Actual 3-Year Survival After Laparoscopy-Assisted Gastrectomy for Gastric Cancer

Hwang, Sun-Hwi; Park, Do Joong; Jee, Ye Seob; Kim, Min-Chan; Kim, Hyung‐Ho; Lee, Hyuk-Joon; Yang, Han–Kwang; Lee, Kuhn Uk

doi:10.1001/archsurg.2009.110

Cited by 51 publications

(38 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Laparoscopic gastrectomy is an alternative option for the treatment of early gastric cancer, and is associated with less postoperative pain, a shorter recovery period after surgery, and fewer complications [8][9][10][11]. Recent studies suggested that the indications for this procedure be extended from locally-advanced cancer to far-advanced cancer to reflect the advances made in laparoscopic devices and techniques [12,13].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic completion total gastrectomy for remnant gastric cancer: a single-institution experience

et al. 2014

View full text Add to dashboard Cite

Background The aim of the present study was to evaluate the feasibility of laparoscopic completion total gastrectomy (LCTG) in patients with remnant gastric cancer. Methods Patients who underwent completion total gastrectomy for remnant gastric cancer between May 2003 and December 2012 were divided into two groups: an open completion total gastrectomy (OCTG) group and an LCTG group. Clinicopathological data, operative data, and patient survival rates were analyzed. Results Thirty-four remnant gastrectomies (17 OCTG and 17 LCTG) were performed. The mean time interval between the prior gastrectomy and the remnant gastrectomy was 17.2 years, and benign disease showed a longer time interval than malignancy (30.9 vs. 8.1 years; p \ 0.0001). LCTG required a longer operation time than OCTG (234.4 vs. 170.0 min; p = 0.002); however, there were no significant differences in the estimated blood loss, the number of retrieved lymph nodes, the time to first flatus passage, the length of hospital stay, complication rates, and postoperative analgesia between the two groups. Eight patients (47.1 %) required conversion to open surgery during LCTG. The median overall survival was 69.1 months. There was no difference in 5-year survival between the two groups (p = 0.085). Conclusion LCTG was technically feasible; however, it showed no definitive clinical advantage over OCTG.

show abstract

Section: Introductionmentioning

confidence: 99%

Laparoscopic completion total gastrectomy for remnant gastric cancer: a single-institution experience

et al. 2014

View full text Add to dashboard Cite

show abstract

“…As a minimally invasive surgery, laparoscopic gastrectomy has several advantages over open gastrectomy, especially with respect to early postoperative outcomesthat is, it reduces postoperative pain, surgical stress, and estimated blood loss, it accelerates recovery and return to normal bowel function and oral intake, and it reduces the duration of hospital stay [6][7][8][9]. Because gastric cancer is mostly located in the distal area in patients in Eastern countries, laparoscopic distal gastrectomy has been a more common procedure than laparoscopic total or proximal gastrectomy.…”

mentioning

confidence: 99%

Laparoscopy-assisted proximal gastrectomy for early gastric cancer is an ugly duckling with unsolved concerns: oncological safety, late complications, and functional benefit

2013

View full text Add to dashboard Cite

There are notable changes in that the proportion of early gastric cancer (EGC) and proximal gastric cancer has increased continuously during the past 20 years, from 24.8 % to nearly 50 % and from 5.3 to 14.0 %, respectively. Proximal EGC consists of 30.3 % of all proximal gastric cancer whereas distal EGC consists of 51.5 % of all distal gastric cancer [1][2][3]. Accordingly, more and more surgeons are interested in laparoscopic gastrectomy for early gastric cancer. In proximal EGC and the concept of minimally invasive surgery, laparoscopy-assisted proximal gastrectomy (LAPG) is a theoretically better treatment option than others [i.e., open proximal gastrectomy, open total gastrectomy, and laparoscopy-assisted total gastrectomy (LATG)]. However, LAPG is not popular these days.Even including the open cases, proximal gastrectomy was performed in only 141 (1.0 %) patients in 2009 [2]. Proximal gastrectomy (PG) is not yet the standard treatment for patients with proximal early gastric cancer (EGC): it is still classified as an investigational treatment by the Japanese gastric cancer treatment guidelines [4]. The application of proximal gastrectomy to proximal EGC has been limited by the following three main concerns. The first is oncological concern, mainly focused on limited lymph node dissection; the second is late complications such as reflux esophagitis and anastomotic stricture, related to reconstruction methods; and the third is functional benefits.In a recent systematic and meta-analysis comparing total gastrectomy with proximal gastrectomy, it was concluded that total gastrectomy and proximal gastrectomy had similar overall survival outcomes for proximal gastric cancer. However, proximal gastrectomy with esophagogastrostomy exhibited a higher incidence of reflux esophagitis and anastomotic stenosis. Total gastrectomy was therefore recommended for proximal gastric cancer [5].However, the number of cases of proximal EGC has been increasing in Korea because of national screening programs and advances in endoscopic diagnosis and devices [1][2][3]. Is it feasible for all these patients with EGC, who are capable of showing a good survival rate after surgery, to undergo open total gastrectomy?As a minimally invasive surgery, laparoscopic gastrectomy has several advantages over open gastrectomy, especially with respect to early postoperative outcomesthat is, it reduces postoperative pain, surgical stress, and estimated blood loss, it accelerates recovery and return to normal bowel function and oral intake, and it reduces the duration of hospital stay [6][7][8][9]. Because gastric cancer is mostly located in the distal area in patients in Eastern countries, laparoscopic distal gastrectomy has been a more common procedure than laparoscopic total or proximal gastrectomy. However, recently, some positive outcomes of laparoscopic total or proximal gastrectomy have been reported [10][11][12]. In this context, laparoscopic proximal gastrectomy is an attractive treatment option for proximal EGC when considering the prognos...

show abstract

“…A large number of surgeries involving gastrectomy with standard lymph node dissection have been carried out in South Korea and Japan (8,9). The results of randomized research allow us to conclude that gastrectomy has a number of advantages over conventional surgery; these are less blood loss and fewer complications, quicker patient recovery, fewer post-operative bed days, better visual effects, and almost the same 5-year survival rates at 57.3% vs. 58.9% (10)(11)(12).…”

Section: Minimally Invasive Treatment For Early Gcmentioning

confidence: 99%

Current practice for gastric cancer treatment in Ukraine

Sydiuk

2017

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

IntroductionGastric cancer (GC) is a significant and unsolved problem, despite a slight decrease in its morbidity. Globally, 952,000 new GC cases were registered in 2012. In South Korea and Japan, because of screening for GC, the 5-year survival rate is more than 60%. In most other countries, this value is 2-3 times lower (1,2). In Ukraine, GC is a serious problem. Annually, the country registers more than 8,000 new GC cases. The disease is usually diagnosed at stage III-IV (65% of cases) and 62.2% of patients die within 1 year. About 70% of patients with GC need chemotherapy, and for most of them, this is the only way to increase their life expectancy. Morbidity and death rateAccording to the national cancer register of Ukraine, there were 8,350 new cases of GC in 2014 (5,104 in men and 3,246 in women). Thus, the morbidity rate is 23.0 cases per 100,000 people (30.3 for men and 16.7 for women), which puts the disease in fourth place for men and eighth place for women for morbidity as a result of malignant tumors in Ukraine. During the period under investigation, 6,414 patients diagnosed with GC died. The death rate was 17.7 cases per 100,000 people (23.8 for men and 12.3 for women), which means that, for men and women respectively, GC has the second and third highest death rates from malignant tumors in Ukraine.People diagnosed with GC for the first time are diagnosed at the following stages according to the TNM classification: stage I-II, 37.6%; stage III, 22.5%; stage IV, 33.9%; and indistinct stage, 5%. Thus, advanced GC is diagnosed for the first time in as many as 60% of all patients, which leads to a high death rate of more than 50% during the first year.The above information allows us to conclude that the early diagnosis of GC, as well as combined methods of treating it with neo-adjuvant and adjuvant therapy, is of paramount importance in Ukraine.Despite the gradual decline in GC morbidity, there are still some serious associated problems. Namely, in the last 10 years, the following was noted ( Table 1): (I) very few changes in the morbidity rate for women; (II) decrease in the diagnosis of stage I-II disease in spite of the necessary endoscopic equipment; (III) high death rate within 1 year.Given this information, we should define the most of patients with GC need chemotherapy, and for most of them, this is the only way to increase their lifeexpectancy. An unsolved problem of nationwide importance is achieving the early diagnosis of GC, which predetermines the treatment outcome. The 5-year survival rate for GC patients in Ukraine is only 13%, while early diagnosed GC is almost totally curable using surgery. Another important task is the development of national diagnosis and treatment standards, which will be based on national breakthroughs and will meet modern international requirements.

show abstract

Actual 3-Year Survival After Laparoscopy-Assisted Gastrectomy for Gastric Cancer

Abstract: Laparoscopy-assisted gastrectomy is acceptable oncologically in early gastric cancer if 3-year disease-free survival represents 5-year overall survival. Laparoscopy-assisted gastrectomy may also play an important role in the treatment of advanced gastric cancer.

Cited by 51 publications

References 45 publications

Laparoscopic completion total gastrectomy for remnant gastric cancer: a single-institution experience

Laparoscopic completion total gastrectomy for remnant gastric cancer: a single-institution experience

Laparoscopy-assisted proximal gastrectomy for early gastric cancer is an ugly duckling with unsolved concerns: oncological safety, late complications, and functional benefit

Current practice for gastric cancer treatment in Ukraine

Contact Info

Product

Resources

About