Multivisceral Resection for Gastric Cancer: Results from the US Gastric Cancer Collaborative

Tran, Thuy B.; Worhunsky, David J.; Norton, Jeffrey A.; Squires, Malcolm H.; Jin, Linda X.; Spolverato, Gaya; Votanopoulos, Konstantinos I.; Schmidt, Carl; Weber, Sharon M.; Bloomston, Mark; Cho, Clifford S.; Levine, Edward A.; Fields, Ryan C.; Pawlik, Timothy M.; Maithel, Shishir K.; Poultsides, George A.

doi:10.1245/s10434-015-4694-x

Cited by 37 publications

(41 citation statements)

References 29 publications

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“…Bias due to the inclusion of tactical/incidental splenectomy (45% of the cases were from splenectomy alone) and other non–en bloc resections (gallbladder and lung) are present 5 . As for the other comparative study, it is from a collaborative database and it is not clear how many splenectomies were performed for lymph node clearance or due to iatrogenic injury 3 . The authors even state that their incidence of pT4 (58%) may be due to these events.…”

Section: Discussionmentioning

confidence: 99%

“…5 As for the other comparative study, it is from a collaborative database and it is not clear how many splenectomies were performed for lymph node clearance or due to iatrogenic injury. 3 The authors even state that their incidence of pT4 (58%) may be due to these events. It is also concerning in this study the low lymph node yield (17 for SG and 18-20 for MVR) and the low 5-year OS for pT1-T3 lesions (<40% for SG).…”

Section: Discussionmentioning

confidence: 99%

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Multivisceral resection vs standard gastrectomy for gastric adenocarcinoma

Dias

Pereira

Oliveira

et al. 2020

Journal of Surgical Oncology

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Introduction Multivisceral resection (MVR) is potentially curative for selected gastric cancer patients, supposedly at the cost of increased complications. However, current data comparing MVR to standard gastrectomy (SG) is lacking. Objectives Compare complications and survival after MVR and SG. Methods In a retrospective cohort of 1015 patients with gastric adenocarcinoma, 58 underwent MVR and 466 SG. Groups were compared concerning their characteristics, complications, and survival. Results One hundred seventy‐six patients had postoperative complications. Major complications were more frequent after MVR (P = .002). Surgical mortality was 8.6% and 4.9% for MVR and SG (P = .221). Older age, higher morbidities, and MVR were independent risk factors for major complications. The odds ratio for major complications was 5.89 for MVR with one or two organs and 38.01 for MVR with three or more organs. The pancreas was the most commonly removed organ and pT4b disease were confirmed in 34 (58.6%) of the MVR cases. Disease‐free survival (DFS) was lower in MVR patients (51% vs 77.8%; P < .001), being worse according to the number of organs resected. In pN+ patients, DFS was worse after MVR. DFS was equivalent to pT4b and non‐pT4b in the MVR group. Conclusions Increased morbidity and lower survival are expected for gastric cancer patients undergoing MVR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multivisceral resection vs standard gastrectomy for gastric adenocarcinoma

Dias

Pereira

Oliveira

et al. 2020

Journal of Surgical Oncology

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“…Multivisceral resections were significant ones, with splenectomy remaining in the final overall morbidity model, and pancreatectomy being associated with overall and major morbidity. Pancreaticosplenectomy has long been related to higher postoperative morbidity and mortality, with a marked impact on survival in retrospective series and lymphadenectomy trials . The other factors were the extent of resection and operative time.…”

Section: Discussionmentioning

confidence: 99%

“…Pancreaticosplenectomy has long been related to higher postoperative morbidity and mortality, with a marked impact on survival in retrospective series 23,24 and lymphadenectomy trials. 3,4 The other factors were the extent of resection and operative time.…”

Section: Discussionmentioning

confidence: 99%

Predicting overall and major postoperative morbidity in gastric cancer patients

Coimbra

Jesus

Franco

et al. 2019

Journal of Surgical Oncology

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Background Postoperative complications after gastric cancer resection vary in different series and they might have a significant impact in long‐term outcomes. Our aim was to build a prediction rule on gastric cancer patients' overall and major morbidity risks. Methods This retrospective study included 1223 patients from a single center who were resected between 1992 and 2016. Overall and major morbidity predictors were identified through multiple logistic regression. Models' performances were assessed through discrimination, calibration, and cross‐validation, and nomograms were constructed. Results The mean age was 61.3‐year old and the male gender was more frequent (60%). The most common comorbidities were hypertension (HTN), diabetes, and chronic obstructive pulmonary disease (COPD). A D2‐distal gastrectomy was the most frequent procedure and 87% of all lesions were located in the middle or distal third. Age, COPD, coronary heart disease, chronic liver disease, pancreatic resection, and operative time were independent predictors of overall and major morbidity. The extent of resection and splenectomy was associated with overall events and HTN with major ones. Both models were very effective in predicting events among patients at higher risk. Conclusions The overall and major morbidity models and nomograms included clinical‐ and surgical‐related data that were very effective in predicting events, especially for high‐risk patients.

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“…Depth invasion state decide whether the tumor can be totally removed. If tumor is limited in T3 layer, a radical resection of tumor is quite possible [9], and if T4 layer invasion is suspected combined organ resection maybe necessary [10]. On the other hand, N2 lymph node resection is the standard requirement for operation of AGC.…”

Section: Discussionmentioning

confidence: 99%

The Role of Preoperative 64 MDCT in the Evaluation of Tumor Stage for Advanced Gastric Carcinoma

WANG¹,

SU²,

Chang³

et al. 2018

dtmse

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To evaluate the accuracy of preoperative 64-detector row computer tomography (MDCT) enhanced scanner in tumor stage prediction for advanced gastric carcinoma, the data of 62 patients with advanced gastric cancer who underwent preoperative 64 MDCT were retrospectively analyzed. Pathological tumor stage was based on international TNM stage of Gastric Carcinoma Association. All MDCT results were compared with surgical and postoperative pathologic results. Results showed that the prediction accuracy of MDCT for T2, T3 and T4 stage evaluation is 42.8% (9/21), 80.7% (21/26) and 60.0% (9/15) respectively. The prediction sensitivity for N2 metastasis is 75%, sensitivity is 92%, and accuracy is 88.7%. It is concluded that preoperative 64 MDCT can provide relatively higher accuracy for detection of T3 and T4 layer invasion of gastric carcinoma, and help to predict the N2 lymph node metastasis for AGC.

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Multivisceral Resection for Gastric Cancer: Results from the US Gastric Cancer Collaborative

Cited by 37 publications

References 29 publications

Multivisceral resection vs standard gastrectomy for gastric adenocarcinoma

Multivisceral resection vs standard gastrectomy for gastric adenocarcinoma

Predicting overall and major postoperative morbidity in gastric cancer patients

The Role of Preoperative 64 MDCT in the Evaluation of Tumor Stage for Advanced Gastric Carcinoma

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