Relationship between complications and long-term prognosis after total gastrectomy with splenectomy for proximal advanced gastric cancer

77 Background: Laparoscopic total gastrectomy (LTG) for advanced gastric cancer (AGC) is technically and oncologically challenging procedure for surgeons. The aim of this study is to compare technical safety and long-term oncologic feasibility of LTG for AGC patients compared to open total gastrectomy (OTG) using propensity score (PS)-matched analysis. Methods: Between 2004 and 2014, 185 patients (OTG: 127, LTG: 58) underwent total gastrectomy due to advanced gastric cancer. PS-matching was done using patients’ age, sex, American Society of Anesthesiologist (ASA) physical status, extent of lymph node dissection, presence of combined resection and pathological stage of gastric cancer. Comparisons were made based on surgical outcomes and long-term survival rates. Results: After PS-matching, 102 patients, respectively 51 patients for each group, were enrolled. LTG had longer tumor-free proximal resection margin (OTG 2.5 cm vs. LTG 3.0 cm, p = 0.008). Total number of retrieved lymph node and metastasized lymph node was similar in both groups. The retrieved number of lymph nodes around splenic hilum (#10 and #11d) was similar in both groups (p = 0.105). Longer operation time was required in LTG (OTG 240 min. vs. LTG 320 min, p = 0.002) but less intraoperative bleeding was observed in LTG (OTG 390 cc vs. LTG 276 cc, p < 0.001). Patients of LTG were discharged earlier than OTG (OTG 12 days vs. LTG 10 days, p = 0.043). Overall morbidity and mortality of both group was similar. Between two groups, there was not a difference in 5-year overall survival rate (OTG 56.3% vs. LTG 56.5%, p = 0.597) or disease free survival rate (OTG 59.0% vs. LTG 67.6%, p = 0.455). Conclusions: For treating proximal AGC, LTG may be a technically and oncologically safe and feasible method.

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A Patient with Advanced Gastric Cancer Who Achieved a Long-Term Prognosis by Early Diagnosis of Sister Mary Joseph’s Nodule

Case Reports in Oncology ◽

10.1159/000484976 ◽

2018 ◽

Vol 11 (1) ◽

pp. 11-16

Author(s):

Shuji Ota ◽

Terunobu Haruyama ◽

Masashi Ishihara ◽

Maika Natsume ◽

Yoko Fukasawa ◽

...

Keyword(s):

Gastric Cancer ◽

Early Diagnosis ◽

Advanced Gastric Cancer ◽

Peritoneal Dissemination ◽

Whole Body ◽

Neoplastic Disease ◽

Direct Infiltration ◽

Sister Mary Joseph’S Nodule ◽

Long Term Prognosis

The patient was a 66-year-old woman. An induration of approximately 15 mm in size that accompanied redness was palpable in the umbilical fossa. She did not respond to 1-month antibiotic treatment provided by the previous physician. For this reason, a biopsy of the site was performed with the possibility of neoplastic disease in mind, resulting in the detection of adenocarcinoma. Subsequent detailed whole-body examination revealed advanced gastric cancer and peritoneal dissemination, and the induration in the umbilical fossa was diagnosed as a direct infiltration from the peritoneal dissemination. Metastasis or infiltration of malignant tumor to the umbilicus is called Sister Mary Joseph’s nodule (SMJN), and considered as a sign of poor prognosis. However, this case was successfully treated and achieved a long-term prognosis by the early diagnosis of SMJN. In routine clinical practice, it is considered necessary to examine patients carefully, as not to overlook SMJN.

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Expression of CD44v6 in advanced gastric cancer and its relationship to hematogenous metastasis and long-term prognosis

Journal of Surgical Oncology ◽

10.1002/jso.10082 ◽

2002 ◽

Vol 79 (4) ◽

pp. 230-235 ◽

Cited By ~ 35

Author(s):

Akio Yamaguchi ◽

Takanori Goi ◽

Jiren Yu ◽

Yasuo Hirono ◽

Makoto Ishida ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Hematogenous Metastasis ◽

Long Term Prognosis

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Lymph Node Noncompliance Affects the Long-Term Prognosis of Patients with Gastric Cancer after Laparoscopic Total Gastrectomy

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-019-04199-9 ◽

2019 ◽

Vol 24 (3) ◽

pp. 540-550 ◽

Cited By ~ 1

Author(s):

Guang-Tan Lin ◽

Qi-Yue Chen ◽

Chao-Hui Zheng ◽

Ping Li ◽

Jian-Wei Xie ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Total Gastrectomy ◽

Laparoscopic Total Gastrectomy ◽

Long Term Prognosis

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Preoperative neoadjuvant chemotherapy on surgical condition and oncogene expression in advanced gastric cancer

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.3.1608 ◽

2020 ◽

Vol 36 (3) ◽

Cited By ~ 1

Author(s):

Guangyu Sun Sun ◽

Shuyan Wang ◽

Guangsheng Liu

Keyword(s):

Gastric Cancer ◽

Neoadjuvant Chemotherapy ◽

Advanced Gastric Cancer ◽

Adverse Reactions ◽

Control Group ◽

Observation Group ◽

Oncogene Expression ◽

Long Term Prognosis ◽

Surgical Condition

Objective: To evaluate the effect of preoperative neoadjuvant chemotherapy regimen of XELOX (capecitabine combined with oxaliplatin) on surgical condition and oncogene expression in advanced gastric cancer. Methods: From January 2015 to July 2016, 124 patients with advanced gastric cancer who were admitted to our hospital were selected. Random number table method was used to divide them into an observation group and a control group, 62 each group. The observation group received two courses of neoadjuvant chemotherapy (XELOX) before operation, and the control group received surgery. The operation condition, expression of oncogenes in gastric cancer lesions, occurrence of adverse reactions and the long-term prognosis were compared between the two groups. Results: The R0 resection rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). The operation time of the observation group was shorter than that of the control group, the amount of intraoperative bleeding and the amount of postoperative drainage of the observation group were less than that of the control group, and the differences were statistically significant (P<0.05). The mRNA expression of gastrokine 1, multiple tumor suppressor protein, Wilms tumor gene on the X chromosome (WTX gene) and gene of phosphate and tension homology deleted on chromosome ten (PTEN gene) in the observation group after treatment was significantly higher than that in the control group before treatment, and the increase amplitude of the observation group was more obvious than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). In terms of long-term prognosis, the disease-free survival time and average survival time of the observation group during the two-year follow-up period were significantly better than those of the control group, and the recurrence rate of the observation group was significantly lower than that of the control group; the differences were statistically significant (P<0.05). Conclusion: Preoperative XELOX for advanced gastric cancer patients can effectively increase the proportion of radical surgery, reduce the risk of surgery, and significantly regulate the expression of oncogene, thus improving the long-term prognosis of patients. doi: https://doi.org/10.12669/pjms.36.3.1608 How to cite this:Sun G, Wang S, Liu G. Preoperative neoadjuvant chemotherapy on surgical condition and oncogene expression in advanced gastric cancer. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1608 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Long-Term Outcomes of Laparoscopic versus Open Total Gastrectomy for Advanced Gastric Cancer: A Propensity Score-Matched Analysis

Digestive Surgery ◽

10.1159/000501427 ◽

2019 ◽

Vol 37 (3) ◽

pp. 220-228 ◽

Cited By ~ 1

Author(s):

Hayemin Lee ◽

Wook Kim ◽

Junhyun Lee

Keyword(s):

Gastric Cancer ◽

Survival Rate ◽

Propensity Score ◽

Lymph Nodes ◽

Advanced Gastric Cancer ◽

Total Gastrectomy ◽

Disease Free Survival ◽

Term Survival ◽

Open Total Gastrectomy

Background: Laparoscopic total gastrectomy (LTG) for advanced gastric cancer (AGC) is a technically and oncologically challenging procedure for surgeons. Objectives: The aim of this study was to compare the technical safety and long-term oncological feasibility between LTG and open total gastrectomy (OTG) for patients with AGC using a propensity score (PS)-matched analysis. Methods: Between 2004 and 2014, 185 patients (OTG: 127, LTG: 58) underwent curative total gastrectomy for AGC. PS matching was performed using the patients’ clinicopathological factors, and comparisons were made based on surgical outcomes and long-term survival rates. Results: After PS matching, 102 patients (51 patients in each group) were enrolled. The total numbers of retrieved lymph nodes were similar in both groups. The numbers of retrieved lymph nodes around the splenic hilum were similar in both groups. A longer operation time was required for the LTG group than for the OTG group, but less intraoperative bleeding was observed in the LTG group. The overall morbidity and mortality rates of both groups were similar. Between the 2 groups, there was no difference in the 5-year overall survival rate or disease-free survival rate. Conclusions: For treating proximal AGC, LTG may be a technically and an oncologically safe and feasible method.

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Long-Term Survival of Two Patients with Liver Metastases from Advanced Gastric Cancer Treated with Radiofrequency Ablation and Chemotherapy

Case Reports in Oncology ◽

10.1159/000507849 ◽

2021 ◽

pp. 67-72

Author(s):

Sung Jin Oh

Keyword(s):

Gastric Cancer ◽

Radiofrequency Ablation ◽

Liver Metastases ◽

Advanced Gastric Cancer ◽

Systemic Chemotherapy ◽

Subtotal Gastrectomy ◽

Hepatic Metastases ◽

Term Survival ◽

Long Term Survival

Liver metastasis from gastric cancer has a very poor prognosis. Herein, we present two cases of liver metastases (synchronous and metachronous) from advanced gastric cancer. In the first case, the patient underwent radical subtotal gastrectomy. Liver metastases occurred 6 months after surgery while the patient was receiving adjuvant chemotherapy, but two hepatic tumors were successfully removed by radiofrequency ablation (RFA). In the second case, liver metastases occurred 15 months after surgery for gastric cancer. The patient also received RFA for one hepatic tumor, and other suspicious metastatic tumors were treated with systemic chemotherapy. Although these case presentations are limited for the efficacy of RFA treatment with systemic chemotherapy for hepatic metastases from gastric cancer, our findings showed long-term survival (overall survival for 108 and 67 months, respectively) of the affected patients, without recurrence. Therefore, we suggest that RFA treatment with systemic chemotherapy could be an effective alternative treatment modality for hepatic metastases from gastric cancer.

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Comparison of clinicopathological features and long-term prognosis between mixed predominantly differentiated-type and pure differentiated-type early gastric cancer

BMC Cancer ◽

10.1186/s12885-021-07962-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yutaka Okagawa ◽

Tetsuya Sumiyoshi ◽

Hitoshi Kondo ◽

Yusuke Tomita ◽

Takeshi Uozumi ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Vascular Invasion ◽

Survival Rates ◽

Malignant Potential ◽

Clinicopathological Features ◽

Node Metastasis ◽

Group 5 ◽

Long Term Prognosis

Abstract Background Recent studies have shown that mixed predominantly differentiated-type (MD) early gastric cancer (EGC) might have more malignant potential than pure differentiated-type (PD) EGC. However, no study has analyzed all differentiated-type EGC cases treated endoscopically and surgically. This study aimed to compare the differences in clinicopathological features and long-term prognosis between MD- and PD-EGC. Methods We evaluated all patients with differentiated-type EGCs who were treated endoscopically and surgically in our hospital between January 2010 and October 2014. The clinicopathological features and long-term prognosis of MD-EGC were compared with those of PD-EGC. Results A total of 459 patients with 459 lesions were evaluated in this study; of them, 409 (89.1%) and 50 (10.9%) were classified into the PD and MD groups, respectively. Submucosal invasion was found in 96 (23.5%) patients of the PD group and in 33 (66.0%) patients of the MD group (p < 0.01). The rates of positive lymphatic and vascular invasion and ulceration were significantly higher in the MD group than in the PD group (p < 0.01). The proportion of patients with lymph node metastasis was also significantly higher in the MD group than in the PD group (5 (10%) vs 6 (1.5%), p < 0.01). The 5-year overall and EGC-specific survival rates in the PD group were 88.3 and 99.5%, respectively, while they were 94.0 and 98.0% in the MD group, respectively. Conclusions MD-EGC has more malignant potential than PD-EGC. However, the long-term prognosis of MD-EGC is good and is not significantly different from that of PD-EGC when treated appropriately.

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