Long-term results of surgical treatment of gastric cancer

1986 ◽  
Vol 67 (2) ◽  
pp. 104-106
Author(s):  
A. S. Abdullin ◽  
F. Sh. Akhmetzyanov ◽  
A. A. Samigullin ◽  
Z. N. Shemeunova ◽  
V. A. Arinin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Stomach Cancer ◽  
Stage Iv ◽  
Stage Ii ◽  
Stage Iii ◽  
Disease Stage ◽  
Long Term Results ◽  
Long Term Outcomes

We analyzed long-term outcomes of the treatment of 217 patients (men - 126, women - 91), who underwent radical operations for stomach cancer in the period of 1972 till 1976. 14 patients were under 39, 52 - from 40 to 49, 50 to 59 - 52, 60 to 69 - 80, over 70 years old - 19. The youngest patient was 28 years old and the oldest - 76 years old. Most patients (185) were operated on at stage III of the disease, stage II was diagnosed in 27 patients, and stage IV - in 5 patients.

Prediction of the long-term outcomes associated with body mass index and advanced gastric cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 82-82
Author(s):  
Jae Gyu Kim ◽  
Beom Jin Kim ◽  
Kyong-Choun Chi ◽  
Jung Min Park ◽  
Mi Kyoung Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Body Mass Index ◽  
Advanced Gastric Cancer ◽  
Body Mass ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Stage Iii ◽  
Long Term Outcomes ◽  
Significant Difference

82 Background: Radical gastrectomy followed by adjuvant chemotherapy for advanced gastric cancer brings about serious nutritional impairment. Recent studies have shown an association between body mass index (BMI) and perioperative outcomes of gastric cancer. However, little is known about the association between BMI and long-term outcomes of advanced gastric cancer. Our study evaluated the clinical impact of BMI on the long-term outcomes of gastric cancer staged at II and III, treated by radical gastrectomy followed by adjuvant chemotherapy. Methods: We analysed a total of 211 cases of advanced gastric cancer stage II and III between January 2005 and December 2010 at Chung-Ang University Hospital. The patients were divided into 4 groups according to BMI; underweight, normal, overweight, and obese. In addition, they were divided into two groups (BMI-High vs BMI-Low). We assessed age, sex, tumor location, lymph node involvement, operation method, initial cancer stage, recurrence, and survival (overall survival and disease free survival) between two groups. Results: We classified them into 4 groups according to BMI; underweight, normal, overweight, and obese. There was no difference in overall survival between normal, overweight, and obese group. However, there was significant difference between underweight group and the other groups. As for disease free survival, similar findings were observed. Among 211 patients, 154 patients (72.9%) were included in BMI-L (body mass index < 25), whereas 57 patients (27.1%) in BMI-H (body mass index ≥ 25). There was no difference in age, sex, tumor location, stage, lymph node involvement, operation method, recurrence, and cancer-related death between two groups. When classified into 4 groups as stage II in BMI-H, stage II in BMI-L, stage III in BMI-H, and stage III in BMI-L, overall survival showed significant difference in stage, however, no difference between BMI-H and BMI-L. Disease free survival showed no significant difference in stage and BMI, especially, no significant difference between stage II in BMI-L and stage III in BMI –H. Conclusions: Our findings suggest that preoperative BMI may predict the long term outcomes of advanced gastric cancer after radical surgery and chemotherapy.

scholarly journals Diagnosis Issues and Management of Nasopharyngeal Non-Hodgkin Lymphomas

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4588-4588
Author(s):  
Vasile Musteata ◽  
Lilian Nichifor ◽  
Larisa Musteata ◽  
Galina Durbailova
Keyword(s):  
Disease Burden ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Long Term Results ◽  
Combined Chemotherapy ◽  
Locoregional Treatment ◽  
Pharyngeal Tonsil

Abstract Background: Non-Hodgkin lymphomas (NHL) comprise a variety of lymphoproliferative malignancies with certain differences related to the morphological, clinical, immunohistochemical and hematological patterns, as well as the results of treatment. The patients with generalized and relapsed nasopharyngeal NHL experience marked disease burden and unfavorable impact on their life quality and working capacity. Objective: The aim of the study was to characterize the diagnosis issues of NHL with primary involvement of the nasopharynx and evaluate the short- and long-term results of management options. Materials and methods: This analytical and cohort study included 66 patients with different stages of nasopharyngeal NHL, who were managed at the Institute of Oncology from Moldova between 2014-2021. The diagnosis was confirmed by cytological, histopathological and immunohistochemical examinations. The histological types of NHL were verified and distinguished according to the 2017 Revision of WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. The patients treatment, follow-up and researches were realized at the comprehensive cancer center. The study was related to the hospitalized care. The patients age ranged between 19-85 years (average age - 58.4±2,14 years). Males were 28 (42%), females - 38 (58%). Stage I NHL was diagnosed in 10 (15.2%) cases, stage II - in 36 (54.5%), stage III - in 8 (12.1%) and stage IV - in 12 (18.2%). The eligible NHL patients underwent combined chemotherapy (CChT) regimens (CVChlP, R-CVChlP, CHOP and R-CHOP), associated with radiotherapy locoregional treatment in cases of bulky disease or residual tumor masses. The ECOG-WHO score and complete response (CR) rate assessed the short-term results. The long-term results were asserted by the overall one- and 5-year survival. Results: Primary nasopharyngeal NHL occurred commonly in females (58%) and in patients over 60 years (42.4%). The ECOG-WHO score accounted 1-3 at diagnosis. The aggressive NHL were diagnosed mostly (76.1%) in stage I and II due to the earlier developed disease burden. The primary tumor site was localized in the palatine tonsils in 22 (33.3%) patients, in 33 (50%) patients in the pharyngeal tonsil, in 2 (3%) patients in the lingual tonsil. The palatine and pharyngeal tonsils were concomitantly involved in 9 (13.7%) patients. Palatine tonsil involvement occurred mostly in patients over 60 years old, and pharyngeal tonsil involvement - in patients of 40-59 years. CR was achieved in 10 (100%) cases with stage I after combined chemotherapy (CChT) and radiotherapy locoregional treatment. CR occurred in 21 (67.7%), partial response (PR) - in 7 (22.6%) and response failure (RF) - in 3 (9.7%) in stage II NHL after CChT and radiotherapy locoregional treatment. In stage II NHL treated with CChT along, CR was achieved in 1 (25%), PR - in 2 (50%) and RF in 1 (25%). In stage III treated with CChT and radiotherapy locoregional treatment, CR was registered in 1 (20%), PR - in 2 (40%) and RF - in 2 (40%). PR occurred in 2 (66.7%), RF - in 1 (33.3%) in stage III managed with CChT alone. In stage IV NHL, CR was obtained 1 (11.1%) case, PR - in 5 (55.6%), RF - in 3 (33.3%) after CChT and radiotherapy locoregional treatment. PR occurred in 1 (33.3%), RF - in 2 (66.7%) cases in stage IV patients managed with CChT alone. No significant differences of CR rate were found in stage III (12,5%) and stage IV (8.3%) NHL (P&gt;0.05). Irrespective of the stage, the highest CR rate was registered after CChT and radiotherapy locoregional treatment (97.1% of all cases), as compared to CChT alone (2.9% of all cases). The ECOG-WHO score reached 0-1 under the management with CChT and radiotherapy locoregional treatment in all cases with CR and PR. The overall survival was 79.9% at one year and 34.5% at 5 years. One- and 5-year survival proved to be significantly higher în stage I and II NHL - 96.1% and 64.2% respectively. One- and 5-year survival was 79.9% and 34.5% in stage III and IV NHL. Conclusions: Primary nasopharyngeal NHL were outlined by the predominant involvement of females, patients over 60 years and frequent site in the pharyngeal tonsil. The aggressive NHL were revealed commonly in stage I and II due to the progressive disease burden. The rates of the indolent and aggressive NHL turned out to be statistically equal in stage III and IV. The response and overall survival rates proved to be superior after R-CHOP regimen followed by the radiotherapy locoregional treatment. Disclosures No relevant conflicts of interest to declare.

Long-term outcome of penile cancer: Single North American institutional study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15645-15645
Author(s):  
N. Radhakrishnan ◽  
R. Roy ◽  
A. Thomas ◽  
B. Mehrotra ◽  
U. Iqbal
Keyword(s):  
Penile Cancer ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Disease Stage ◽  
Long Term Outcome ◽  
Partial Penectomy ◽  
Disease Free

15645 Background: Penile cancer is a rare malignancy in the Western world with limited published data. We conducted a review of patient (pt.) records diagnosed with penile cancer at our instituition to evaluate the patterns of treatment, responses, recurrences and long term outcomes. Methods: IRB approval was obtained for this retrospective analysis. Tumor registry data was analysed for all adult patients diagnosed with penile cancers between 1995 and 2005. Patient characteristics including age, disease stage, histology, grade, ethnicity, treatment modalities and outcomes were recorded. Results: 24 pts were identified. Median age: 68 years (range: 38 - 86), Stage distribution: Stage 0 (n=7, 29%), Stage I: n =8 (33.%) ; Stage II: n= 4 (17%); Stage III: n = 1 (4%), Stage IV: n=4 (16.7%); ethnicity: Caucasian:17, African-American: n=3; Hispanic: n=1;and South Asian: n=6; Histology: squamous (sq.): n = 21(88%), sq. with sarcomatoid features: n=1(4%), small cell ca: n = 1, (4%); poorly diff. ca: n = 1 (4%). Grades 1,2,3 in each stage respectively : stage I: ( n= 4, 2, 1), stage II: (n = 0,1,2), stage III: (1,0,0), stage IV: (n = 1,2,1). Treatment and Outcome: All pts with stage 0 disease were treated with excision biopsy. 3 of 7 (40%) recurred but are disease free after re-excision. All pts with Stage I disease were treated with partial penectomy. Two of 8 (25%) recurred, of which one pt died of his disease. All pts with stage II were treated with surgery (penectomy) and CT. One pt was additionally treated with RT to the groin. Except for this pt all stage II pts recurred and died due to recurrent disease. The pt with stage III disease was treated with a partial penectomy and CT and remains disease free without recurrence. All pts with stage IV disease were treated with CT, 3 were also treated with RT , but all died of metastatic disease. Median OS: Stage 0: 70+ mo, (20–150 ); Stage I: 69 mo (11–133); Stage II: 25 mo(12–84); Stage III: 25 mo; Stage IV: 7 mo ( 7- 23); Conclusions: Pts with early stage 0 and I disease have a high local recurrence rate (33%) but are curable with surgical salvage. Stages II, III and IV pts have high recurrence rates and poor prognoses despite treatment with penectomy and CT. Future trials should address the benefit of adjuvant chemo/RT in patients with intermediate stage (II & III) disease. No significant financial relationships to disclose.

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.

scholarly journals Immediate and Long-Term Results of the Spleen-Preserved Operations in the Surgical Treatment of Gastric Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 227-232
Author(s):  
Marina I. Rogozianskaia ◽  
Alexander Nikolayevich Redkin ◽  
Ivan Petrovich Moshurov
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Total Gastrectomy ◽  
The Body ◽  
Long Term Results ◽  
D2 Lymphadenectomy ◽  
Spleen Preserving ◽  
Cardiac Region ◽  
Clinically Significant

ntroduction. Currently, total gastrectomy with D2 lymphadenectomy is the standard surgical treatment for proximal gastric cancer at the resectable stages (I-III). The issue of advisability of splenectomy as a component of lymphadenectomy remains a controversial one, especially when the tumor is localized in the region of the body or cardiac region of the stomach.The aim of the study was to compare immediate and long-term outcomes, including the quality of life, between spleen preserving and spleen removing surgeries.Methods. The study included 363 patients with gastric cancer II-III stages, localized in the upper and/or the middle third of the stomach, who underwent surgery at the Voronezh Regional Clinical Oncology Hospital and the Voronezh Clinical Hospital of the Russian Railway-Medicine in 2015-2017. All patients were conditionally divided into 2 groups for comparative retrospective analysis. All patients of the first (experimental or spleen-preserved) group (144 patients) were performed R0 total gastrectomy with D2 lymphadenectomy, including splenic hilar nodes (№ 10,11) removal without splenectomy. Patients of the second (control or splenectomy) group (219 patients) were performed R0 total gastrectomy with D2 lymphadenectomy and prophylactic splenectomy (for splenic hilar nodes removal).Results. The average duration of the operation and the volume of blood loss did not differ in both groups. The incidence of early postoperative surgical complications was lower in the spleen-preserved group. Splenectomy was associated with more severe complications of class 4 and 5 according to the Clavien-Dindo classification. Conclusion. Parameters of the 1- and 3-year overall survival rate did not differ in both groups. The results of the GSRS questionnaire were similar in both groups, excluding reflux-esophageal symptoms scale. The reflux scale demonstrated a statistically and clinically significant advantage of spleen preservation.

Prognostic Indicators in Stage IV Surgically Treated Gastric Cancer Patients: A Retrospective Multi-Institutional Study

2018 ◽  
Vol 36 (4) ◽  
pp. 331-339
Author(s):  
Alberto Biondi ◽  
Domenico D’Ugo ◽  
Ferdinando Cananzi ◽  
Stefano Rausei ◽  
Federico Sicoli ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Residual Disease ◽  
Stage Iv ◽  
Long Term Results ◽  
Stage Iv Gastric Cancer ◽  
Short And Long Term ◽  
Gastric Cancer Patients

Introduction: The role of gastric resection in treating metastatic gastric adenocarcinoma is controversial. In the present study, we reviewed the short- and long-term outcomes of stage IV patients undergoing surgery. Methods: A retrospective review was conducted that assessed patients undergoing elective surgery for incurable gastric carcinoma. Short- and long-term results were evaluated. Results: A total of 122 stage IV gastric cancer patients were assessed. Postoperative mortality was 5.7%, and the overall rate of complications was 35.2%. The overall survival rate at 1 and 3 years was 58 and 19% respectively; the median survival was 14 months. Improved survival was observed for the factors age less than 60 years (p = 0.015), site of metastases (p = 0.022), extended lymph node dissection (p = 0.044), absence of residual disease after surgery (p = 0.001), and administration of adjuvant chemotherapy (p = 0.016). Multivariate analysis showed that residual disease and adjuvant chemotherapy were independent prognostic factors. Conclusions: The results of this study suggest that surgery combined with systemic chemotherapy in selected patients with stage IV gastric cancer can improve survival.

Anterior diaphragmatic hernias in children: long-term surgical outcomes

2021 ◽  
Vol 16 (3) ◽  
pp. 7-15
Author(s):  
D.A. Morozov ◽  
◽  
D.V. Khaspekov ◽  
E.A. Okulov ◽  
V.G. Masevkin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diaphragmatic Hernia ◽  
Complex Analysis ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
X Ray ◽  
Hernial Sac ◽  
Chest X Ray ◽  
Diaphragmatic Hernias

Anterior diaphragmatic hernia (ADH) is a rare congenital pathology that occurs in children with a frequency of 1:4800 (1–6% of all congenital diaphragmatic hernias). There are many controversial aspects in the surgical treatment of patients with ADH: the choice of surgical approach, the method of diaphragmatic repair and the feasibility of excision of the hernial sac. Objective. To conduct a comparative analysis of the surgical treatment of patients with ADH in different clinics, assessing longterm outcomes. Patients and methods. The medical records of 7 children with ADH who underwent surgical repair in different clinics (in time period from 2009 to 2019) were retrospecively reviewed. Evaluating the long-term results of ADH repair was made by telephone and online surveys of the parents of patients and by outpatient examination of children (chest x-ray in two projections). Results. In a ten-year period, 7 patients (4 boys and 3 girls) were operated on with a diagnosis of “anterior diaphragmatic hernia” at the age of 3 months to 12 years. In most children, a hernia was discovered accidentally by chest x-ray. Laparoscopic correction was performed in 5 (71%) cases, thoracoscopic correction – in 2 cases (29%). The main difference in surgical tactics in ADH patients was the manipulation with the hernial sac – the hernial sac was excised in 4 (57%) patients, but it was left in three cases (43%). The defect closure was performed by “full-thickness” separated sutures that fix the diaphragm to the anterior abdominal wall during laparoscopy (5) and to the chest tissue during thoracoscopy (2); in some cases, additional fixation to the rib (4) was performed. Sutures were tied extracorporeally and buried in the subcutaneous layer in 6 (86%) patients. Average follow-up was 7 years. While evaluating long-term outcomes no ADH recurrence were found. Conclusions. There are still many controversial aspects in the surgical treatment of ADH patients. In our opinion, multicenter studies with complex analysis of long-term results are required to standardize the surgical treatment of such patients. Key words: anterior diaphragmatic hernia, Larrey hernia, long-term outcomes, Morgani hernia

scholarly journals Favorable long-term outcomes of one-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer treated at a high-volume center

2018 ◽  
Vol 21 (6) ◽  
pp. 1024-1030 ◽  
Author(s):  
Yosuke Kano ◽  
Manabu Ohashi ◽  
Naoki Hiki ◽  
Daisuke Takahari ◽  
Keisho Chin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Volume ◽  
Stage Ii ◽  
Pathological Stage ◽  
Long Term Outcomes ◽  
High Volume Center ◽  
One Year

The Preoperative Prognostic Nutritional Index Predicts Short-Term and Long-Term Outcomes of Patients with Stage II/III Gastric Cancer: Analysis of a Multi-Institution Dataset

2019 ◽  
Vol 37 (2) ◽  
pp. 135-144 ◽  
Author(s):  
Masahiro Sasahara ◽  
Mitsuro Kanda ◽  
Seiji Ito ◽  
Yoshinari Mochizuki ◽  
Hitoshi Teramoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Area Under The Curve ◽  
Prognostic Nutritional Index ◽  
Stage Ii ◽  
Long Term Outcomes ◽  
Short Term ◽  
Nutritional Index ◽  
Appropriate Treatment ◽  
Disease Free

Background/Aims: Identification of nutritional indicators to predict short-term and long-term outcomes is necessary to provide appropriate treatment to patients with gastric cancer. Methods: We designed an analysis of a multicenter dataset of patients with gastric cancer who underwent gastrectomy between 2010 and 2014. We enrolled 842 eligible patients who had stage II/III gastric cancer. The area under the curve (AUC) values were compared among prognostic nutritional index (PNI), calculated as 10 × albumin g/dL + 0.005 × total lymphocyte count/mm3, and its constituents, and the predictive value of preoperative PNI for postoperative short-term and long-term outcomes was evaluated. Results: Preoperative PNI exhibited higher AUC values (0.719) for 1-year survival than its constituents, and the optimal cutoff value was 47. The disease-free and overall survival of patients in the PNI-low group were significantly shorter compared with those in the PNI-high group. The prognostic difference between the PNI-high and PNI-low groups was significantly greater in the subgroup of patients who underwent total gastrectomy. Clinically relevant postoperative complications were more frequently observed in the PNI-low group. Conclusions: The preoperative PNI is a useful predictor reflecting the incidence of complications after gastrectomy and the prognosis of patients with stage II/III gastric cancer.

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