scholarly journals Effect of Prophylactic Radiotherapy on Patients with Stage II-III Esophageal Cancer after Esophageal Cancer Radical Operation and Influencing Factors in Its Recurrence

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Dan Guo ◽  
Kang Zheng
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Recurrence Rate ◽  
Influencing Factors ◽  
Life Quality ◽  
Stage Ii ◽  
Radical Operation ◽  
Self Rating ◽  
Before And After ◽  
Prophylactic Radiotherapy

Objective. To explore the effect of prophylactic radiotherapy on patients with stage II-III esophageal cancer (EC) after esophageal cancer radical operation (ECRO) and influencing factors on EC recurrence. Methods. Totally, 65 patients with EC in our hospital were enrolled. Among them, 30 patients were treated by routine ECRO as a control group (Con group) and 35 patients by prophylactic radiotherapy as a research group (Res group). Then, the following measures were taken: record the efficacy on both groups, quantify their C-reactive protein (CRP) and white blood cell count (WBC) before and after therapy, evaluate their mental state through the revised piper fatigue scale (PFS-R) before and after therapy, determine their changes in Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after therapy, compare them in terms of lymph-node metastatic rate (LNMR), hematogenous metastasis rate (HMR), anastomotic recurrence rate (ARR), and 3-year survival rate, compare them in terms of life quality after therapy via the Quality of Life-Core Questionnaire (QLQ-C30), and analyze influencing factors on their recurrence. Results. The Res group showed a notably higher total effective rate (TER) than the Con group ( P = 0.037 ). After therapy, CRP and WBC in both groups increased, but their levels were not considerably different in both ( P > 0.05 ). Additionally, after therapy, in contrast to the Con group, the Res group got notably lower PFS-R, SDS, and SAS scores, showed notably lower LNMR and ARR and notably higher 3-year survival rate, and experienced notably higher life quality (all P < 0.05 ), and the HMR results were not considerably different in both groups ( P > 0.05 ). Moreover, carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), esophageal inflammation history, family medical history, postoperative complications, and lymphatic and vascular infiltration were risk factors for the disease recurrence, and treatment method was the protective factor for it. Conclusion. For patients with stage II-III EC after ECRO, prophylactic radiotherapy is highly effective and safe and can lower the recurrence rate, so it is worth popularizing in clinical practice.

PS02.031: DEFINITIVE CHEMORADIOTHERAPY WITH DOCETAXEL, CISPLATIN, AND 5-FLUOROURACIL (DCF-R) FOR ADVANCED CERVICAL ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 128-129
Author(s):  
Hiroshi Okamoto ◽  
Yusuke Taniyama ◽  
Tadashi Sakurai ◽  
Takahiro Heishi ◽  
Chiaki Sato ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Lymph Node ◽  
Survival Rate ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Conflicts Of Interest ◽  
Clinical Stage ◽  
Stage Ii ◽  
Definitive Chemoradiotherapy

Abstract Background Recently, definitive chemoradiotherapy (dCRT) has become one of the essential treatment strategies for esophageal squamous cell carcinoma (ESCC) and has been especially gaining prevalence for cervical ESCC to preserve the larynx. There have been recent reports on favorable outcomes of docetaxel/CDDP/5-FU (DCF-R) for advanced esophageal cancer. Our department recently introduced DCF-R for treating advanced cervical ESCC. We analyzed the safety and outcomes of DCF-R in patients with advanced cervical ESCC. Methods We retrospectively evaluated 12 advanced cervical ESCC patients (clinical stage II–IV, including T4b and/or M1 lymph node) in our department who received DCF-R as the first-line treatment between December 2010 and February 2015. Results Our patient cohort comprised 9 males and 3 females (median age, 67.5 years; range: 54–76 years). All patients were squamous cell carcinoma. The median observation period was 34.5 (8–80) months with total irradiation dose of 64.0 (60–70) Gy. The pretreatment clinical stage (according to Union for International Cancer Center) included one stage II, seven stage III, and four stage IV cases (including 3 patients with T4b [2 trachea and 1 thyroid] and 4 patients with M1 lymph node. We attained complete response (CR) in 10 patients and stable disease in 2 patients. Of 10 patients with CR, 5 experienced recurrence and 5 continued exhibiting CR. Two persistent patients included one patient who died of cancer and one patient who underwent salvage surgery. Furthermore, grade 3 or more adverse events as defined in Common Terminology Criteria for Adverse Event version 4 included leucopenia (91.7%), neutropenia (91.7%), febrile neutropenia (50%), and pharyngeal pain (50%). There was no treatment-related mortality and treatment schedules were completed in all patients, although dose reduction of the second cycle of chemotherapy was required in four patients (33%) and change in the radiation schedule was required in one patient (8.3%). While the 2-/3-/5-year overall survival rate was 66.7%/48.6%/48.6%, the 2-/3-/5-year recurrent-free survival rate was 58.3%/50.0%/37.5%, respectively. Conclusion DCF-R treatment for advanced cervical ESCC could be completed by the careful administration, and although a strong blood toxicity might occur, a favorable prognosis can be obtained with larynx preservation. Disclosure All authors have declared no conflicts of interest.

Endoscopic resection as salvage treatment for patients with local failure after definitive chemoradiotherapy for stage II or III esophageal squamous cell cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 109-109
Author(s):  
Makomo Makazu ◽  
Ken Kato ◽  
Hajime Takisawa ◽  
Shigetaka Yoshinaga ◽  
Ichiro Oda ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Residual Tumor ◽  
Local Failure ◽  
Esophageal Squamous Cell Cancer ◽  
Stage Ii

109 Background: Local failure after definitive chemotherapy and/or radiotherapy for stage II or III esophageal cancer is one of the causes of poor outcome. Endoscopic resection (ER) is an effective treatment for superficial esophageal cancer. However, its curative potential and safety remain unclear for local recurrent or residual tumor. Methods: Two hundred and sixty patients (pts.) who received definitive chemotherapy and/or radiotherapy for stage II or III esophageal squamous cell cancer between January 2000 and July 2007 were retrospectively reviewed. Results: Characteristics of all patients were as follows: median age of 65 (range 35-86); male/female: 226/34; performance status 0/1/2:117/141/2; clinical stage IIA/IIB/III: 64/70/126; regimen of chemoradiotherapy/radiotherapy: 235/15; and radiation dose 50.4/60/>66 Gy: 31/218/10. Of 260pts, 170 (65%) achieved complete response after chemoradiotherapy. Median survival time was 38.5 months and 5-year survival rate was 43.5%. While 81 of them had recurrent disease, 39 had locoregional recurrence without distant metastasis. While 86 of 260 pts (33%) had residual disease after chemoradiotherapy, 68 had only locoregional disease. Of the 107 pts who had only locoregional recurrent or residual tumor, 15 (14%) underwent salvage ER (17 lesions in total). Tumor depth was limited in mucosal layer in 10 lesions and submucosal in 7 lesions. En bloc resection was performed in 9 lesions (52.9%). The vertical margin was free from cancer cells in 15 lesions (88.2%). No major complications, such as hemorrhage requiring blood transfusion and perforation, were experienced. Only one pt experienced minor hemorrhage 16 days after EMR, and was treated by endoscopic treatment. At a median follow-up period of 40.0 months (range, 0.7-94 months) after salvage ER, no recurrence was detected in 9 pts. (60%). Local recurrence was detected in 4 pts. (27%). The clinical courses of the remaining 2 pts were unknown. Three-year survival rate after salvage ER was 58%. Conclusions: Salvage ER is feasible and one of the promising treatments for local recurrent or residual esophageal cancer after chemoradiotherapy or radiotherapy.

Efficacy and feasibility of neoadjuvant chemotherapy for elderly patients with stage II/III esophageal cancer: Retrospective study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 220-220
Author(s):  
Takahiro Miyamoto ◽  
Tetsuji Terazawa ◽  
Masahiro Goto ◽  
Ken Asaishi ◽  
Fukutaro Shimamoto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Neoadjuvant Chemotherapy ◽  
Elderly Patients ◽  
Clinical Stage ◽  
Kidney Injury ◽  
Stage Ii ◽  
Free Survival ◽  
Age Range

220 Background: From the result of JCOG 9907 study, which showed the supremacy of neoadjuvant chemotherapy (NAC) of 5-fluorouracil plus cisplatin infusion (FP) over adjuvant chemotherapy, NAC FP is standard therapy for stage II or III esophageal cancer in Japan. However, the efficacy and feasibility of NAC FP for elderly patients (pts) still remains unclear. Methods: We examined stage II or III esophageal cancer patients aged 70 or over, who received NAC FP at our institution between April 2008 and August 2014, retrospectively. Results: 12 pts received NAC FP at least 1 course. The pts characteristics were as follows: median age (range), 73 (70-78); male/ female, 11/1; PS 0/1, 3/9. Location of primary tumor and clinical stage based on UICC 2009 were as follows: upper/middle/lower, 3/6/3; stage IIA/IIB/IIIA/IIIB, 3/3/3/3. 2 pts (16.7%) occurred grade3/4 neutropenia (16.7%). grade3/4 non-hematotoxicities were nausea; 2 pts (16.7%), vomiting; 1 pt (8.3%), appetite loss; 4 pts (33.3%), stomatitis; 1 pt (8.3%) and acute kidney injury; 1 pt (8.3%). 3 pts were underwent surgery after 1 course of NAC FP due to renal dysfunction. 3 pts were not performed surgery because of decreased respiratory function, decreased PS and progression disease. 9 pts were performed surgery after NAC FP. The histological efficacy was 1a/1b/2/3; 4/3/1/1 and curativity was R0 (degree A)/R0 (degree B); 8/1. 4 pts (44%) had down staging. Median follow-up time was 16.5 months (range; 4-63), the 5-year relapse free survival rate was 19.0% (95% CI: 2.7-66.4%) and the 5-year overall survival rate was 67% (95% CI: 32-89%). Conclusions: NAC FP for stage II/III esophageal cancer might be effective even in pts ≥70 years of age. However, gastrointestinal toxicity and renal toxicity were developed frequently, therefore the indication of NAC FP for elderly pts must be decided carefully.

scholarly journals Simple cholecystectomy versus radical resection for stage Ⅱ gallbladder cancer: a meta-analysis

2017 ◽  
Vol 4 (2) ◽  
pp. 479
Author(s):  
Zheng-jun Cheng ◽  
Chan Qiu ◽  
Da-xing Li ◽  
Jian-ping Gong ◽  
Qian Cheng
Keyword(s):  
Survival Rate ◽  
Quality Assessment ◽  
Gallbladder Cancer ◽  
Recurrence Rate ◽  
Tumor Recurrence ◽  
Radical Resection ◽  
Stage Ii ◽  
Term Survival ◽  
Simple Cholecystectomy ◽  
Tumor Recurrence Rate

Background: GBC was first reported more than two hundred years ago, but the poor therapeutic effect for GBC patients is still frustrating now, the 5-year survival rate is no more than 5%, and the mean survival time is only about half a year. The objective of this study was to evaluate the importance of radical resection in the treatment of Nevin II and T1b stage gallbladder cancer (stage II GBC) by analyzing the survival rate and tumor recurrence rate after accepting simple cholecystectomy (SC) and radical resection (RR).Methods: PubMed, Embase, Chinese National Knowledge Infrastructure and Wanfang databases was searched from inception to February 2016. Quality assessment was conducted in each of the available studies by using the validated Newcastle-Ottawa Quality Assessment Scale (NOS) for cohort and case-control studies. Publication bias was also assessed by using a funnel plot. The odds ratio (OR) and its 95% confidence interval (95% CI) were employed to estimated effect size. All statistical analyses were carried out using Rev Man 5.2 software.Results: A total of fifteen studies encompassing 424 patients meeting the search criteria were included. Pooled analyses revealed that comparing to simple cholecystectomy, radical resection can significantly increase the 1-, 3- and 5-year survival rate of patients with stage IIGBC (OR = 3.28, 95% CI: 1.83-5.89, P<0.0001; OR = 2.52, 95% CI: 1.49-4.28, P = 0.0006; OR = 3.19, 95% CI: 1.85-5.51, P<0.0001), and patients after radical resection have a significant lower tumor recurrence rate (OR = 0.30, 95% CI: 0.11-0.80, P = 0.02).Conclusions: The short- and long-term survival rate of patients with stage II GBC following radical resection is obviously higher than that of patients receiving simple cholecystectomy, and the tumor recurrence rate is obviously lower. Radical resection would be a better choice for stage IIGBC. 

Concurrent chemoradiotherapy with S-1 and cisplatin for locally advanced esophageal cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15007-15007
Author(s):  
H. Iwase ◽  
M. Shimada ◽  
T. Tsuzuki ◽  
M. Okeya ◽  
K. Kobayashi ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Concurrent Chemoradiotherapy ◽  
Objective Response ◽  
Locally Advanced ◽  
Response Rates ◽  
Stage Ii ◽  
Stage Iii ◽  
Advanced Esophageal Cancer ◽  
Locally Advanced Esophageal Cancer

15007 Background: Both oral fluoropyrimidine anti-cancer agent (UFT, S-1) and cisplatin can enhance the effectiveness of radiotherapy. We previously reported a phase II trial of UFT and cisplatin combined with radiotherapy (Int J Clin Oncol 8 (2003): 305–311) and a phase I trial of S-1 and cisplatin combined with radiotherapy (Jpn J Cancer Chemother 33 (2006): 224–229) for advanced esophageal cancer. The present study analyzes the efficacy of concurrent chemoradiotherapy by using S-1 and cisplatin for locally advanced esophageal cancer. Methods: Chemoradiotherapy consisted of two courses. The first course included 30 Gy of radiotherapy given over 3 weeks, together with daily oral administration of S-1 (80 mg/m2/day) for 2 weeks and a 24-h infusion of cisplatin (70 mg/m2) on day 8. The second course of chemoradiotherapy was administered after 2 weeks. For patients who exhibited an objective response to chemoradiotherapy, at least 2 four-week courses consisting of chemotherapy of S-1 and cisplatinon were administered. If a patient was unable to take S-1 as a capsule, S-1 was administered in the powdered form with water. Results: Fifty-nine patients were enrolled. They had the following characteristics: median age 65 years; M/F 52/7; PS 0/1/2: 33/19/7. There were 9 patients with stage II tumors and 50 with stage III. Fifty-four patients (92%) completed 2 courses of chemoradiotherapy. The major toxicity was myelosuppression. Fifteen patients (25%) developed grade 3 leukocytopenia, while 7 patients (12%) developed grade 4 leukocytopenia. Nonhematologic toxicity was moderate: grade 2 nausea/vomiting, pain, oral mucositis, and renal dysfunction occurred in 20%, 12%, 5% and 5% of patients, respectively. In stage II cases, complete response (CR), partial response (PR), and response rates were 78%, 22%, and 100%, respectively. In stage III cases, CR, PR, and response rates were 58%, 32%, and 90%, respectively. All stage II patients survived. In stage III cases, the 1-year survival rate was 70% and the 3-year survival rate was 44%. Conclusions: Chemoradiotherapy with S-1 and cisplatin is convenient, tolerable, and effective, and may be a promising nonsurgical management option for patients with locally advanced esophageal cancer. No significant financial relationships to disclose.

scholarly journals The Anti-PD-1/PD-L1 Immunotherapy for Gastric Esophageal Cancer: A Systematic Review and Meta-Analysis and Literature Review

2021 ◽  
Vol 28 ◽  
pp. 107327482199743
Author(s):  
Ke Chen ◽  
Xiao Wang ◽  
Liu Yang ◽  
Zheling Chen
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Survival Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control

Background: Treatment options for advanced gastric esophageal cancer are quite limited. Chemotherapy is unavoidable at certain stages, and research on targeted therapies has mostly failed. The advent of immunotherapy has brought hope for the treatment of advanced gastric esophageal cancer. The aim of the study was to analyze the safety of anti-PD-1/PD-L1 immunotherapy and the long-term survival of patients who were diagnosed as gastric esophageal cancer and received anti-PD-1/PD-L1 immunotherapy. Method: Studies on anti-PD-1/PD-L1 immunotherapy of advanced gastric esophageal cancer published before February 1, 2020 were searched online. The survival (e.g. 6-month overall survival, 12-month overall survival (OS), progression-free survival (PFS), objective response rates (ORR)) and adverse effects of immunotherapy were compared to that of control therapy (physician’s choice of therapy). Results: After screening 185 studies, 4 comparative cohort studies which reported the long-term survival of patients receiving immunotherapy were included. Compared to control group, the 12-month survival (OR = 1.67, 95% CI: 1.31 to 2.12, P < 0.0001) and 18-month survival (OR = 1.98, 95% CI: 1.39 to 2.81, P = 0.0001) were significantly longer in immunotherapy group. The 3-month survival rate (OR = 1.05, 95% CI: 0.36 to 3.06, P = 0.92) and 18-month survival rate (OR = 1.44, 95% CI: 0.98 to 2.12, P = 0.07) were not significantly different between immunotherapy group and control group. The ORR were not significantly different between immunotherapy group and control group (OR = 1.54, 95% CI: 0.65 to 3.66, P = 0.01). Meta-analysis pointed out that in the PD-L1 CPS ≥10 sub group population, the immunotherapy could obviously benefit the patients in tumor response rates (OR = 3.80, 95% CI: 1.89 to 7.61, P = 0.0002). Conclusion: For the treatment of advanced gastric esophageal cancer, the therapeutic efficacy of anti-PD-1/PD-L1 immunotherapy was superior to that of chemotherapy or palliative care.

scholarly journals Changes in Cellular Regulatory Factors before and after Decompression of Odontogenic Keratocysts

2020 ◽  
Vol 10 (1) ◽  
pp. 30
Author(s):  
Slmaro Park ◽  
Han-Sung Jung ◽  
Young-Soo Jung ◽  
Woong Nam ◽  
Jung Yul Cha ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Biological Behavior ◽  
Nuclear Antigen ◽  
Epithelial Cyst ◽  
Ki 67 ◽  
Proliferation Markers ◽  
Odontogenic Keratocysts ◽  
Wide Range ◽  
Before And After ◽  
Cyst Lining

Decompression followed by enucleation, which is one of the treatments used for odontogenic keratocysts (OKCs), is frequently used in OKC lesions of large sizes. This method offers the advantage of minimizing the possibility of sensory impairment without creating a wide-range bone defect; moreover, the recurrence rate can be significantly lower than following simple enucleation. This study aimed to assess the changes in histology and expression of proliferation markers in OKCs before and after decompression treatment. A total of 38 OKC tissue samples from 19 patients who had undergone decompression therapy were examined morphologically and immunohistochemically to observe changes in proliferative activity before and after decompression. The markers used for immunohistochemistry (IHC) staining were Bcl-2, epidermal growth factor receptor (EGFR), Ki-67, P53, PCNA, and SMO. The immunohistochemistry positivity of the 6 markers was scored by using software ImageJ, version 1.49, by quantifying the intensity and internal density of IHC-stained epithelium. The values of Bcl-2, Ki-67, P53, proliferating cell nuclear antigen (PCNA), and SMO in OKCs before and after decompression showed no significant change. No correlation between clinical shrinkage and morphologic changes or expression of proliferation and growth markers could be found. There was no statistical evidence that decompression treatment reduces potentially aggressive behavior of OKC within the epithelial cyst lining itself. This might indicate that decompression does not change the biological behavior of the epithelial cyst lining or the recurrence rate.

scholarly journals PER2 Circadian Oscillation Sensitizes Esophageal Cancer Cells to Chemotherapy

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 266
Author(s):  
Juan Alfonso Redondo ◽  
Romain Bibes ◽  
Alizée Vercauteren Drubbel ◽  
Benjamin Dassy ◽  
Xavier Bisteau ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Circadian Rhythm ◽  
Survival Rate ◽  
Circadian Clock ◽  
Cancer Cells ◽  
Molecular Mechanisms ◽  
Human Cancer ◽  
Response To Therapy ◽  
Circadian Oscillation ◽  
Resistance To Therapy

Esophageal squamous cell carcinoma (eSCC) accounts for more than 85% cases of esophageal cancer worldwide and the 5-year survival rate associated with metastatic eSCC is poor. This low survival rate is the consequence of a complex mechanism of resistance to therapy and tumor relapse. To effectively reduce the mortality rate of this disease, we need to better understand the molecular mechanisms underlying the development of resistance to therapy and translate that knowledge into novel approaches for cancer treatment. The circadian clock orchestrates several physiological processes through the establishment and synchronization of circadian rhythms. Since cancer cells need to fuel rapid proliferation and increased metabolic demands, the escape from circadian rhythm is relevant in tumorigenesis. Although clock related genes may be globally repressed in human eSCC samples, PER2 expression still oscillates in some human eSCC cell lines. However, the consequences of this circadian rhythm are still unclear. In the present study, we confirm that PER2 oscillations still occur in human cancer cells in vitro in spite of a deregulated circadian clock gene expression. Profiling of eSCC cells by RNAseq reveals that when PER2 expression is low, several transcripts related to apoptosis are upregulated. Consistently, treating eSCC cells with cisplatin when PER2 expression is low enhances DNA damage and leads to a higher apoptosis rate. Interestingly, this process is conserved in a mouse model of chemically-induced eSCC ex vivo. These results therefore suggest that response to therapy might be enhanced in esophageal cancers using chronotherapy.

scholarly journals A Qualitative Case Study on Influencing Factors of Parents’ Child Abuse of North Korean Refugees in South Korea

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 49
Author(s):  
Wonjung Ryu ◽  
Hyerin Yang
Keyword(s):  
Child Abuse ◽  
South Korea ◽  
Influencing Factors ◽  
Acculturative Stress ◽  
North Korean Refugees ◽  
Korean Parents ◽  
Before And After ◽  
Maternal Parenting Stress ◽  
Past Experiences

The purpose of this study is to investigate the influencing factors of parental child abuse by North Korean refugees who are living in South Korea. In-depth interviews were conducted with five parents who escaped from North Korea. The study identified three categories of factors impacting child abuse: the weakening of family functions from past experiences before and after defection, the stress of adapting to the culture of an unfamiliar society, and low parenting self-efficacy. North Korean parents suffered from emotional and functional crises from past traumatic events and, at the same time, experienced additional acculturative stress as a “minority” after entering South Korea, even as they continued to deal with Maternal Parenting Stress. These complex factors have been shown to lead to child abuse in migrant societies. This study contemplated the context of child abuse through specific examples. The results could provide thoughtful insights into child abuse among migrants and refugee parents, and provide evidence-based intervention plans for its prevention.

scholarly journals Impact of the Number of Dissected Lymph Nodes on Survival for Gastric Cancer after Distal Subtotal Gastrectomy

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Chang-Ming Huang ◽  
Jian-Xian Lin ◽  
Chao-Hui Zheng ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Lymph Nodes ◽  
Distal Gastrectomy ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Prognostic Impact ◽  
Term Survival

Objectives. To investigate the prognostic impact of the number of dissected lymph nodes (LNs) in gastric cancer after curative distal gastrectomy.Methods. The survival of 634 patients who underwent curative distal gastrectomy from 1995 to 2004 was retrieved. Long-term surgical outcomes and associations between the number of dissected LNs and the 5-year survival rate were investigated.Results. The number of dissected LNs was one of the most important prognostic indicators. Among patients with comparable T category, the larger the number of dissected LNs was, the better the survival would be (). The linear regression showed that a significant survival improvement based on increasing retrieved LNs for stage II, III and IV (). A cut-point analysis yields the greatest variance of survival rate difference at the levels of 15 LNs (stage I), 25 LNs (stage II) and 30 LNs (stage III).Conclusion. The number of dissected LNs is an independent prognostic factor for gastric cancer. To improve the long-term survival of patients with gastric cancer, removing at least 15 LNs for stage I, 25 LNs for stage II, and 30 LNs for stage III patients during curative distal gastrectomy is recommended.

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