Studies on clinical features and reasonable lymph node dissection of cancer in upper stomach from the viewpoint of histological form of esophageal invasion.

Abstract Background: Elderly patients with gallbladder cancer (GBC) may be a special group of individuals. The present study aimed to explore the clinical features and prognostic factors of elderly patients with GBC and establish nomogram to predict their overall survival (OS). Methods: Patients diagnosed with GBC from 2010 to 2015 were identified from the Surveillance Epidemiology and End Results database. Clinical characteristics and prognostic factors in elderly GBC patients were examined. Results: Elderly patients and young patients with GBC differed in many aspects, including race, marital status, AJCC stage, T stage, N stage, M stage, surgery, lymph node dissection, radiation, chemotherapy, and OS (P<0.05). Analysis of prognostic factors showed that chemotherapy and surgery with lymph node dissection (radical surgery), as the main treatment for elderly patients, can significantly improve prognosis. Other factors, including being unmarried, higher grade of histological type and AJCC stage, had a negative effect on OS. Nomogram was developed based on the above prognostic factors. The C-indexes of 1-year survival and 3-year survival nomogram were 0.73 and 0.736 and AUCs at 1 and 3 years were 0.789 and 0.780, respectively. Conclusions: Elderly patients with GBC comprise a distinct group of individuals whose clinical characteristics differ from those of young patients, and the nomogram constructed accurately predicted OS in elderly patients with GBC.

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SURGICAL OUTCOMES IN PATIENTS WITH PROXIMAL GASTRIC CANCER WITHOUT ESOPHAGEAL INVASION

Siberian Journal of Oncology ◽

10.21294/1814-4861-2021-20-4-84-90 ◽

2021 ◽

Vol 20 (4) ◽

pp. 84-90

Author(s):

F. Sh. Akhmetzyanov ◽

A. H. Kaulgud ◽

F. F. Akhmetzyanova

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Postoperative Complications ◽

Lymph Node Dissection ◽

Surgical Outcomes ◽

Survival Rates ◽

Node Dissection ◽

Proximal Gastric Cancer ◽

D2 Lymph Node Dissection ◽

Esophageal Invasion

The aim of the study was to improve surgical outcomes in patients with proximal gastric cancer without invading the esophagus.Material and methods. Data regarding lymph node metastasis, short-term postoperative complications/lethality, and long-term outcomes were analyzed in 162 patients with proximal gastric cancer without invasion of the esophagus. All patients underwent gastrosplenectomy with expanded d2 lymph node dissection. The age of the patients ranged from 25 to 91 years, and the median age was 60 years. There were 105 (64.8 %) patients aged over 60 years and 45 (27.8 %) over 70 years.Results. Postoperative complications occurred in 14 patients (8.6 %), 8 of them (4.9 %) died. The 1-, 3- and 5 year survival rates were 85.4 %, 61.8 %, and 38.9 %, respectively.Discussion. In patients with gastric cancer without esophageal invasion, perigastric lymph nodes (№ 3b, 4d) located in segments iv and v are often affected by metastases; therefore, we consider it inexpedient to perform proximal resections in these cases.Conclusion. In patients with proximal gastric cancer without esophageal invasion, it is not advisable to perform proximal subtotal gastric resections due to the high frequency of 3b and 4d lymph node metastases. Postoperative complication and mortality rates were 8.6 % and 4.9 %, respectively in patients who underwent gastrosplenectomy with d2 lymph node dissection.

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