Postoperative mortality and morbidity after D2 lymphadenectomy for gastric cancer: A retrospective cohort study

Brisinda, Giuseppe; Chiarello, Maria Michela; Crocco, Anna; Adams, Neill James; Fransvea, Pietro; Vanella, Serafino

doi:10.3748/wjg.v28.i3.381

Cited by 16 publications

(18 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…LNM strongly affects the prognosis[ 14 , 54 ]. This is a topic of not negligible importance because EGC is believed to be a curable albeit malignant disease.…”

Section: Treatmentmentioning

confidence: 99%

Early gastric cancer: A challenge in Western countries

Chiarello¹,

Fico²,

Pepe³

et al. 2022

WJG

Self Cite

View full text Add to dashboard Cite

Early gastric cancer (EGC) is an invasive carcinoma involving only the stomach mucosa or submucosa, independently of lymph node status. EGC represents over 50% of cases in Japan and in South Korea, whereas it accounts only for approximately 20% of all newly diagnosed gastric cancers in Western countries. The main classification systems of EGC are the Vienna histopathologic classification and the Paris endoscopic classification of polypoid and non-polypoid lesions. A careful endoscopic assessment is fundamental to establish the best treatment of EGC. Generally, EGCs are curable if the lesion is completely removed by endoscopic resection or surgery. Some types of EGC can be resected endoscopically; for others the most appropriate treatment is surgical resection and D2 lymphadenectomy, especially in Western countries. The favorable oncological prognosis, the extended lymphadenectomy and the reconstruction of the intestinal continuity that excludes the duodenum make the prophylactic cholecystectomy mandatory to avoid the onset of biliary complications.

show abstract

“…LNM strongly affects the prognosis[ 14 , 54 ]. This is a topic of not negligible importance because EGC is believed to be a curable albeit malignant disease.…”

Section: Treatmentmentioning

confidence: 99%

Early gastric cancer: A challenge in Western countries

Chiarello¹,

Fico²,

Pepe³

et al. 2022

WJG

Self Cite

View full text Add to dashboard Cite

show abstract

“…Hayashi et al [ 12 ] recommended the retrieval of more than 40 LNs after total gastrectomy for stage III patients, whereas Lu et al [ 13 ] suggested that harvesting 21 LNs might represent a superior cut-off point for radical gastrectomy to better determine the prognosis of the patients. Total LN number is a powerful qualifier of staging and survival information for GC [ 31 ] without increased postoperative mortality [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The presence of lymph node (LN) metastasis is one of the most significant prognostic factors in patients with gastric cancer (GC) [ 1 , 2 , 3 ]. Metastases occur during the early stages of the disease [ 3 , 4 , 5 , 6 ], and because their pre- and intra-operative diagnosis remain unreliable, a D2 lymphadenectomy should be performed whenever nodal involvement is suspected [ 6 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pattern of Distribution of Lymph Node Metastases in Individual Stations in Middle and Lower Gastric Carcinoma

Brisinda

Chiarello²,

Fico

et al. 2023

Cancers

Self Cite

View full text Add to dashboard Cite

(1) Background: Lymph node (LN) dissection is the cornerstone of curative treatment of GC. The pattern of distribution of LN metastases is closely related to several factors. The aim of this study is to evaluate the factors determining the distribution of nodal metastases in a population of N+ distal GC patients undergoing gastrectomy and D2 lymphadenectomy. (2) Methods: The medical charts of 162 N+ GC patients who underwent surgical resection over a 15-year period were retrospectively analyzed. Clinical, pathological and anatomical characteristics were evaluated to identify the factors affecting the patterns and prevalence of metastases in individual LN stations. (3) Results: LN metastasis is correlated with the depth of the tumor and to diffuse-type tumors. A higher number of metastatic nodes was documented in patients with middle-third tumors (8.2 ± 7.3 vs. 4.5 ± 5.0 in lower-third tumors, p = 0.0001) and in patients with tumors located on the lesser curve. Station 4 showed the highest rate of metastases (53.1%). Concerning stations 7 to 12, station 8 showed the highest metastasis rate (28.4%). Metastases at stations 1, 2, 4 and 7 to 11 were dominant in middle-third cancer, whereas stations 5 and 6 were dominant in lower-third cancers. Station 4, 5, 6, 10 and 11 metastases were dominant when the cancer was located on the greater curve, whereas stations 1, 2, 7, 8 and 12 were dominant in lesser-curve cancers. (4) Conclusions: The study documented that in patients with distal GC, the distribution of nodal metastases at individual stations is closely related to primary tumor location.

show abstract

“…Which is the most appropriate lymphadenectomy to perform, to offer the best oncological outcome without increasing postoperative morbidity and mortality, is in fact controversial, due to the differences in results between East and West and between high and low volume centres[ 11 ]. This aspect is not of negligible importance, since LN metastasis, which can also appear in the early stages of the disease, is one of the most significant prognostic factors in these patients[ 7 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

How to identify early complications in patients undergoing distal gastrectomy?

Tropeano,

Chiarello,

Fico

et al. 2024

World J Gastrointest Surg

Self Cite

View full text Add to dashboard Cite

In this editorial we comment on the article by Zhang et al published in a recent issue of the World Journal of Gastrointestinal Surgery . Gastrectomy with appropriate lymph node dissection is still standard curative treatment in locally advanced gastric cancer. Several studies point out that gastric cancer surgery is a complex procedure that leads to a high risk of morbidity and mortality. Many factors can contribute to the onset of complications with consequent effects on prognosis and increased mortality. The complications can be divided in complications related to anastomosis, to motility and to surgical site infection. The study presented by Zhang B et al represent an interesting analysis on the possibility to prevent postoperative morbidity. The study was performed on 131 patients with distal gastric cancer who underwent gastrectomy with D2 lymph node dissection. Of these patients, 16% developed early postoperative complications. The univariate analysis showed that prealbumin level, hypertension, diabetes, history of abdominal surgery, R0 resection, and blood transfusion were factors influencing early postoperative complications after distal gastrectomy. Moreover, the inclusion of the above significant variables in the logistic regression analysis revealed that hypertension, diabetes, a history of abdominal surgery, and blood transfusion were independent predictors of postoperative complications. In conclusion, preoperative and intraoperative factors can be used to establish an early postoperative nomogram model. The results of the study presented by Zhang et al suggest that the prediction model can be used to guide the detection of postoperative complications and has clinical reference value.

show abstract

Postoperative mortality and morbidity after D2 lymphadenectomy for gastric cancer: A retrospective cohort study

Cited by 16 publications

References 60 publications

Early gastric cancer: A challenge in Western countries

Early gastric cancer: A challenge in Western countries

Pattern of Distribution of Lymph Node Metastases in Individual Stations in Middle and Lower Gastric Carcinoma

How to identify early complications in patients undergoing distal gastrectomy?

Contact Info

Product

Resources

About