower than those in the OG group. The mortality rate and the 3-year survival rate for patients in the LG group were comparable to those of patients in the OG group (4.6% vs. 9.7% and 68.3% vs. 58.1%, respectively). Similar trends were observed regarding the 3-year recurrence rate and metastasis. The mean survival time was 52.9 months (95% confidence interval [CI], 44.2–61.6) in the OG group compared with 43.3 (95% CI, 36.6–49.8) in the LG group. Likewise, the mean disease-free survival was 56.1 months (95% CI, 46.36–65.8) in the LG group compared with 50.9 months (95% CI, 44.6–57.2) in the OG group. Conclusion LG is a feasible and safe alternative to OG for patients with locally advanced GC receiving neoadjuvant chemotherapy.

scholarly journals Treatment Switch in Poor Responders with Locally Advanced Gastric Cancer After Neoadjuvant Chemotherapy

2021 ◽  
Author(s):  
Zining Liu ◽  
Yinkui Wang ◽  
Fei Shan ◽  
Xiangji Ying ◽  
Yan Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Events ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Postoperative Treatment ◽  
Tumor Regression Grade ◽  
Poor Responders ◽  
Matched Cohort ◽  
Locally Advanced Gastric Cancer

Abstract Background Among locally advanced gastric cancer (LAGC) patients, poor response to initial neoadjuvant chemotherapy (NAC) is associated with unfavorable outcomes; however, changing the postoperative therapy regimen in this group of patients is unclear. We compared the poor responders who continued the original protocols with that of patients who switched treatment after NAC plus D2 gastrectomy. Methods Our study included LAGC patients who achieved tumor regression grade 3 according to the American Joint Committee on Cancer/College of American Pathologists system, after NAC, between December 2006 and December 2017 at our institution. Outcomes were overall survival (OS), progression-free survival (PFS), and adverse events during postoperative treatment. The propensity score matching method was used to match patients. Results Overall, 160 patients were enrolled in the final analysis set, including 21 switched cases and 139 non-switched cases. A 1:2 matched cohort (21 switching vs. 42 non-switching) was generated to eliminate all confounding factors. No statistical differences were observed in OS and PFS, either in the whole patients (OS: log-rank p = 0.804; PFS: log-rank p = 0.943) or in the matched cohort (OS: log-rank p = 0.907; PFS: log-rank p = 0.670) between the two groups. Patients with changed regimens had a significantly higher rate of peripheral neurotoxicity (p = 0.045). Contrarily, a lower rate of overall adverse events was observed in the non-switching group with marginal significance (p = 0.069). Conclusion Adjusting to a non-cross-resistant regimen only by post-NAC pathological evaluation may not be sufficient for designing an effective treatment route for LAGC poor responders. Treatment change required a more scrutinized clinical track, which involved a multifaceted assessment.

scholarly journals Totally Laparoscopic Versus Open Gastrectomy for Gastric Cancer: A Matched Cohort Study

2013 ◽  
Vol 23 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Fabio Cianchi ◽  
Etleva Qirici ◽  
Giacomo Trallori ◽  
Giuseppe Macrì ◽  
Giampiero Indennitate ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cohort Study ◽  
Open Gastrectomy ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Totally Laparoscopic
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