Carcinoma of the gastric cardia: Surgical management and long‐term survival

Moreaux, J; Msika, Simon

doi:10.1007/bf01658061

Cited by 38 publications

(17 citation statements)

References 28 publications

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“…Although curative resection for gastric cancer is most effective, most cases are in stage III and IV on identification in China [11][12][13] , as seen from the high rate of 74.9% in this study, and many of them were ineligible for radical treatment. Ekbom et al [14] reported that BPP in advanced cases only resulted in the average survival period of 5.9 mo, and none of the patients survived for more than one year, similar to the results of without tumor resection [15] . The average survival periods of patients without operation, with EL and BPP in China, as reported by National Gastric Cancer Cooperation Organization, were 4.1, 4.7, and 5.5 mo, respectively [11] , comparable with our findings (4.6, 5.2, and 6.4 mo, respectively, P>0.05).…”

Section: Discussionmentioning

confidence: 59%

Surgical treatment and prognosis of gastric cancer in 2 613 patients

Zhang

Huang²,

Lu³

et al. 2004

WJG

104

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AIM:To analyze the factors influencing the prognosis of patients with gastric cancer after surgical treatment, in order to optimize the surgical procedures. METHODS:A retrospective study of 2 613 consecutive patients with gastric cancer was performed. Of these patients, 2 301 (88.1%) received operations; 196 explorative laparotomy (EL), 130 by-pass procedure (BPP), and 1 975 surgical resection of the tumors (891 palliative resection and 1 084 curative resection). The survival rate was calculated by the actuarial life table method, and the prognostic factors were evaluated using the Cox regression proportional hazard model. RESULTS:Of the patients, 2 450 (93.8%) were followed-up. The median survival period was 4.6 mo for patients without operation, 5.2 mo for EL, 6.4 mo for BPP, and 15.2 mo for palliative resection (P = 0.0001). Of the patients with surgical resection of the tumors, the overall 1, 3 and 5-year survival rates after were 82.7%, 46.3% and 31.1%, respectively, with the 5-year survival rate being 51.2% in patients with curative resection, and 7.8% for those with palliative resection. The 5-year survival rate was 32.5% for patients with total gastrectomy, and 28.3% for those with total gastrectomy plus resection of the adjacent organs. The factors that independently correlated with poor survival included advanced stage, upper third location, palliative resection, poor differentiation, type IV of Borrmann classification, tumor metastasis (N 3 ), tumor invasion into the serosa and contiguous structure, proximal subtotal gastrectomy for upper third carcinoma and D 1 lymphadenectomy after curative treatment. CONCLUSION:The primary lesion should be resected as long as the local condition permitted for stage III and IV tumors, in order to prolong the patients' survival and improve their quality of life after operation. Total gastrectomy is indicated for carcinomas in the cardia and fundus, and gastric cancer involving the adjacent organs without distant metastasis requires gastrectomy with resection of the involved organs.

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Section: Discussionmentioning

confidence: 59%

Surgical treatment and prognosis of gastric cancer in 2 613 patients

Zhang

Huang²,

Lu³

et al. 2004

WJG

104

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“…Cancers of the proximal stomach are more likely to have lymph node metastases, present with an advanced stage of disease, and are less amendable to curative resection compared to distal gastric cancers [18]. Despite its increasing incidence worldwide, a consensus on the standard surgical treatment of proximal gastric cancer remains elusive.…”

Section: Discussionmentioning

confidence: 99%

Survival benefit of extended D2 resection for proximal gastric cancer

et al. 1997

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“…Estimated therapeutic value corresponds to the percentage of patients who will benefit from dissection of each lymph node station MST mean survival time favor of total gastrectomy [13]. Others pointed out there were no differences in the 5-year survival rate as well as in operative mortality between total gastrectomy versus proximal gastrectomy for advanced (pT2-pT4) type II and III carcinoma [6,[27][28][29][30]. Of note, it has never been clarified whether proximal gastrectomy can really provide some benefits, such as a better postoperative quality of life, when compared with total gastrectomy in patients with carcinoma of the cardia.…”

Section: Discussionmentioning

confidence: 99%

Pattern of abdominal nodal spread and optimal abdominal lymphadenectomy for advanced Siewert type II adenocarcinoma of the cardia: results of a multicenter study

et al. 2012

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Background It remains uncertain whether radical lymphadenectomy combined with total gastrectomy actually contributes to long-term survival for Siewert type II adenocarcinoma of the cardia. We identified the pattern of abdominal nodal spread in advanced type II adenocarcinoma and defined the optimal extent of abdominal lymphadenectomy. Methods Eighty-six patients undergoing R0 total gastrectomy for advanced type II adenocarcinoma were identified from the gastric cancer database of 4,884 patients. Prognostic factors were investigated by multivariate analysis. The therapeutic value of lymph node dissection for each station was estimated by multiplying the incidence of were considered not beneficial to dissect, whereas there were substantial therapeutic benefits to dissecting the perigastric nodes of the upper half of the stomach in positions 1-3 and the second-tier nodes in positions 7 and 11. Conclusions Limited lymphadenectomy attained by proximal gastrectomy might suffice as an alternative to extended lymphadenectomy with total gastrectomy for obtaining On behalf

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Carcinoma of the gastric cardia: Surgical management and long‐term survival

Cited by 38 publications

References 28 publications

Surgical treatment and prognosis of gastric cancer in 2 613 patients

Surgical treatment and prognosis of gastric cancer in 2 613 patients

Survival benefit of extended D2 resection for proximal gastric cancer

Pattern of abdominal nodal spread and optimal abdominal lymphadenectomy for advanced Siewert type II adenocarcinoma of the cardia: results of a multicenter study

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