scholarly journals Radical Versus Non-Radical Resection for Small intestinal Gastrointestinal Stromal Tumors: A Propensity Score-Matched Analysis

2021 ◽  
Author(s):  
Linlin Yin ◽  
Haihao Yan ◽  
Jue Lin ◽  
Zuhong Ji ◽  
Guozhong Ji ◽  
...  
Keyword(s):  
Propensity Score ◽  
Gastrointestinal Stromal Tumors ◽  
Radical Surgery ◽  
Radical Resection ◽  
Term Survival ◽  
Long Term Survival ◽  
Resection Group ◽  
Stromal Tumors ◽  
Small Intestinal

Abstract Surgical resection is the first choice for the treatment of small intestinal gastrointestinal stromal tumors (GISTs), but the best surgical method for small intestinal stromal tumors remains undefined. It is not clear whether there is a difference in the long-term survival of small intestinal GISTs between radical surgery and non-radical surgery. We included 877 patients with small intestinal stromal tumors who underwent surgery between 2010 and 2015 from the SEER database. They were divided into the radical resection group and the non-radical resection group. To minimized the selection bias and mixed bias in the comparison, propensity score matching (PSM) and multivariate regression analysis were carried out. In the entire cohort, 120 patients underwent radical surgery and 757 patients received non-radical resection. The 1, 3, and 5-year OS rates were 95.7%, 80.2%, and 69.6% in the radical resection group versus 94.3%, 86.8%, and 77.2% in the non-radical resection group, respectively. (p=0.069) Meanwhile, radical resection had the similar CSS rates of 1, 3 and 5-year compared with non-radical surgery. (1-year CSS rate: 97.4% vs. 98.0%, 3-year CSS rate: 86.1% vs. 93.2%, 5-year CSS rate: 81.6% vs. 88.3%; p =0.056) Besides, after adjusting for other clinical factors and PSM, the long-term OS and CSS did not significantly differ between radical surgery and non-radical surgery. Our study preliminarily found that for small intestinal GISTs, there was no significant difference in long-term survival between radical surgery and non-radical surgery.

Perioperative glucocorticoids are associated with improved long-term survival after pancreatic cancer surgery: A retrospective cohort study

2020 ◽  
Author(s):  
Yun-Xiao Zhang ◽  
Dong-Liang Mu ◽  
Ke-Min Jin ◽  
Xue-Ying Li ◽  
Dong-Xin Wang
Keyword(s):  
Pancreatic Cancer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Radical Surgery ◽  
Radical Resection ◽  
Cancer Surgery ◽  
Term Survival ◽  
Long Term Survival

Abstract Background Perioperative anesthetic management may affect long-term outcome after cancer surgery. This study aimed to investigate the effect of perioperative glucocorticoids on long-term survival in patients after radical resection for pancreatic cancer.Methods In this retrospective cohort study, patients who underwent radical resection for pancreatic cancer from January 2005 to December 2016 were recruited. Baseline and perioperative data including use of glucocorticoids for prevention of postoperative nausea and vomiting were collected. Patients were followed up for tumor recurrence and survival. The primary outcome was the overall survival (OS); the secondary outcome was the recurrence-free survival (RFS). A multivariable Cox proportional hazard model was used to analyze the influence of perioperative glucocorticoid use on OS and RFS after correction for confounding factors.Results A total of 215 patients after radical surgery for pancreatic cancer were included in the study; of these, 112 received perioperative glucocorticoids and 103 did not. Patients were followed up for a median of 74.0 months (95% confidence interval [CI] 68.3-79.7). Both OS and RFS were significantly longer in patients with glucocorticoids than in those without (for OS: median 19.7 months [95% CI 12.3-36.2] vs. 13.9 months [8.0-23.9], P=0.001; for RFS: 12.0 months [6.0-28.0] vs. 6.9 months [4.2-17.0], P=0.002). After correction for confounding factors, perioperative glucocorticoids were significantly associated with prolonged OS (HR 0.692, 95% CI 0.499-0.959, P=0.027) and RFS (HR 0.634, 95% CI 0.459-0.878, P=0.006).Conclusions Perioperative use of low-dose glucocorticoids may improve long-term survival in patients undergoing radical surgery for pancreatic cancer.

scholarly journals Liver Resection for Metastases from Gastrointestinal Stromal Tumors: Does it Improve Long-Term Survival?

Chirurgia ◽  
2021 ◽  
Vol 116 (4) ◽  
pp. 438
Author(s):  
Alin Kraft ◽  
Adina Croitoru ◽  
Cristian Gheorghe ◽  
Ioana Lupescu ◽  
Mugur Grasu ◽  
...  
Keyword(s):  
Liver Resection ◽  
Gastrointestinal Stromal Tumors ◽  
Term Survival ◽  
Long Term Survival ◽  
Stromal Tumors

scholarly journals Effects of Clavien-Dindo classification on long-term survival of patients with advanced gastric cancer after radical resection:A propensity score-matched study

2021 ◽  
Author(s):  
Wenwu Yan ◽  
Jun Du ◽  
Qingyi Li ◽  
Changsheng Yao ◽  
Mengxiang Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Propensity Score ◽  
Radical Resection ◽  
Survival Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Independent Risk Factors

Abstract Background The impact of postoperative complications (POCs) classified by the Clavien-Dindo (C-D) system on long-term survival after radical resection in patients with advanced gastric cancer (AGC) is not yet clear.Methods This study analyzed 531 patients with AGC who underwent radical resection in an institution between January 2015 and December 2017. Patients were divided into two groups according to the occurrence of POCs and recorded according to C-D classifications.The long-term survival outcomes of the entire cohort after propensity score matching (PSM) were compared.Results After PSM, there was no significant difference in baseline data between the complications (C) group (n = 92) and the non-complications (NC) group (n = 92). Survival analysis showed that the 5-year overall survival (OS) and relapse-free survival (RFS) were lower in the C group (48.9% vs. 62.0%, p = 0.040; 38.5% vs. 54.9%, p = 0.005; respectively). Subgroup analysis showed that severe complications (C-D grade > II) were associated with a decrease in 5-year OS and RFS compared with the matched NC group (40.0% vs. 62.0%, p = 0.008; 29.4% vs. 54.9%, p = 0.001; respectively). Multivariate analysis confirmed adjuvant chemotherapy, tumor size, and complications were independent risk factors for poor survival outcomes. Further multivariate analysis showed that older age, combined excision, and comorbidities were independent risk factors for POCs.Conclusions Severe complications reduced the survival outcome of patients.Older age, combined excision, and comorbidities were independent risk factors for POCs. More attention should be paid to perioperative management of patients with high risk factors for complications.

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