Surgical outcomes and survival for T4 gastric cancer extending to the transverse colon

2020 ◽  
Author(s):  
Gang-Cheng Wang ◽  
Chong-Qing Gao ◽  
You-cai Wang ◽  
Hui-Fang Lv ◽  
Bei-Bei Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Surgical Outcomes ◽  
Transverse Colon ◽  
Curative Resection ◽  
Node Metastasis ◽  
T4 Gastric Cancer

Abstract Purpose Extended multi-organ resection for locally advanced (T4) gastric cancer remains controversial. Herein we aimed to evaluate the surgical outcomes and survival of patients with T4 gastric cancer extending to the transverse colon. Materials and Methods Between 2011 and 2015, forty patients had undergone curative resection for T4 gastric cancer extending to the transverse colon. Patient characteristics, related complications, long-term survival, and prognostic factors for T4 gastric cancer were analyzed. Results ost-operative morbidity occurred in 5 (12.5%) patients. The 1-, 3-, and 5-year overall survival rates were 75.0%, 49.2%, and 36.9%, respectively. Univariate analysis revealed that tumor size ( P =0.049), advanced T stage ( P =0.013), and lymph node metastasis ( P =0.006) are poor prognostic factors of overall survival. Based on multivariate analysis, advanced T stage and lymph node metastasis were identified as independent prognosis factors. Conclusions Patients with T4 gastric cancer extending to the transverse colon might benefit from curative resection with acceptable morbidity and mortality.

Primary Treatment and Prognostic Factors of Carcinosarcoma of the Ovary, Fallopian Tube, and Peritoneum: A Taiwanese Gynecologic Oncology Group Study

2014 ◽  
Vol 24 (3) ◽  
pp. 506-512 ◽  
Author(s):  
Chien-Hsing Lu ◽  
I-Hui Chen ◽  
Yi-Jen Chen ◽  
Kung-Liahng Wang ◽  
Jian-Tai Timothy Qiu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Fallopian Tube ◽  
Gynecologic Oncology ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
Node Metastasis ◽  
The Mean

ObjectiveThis study aimed to determine the clinical prognostic factors involved in carcinosarcoma of the ovary, fallopian tube, and peritoneum.Materials and MethodsThis retrospective study was undertaken by the Taiwanese Gynecologic Oncology Group. The retrieved clinical data included demographic characteristics, medical disease, tumor status, extent of surgery, and adjuvant chemotherapy.ResultsIn total, 63 patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum were identified. Sixty-one patients with complete data were enrolled for further data analysis. The mean follow-up period was 1.0 year, and the mean overall survival was 15.4 months. By log-rank tests, age, menopausal status, parity, hypertension, diabetes, primary tumor size, para-aortic lymph node metastasis, pretreatment CA-125, preceding diagnostic surgery, hysterectomy, lymphadenectomy, other surgeries, and paclitaxel use were not predictive of overall survival.Omentectomy, no gross residual implants after surgery, platinum treatment, and no pelvic lymph node metastasis had a trend toward better survival. Early diagnosis at stage I and cisplatin/ifosfamide regimen were significant associated with a better overall survival in log-rank and simple Cox regression tests. Bilateral ovarian tumors and metastatic tumors larger than 2 cm were significantly associated with a poorer overall survival.ConclusionsEarly diagnosis at stage I, unilateral ovarian tumor, metastatic tumors less than 2 cm, and cisplatin/ifosfamide regimen were predictive of a better survival.Omentectomy and complete debulking surgery also showed a trend toward better survival. Thus, these treatment strategies should be applied in patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum.

scholarly journals Prognosis of Stage IIB early gastric cancer has a unique and dismal property putatively requiring post operative adjuvant chemothrapy

2017 ◽  
Author(s):  
Hideki Ushiku ◽  
Keishi Yamashita ◽  
Akira Ema ◽  
Natsuya Katada ◽  
Kei Hosoda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Cancer Prognosis ◽  
Node Metastasis ◽  
Dismal Prognosis

Abstract Background Pathological T1 (pT1) gastric cancer showed excellent prognosis, however lymph node metastasis sometimes reflects patients with dismal prognosis. In this study, we investigated prognosis of pT1 gastric cancer with lymph node metastasis to identify prognostic factors. Patients and Methods Among 1,442 gastric cancer patients between 2002 and 2010, 73 (5%) of pT1 with lymph node metastasis were identified. Univariate prognostic factors were applied to multivariate Cox proportional hazards model. Results (1) Among the 1,442 patients, pT1 was composed of 333 patients with pT1a and 423 patients with pT1b, which included 9 (2.7%) and 64 cases (15.1%) with lymph node metastasis, respectively. (2) Ten (13.7%) patients of the 73 patients with lymph node metastasis showed tumor relapse.　　Univariate negative prognostic factors were tumor size (p=0.03), intraoperative bleeding (p=0.03), and perioperative transfusion (POT)(p=0.001), as well as 14th JGCA Stage (p<0.0001), and multivariate analysis identified 14th JGCA Stage (p=0.0004) and POT (p=0.03) as independent prognostic factors. (3) pT1 gastric cancer representing pN3 (Stage IIB) was rare (n=4) and unique entity from a prognostic point of view, exhibiting dismal prognosis (0% at 5 years). We thereafter identified 17 such cases from 5,204 gastric cancer including the earliest cases. Prognosis of such 17 patients was very unique, in that recurrences occurred even 5 years after curative operation, and the frequent recurrent sites were bone. Conclusion pT1 gastric cancer prognosis is robustly affected by pN3 and POT, and Stage IIB disease showed unique prognosis requiring special attention even after 5 years of operation.

The survival outcome after hepatic resection in patients with liver metastasis from gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 161-161
Author(s):  
Taichi Tatsubayashi ◽  
Yuichiro Miki ◽  
Wataru Takagi ◽  
Fumiko Hirata ◽  
Hayato Omori ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Survival Rate ◽  
Liver Metastasis ◽  
Lymph Node Metastasis ◽  
Hepatic Resection ◽  
Treatment Strategy ◽  
Survival Outcome ◽  
Node Metastasis

161 Background: Optimal treatment strategy for patients with liver metastasis from gastric cancer (LMGC) has not yet been established. Although systemic chemotherapy remains mainstay of treatment for LMGC, complete resection of primary tumor and LMGC may improve survival outcome. Thus, the aim of this study is to investigate survival outcome and prognostic factors of patients who underwent hepatic resection for LMGC. Methods: From September 2002 to February 2014, 30 patients underwent hepatic resection for LMGC in our hospital. Indications of hepatic resection were as follows; (1) hepatic lesion is not more than three, (2) without extrahepatic metastasis other than lymph node metastasis, (3) adequate liver function. We investigated the overall median survival time (MST) and 5-year survival rate of all eligible patients. Univariate and multivariate analyses were performed to assess the association between each clinicopathological features and overall survival time. Results: There were 25 males and 5 females with a median age of 72 (range, 39-86). There were 16 synchronous LMGCs and 14 metachronous LMGCs. With respect to the number of LMGC, 22 patients had 1 lesion, 7 patients had 2 lesions, and 1 patient had 3 lesions. Overall MST and 5 year survival rates after hepatic resection were 2.8 years and 31.0%, respectively. The significant prognostic factors were age (70 years or older, p=0.029) and blood transfusion (p=0.013). Multivariate analysis showed that lymph node metastasis was an only independent indicator of poor prognosis (HR=6.13, p=0.026). Conclusions: Hepatic resection for patients with LMGC might be a promising treatment strategy, with 5-year survival rate of 31.0%. Lymph node metastasis was an only independent prognostic factor. A multi-institutional confirmatory study will be required to evaluate the role of hepatic resection in patients with LMGC.

scholarly journals The Clinical and Prognostic Factors for Biliary Neuroendocrine Neoplasm: A Study Based on the SEER Database

2021 ◽  
Author(s):  
Bohao Zheng ◽  
Cheng Zhang ◽  
Wenze Wan ◽  
Wentao Sun ◽  
Xi Cheng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Bile Duct ◽  
Lymph Node Metastasis ◽  
Neuroendocrine Neoplasm ◽  
Biliary Duct ◽  
Seer Database ◽  
Postoperative Prognosis ◽  
Node Metastasis

Abstract Background: In this study, we aimed at elucidating the postoperative survival and prognostic factors in patients with biliary neuroendocrine neoplasm (NEN).Methods: Cases of biliary system NEN and adenocarcinoma were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A propensity score matching (PSM) method was used to adjust baseline differences in clinicopathological characteristics in our analysis. The Kaplan-Meier analysis was carried out for survival analysis. Results：A total of 243 patients with biliary system NEN were enrolled in this study, of which 119 patients’ lesions located in gallbladder, while the others’ located in bile duct. The postoperative overall survival of bile duct NEN is significantly longer than that of gallbladder NEN (P<0.001). For GB-NENs, surgery method (P=0.020) and lymph node metastasis (P=0.018) were identified as independent prognostic factors. In terms of AOV NENs, age (P=0.017) and lymph node metastasis (P=0.006) were identified was independent prognostic factor, while grade (P=0.002) and lymph node metastasis (P=0.036) were identified as independent prognostic factors for EBD NENs. PSM analysis indicated that patients with biliary duct NENs have better postoperative prognosis than biliary duct adenocarcinoma.Conclusions: Patients with NEN have better overall survival than patients with adenocarcinoma. Gallbladder NEN has adverse prognosis than that of biliary tract NEN. Pathological subtype, differentiation, lymph node metastasis, surgery method and lymph node resection could affect postoperative prognosis of gallbladder and biliary tract NEN.

Impact of external-beam radiation therapy on outcomes among patients with resected gastric cancer: A multi-institutional analysis.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 84-84
Author(s):  
Aslam Ejaz ◽  
Gaya Spolverato ◽  
Yuhree Kim ◽  
Malcolm Hart Squires ◽  
Sharon M. Weber ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Perioperative Therapy ◽  
Curative Intent ◽  
Factors Associated ◽  
Node Metastasis

84 Background: Use of perioperative chemotherapy (CTx) alone versus chemo-radiation therapy (cXRT) in the treatment of resectable gastric cancer remains varied. We sought to define the utilization and effect of CTx alone versus cXRT on patients having undergone curative-intent resection for gastric cancer. Methods: Using the multi-institutional U.S. Gastric Cancer Collaborative database, we identified 505 patients between 2000 and 2012 with gastric cancer who received perioperative therapy in addition to curative-intent resection. The impact of perioperative therapy on survival was analyzed by the use of propensity-score matching of clinicopathologic factors among patients who received CTx alone versus cXRT. Results: Median patient age was 62 years and the majority of patients were male (58%). Surgical resection involved either partial gastrectomy (54%) or total gastrectomy (46%). On pathology, median tumor size was 5.0 cm; most patients had a T3 (37%) or T4 (36%) lesion and lymph node metastasis (74%). Margin status was R0 in most patients (89%). 211 (42%) patients received perioperative CTx alone whereas the remaining 294 (58%) patients received 5-FU based cXRT. Factors associated with receipt of cXRT were younger age (OR 0.98), T3 tumors (OR 1.52), and lymph node metastasis (OR 2.03) (all P < .05). Recurrence occurred in 214 (39%) patients. At a median follow-up of 28 months, median overall survival (OS) was 33.4 months and 5-year survival was 36.7%. Factors associated with worse OS included tumor size (HR 1.1), T-stage (HR 1.5), and lymph node metastasis (HR 1.58) (all P<0.05). In contrast, receipt of cXRT was associated with improved long-term OS (CTx alone: 21 months vs. cXRT 45 months; p<0.001). In the propensity-matched multivariate model that adjusted for tumor size, T-stage, and nodal status, cXRT remained associated with an improved long-term disease-free (HR 0.43) and overall (HR 0.41) survival (both P<0.001). Conclusions: XRT was utilized in 58% of patients undergoing curative-intent resection for gastric cancer. Using propensity-matched analysis, cXRT was an independent factor associated with improved recurrence-free and overall survival.

scholarly journals Recurrence after ESD curative resection for early gastric cancer

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ayako Kamiya ◽  
Hitoshi Katai ◽  
Kenichi Ishizu ◽  
Takeyuki Wada ◽  
Tsutomu Hayashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Curative Resection ◽  
Treatment Guidelines ◽  
Submucosal Tumor ◽  
Pathological Examination ◽  
Node Metastasis

Abstract Background Endoscopic submucosal dissection (ESD) is gaining ground as a minimally invasive treatment for early gastric cancer (EGC) that has a negligible risk of lymph node metastasis. According to the 5th edition of Japanese gastric cancer treatment guidelines, annual or biannual follow-up with endoscopy is recommended, but follow-up with abdominal ultrasonography or computed tomography (CT) for surveillance of metastases is not recommended after the eCuraA resection. However, we experienced a case of lymph node recurrence following ESD resulting in eCuraA. Case presentation A 76-year-old female received ESD for EGC in a previous hospital 4 years ago. Pathological findings were tub1, 30 mm, T1a (M), UL0, Ly0, V0, pHM-, pVM- (eCuraA) according to the 15th edition of Japanese Classification of Gastric Carcinoma. Follow-up esophagogastroduodenoscopy revealed submucosal tumor, which was suspected as a swollen lymph node by CT and endoscopic ultrasound fine-needle aspiration revealed the recurrence of gastric cancer. We performed total gastrectomy with D2 lymph node dissection. Postoperative pathological examination revealed no local recurrent tumor at the ESD site in the stomach. Swollen lymph node was diagnosed as metastasis and lymph node metastasis was limited near the cardia. Conclusion This case provides valuable information about tumor with a minimum poorly differentiated adenocarcinoma component may develop lymph node metastasis even satisfying the guidelines criteria for curative resection.

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