Postoperative quality of life after laparoscopy‐assisted pylorus‐preserving gastrectomy compared with laparoscopy‐assisted distal gastrectomy for early gastric cancer

Huang, Chen; Yu, Fengrong; Zhao, Gang; Xia, Xiang

doi:10.1111/jgh.14985

Cited by 21 publications

(32 citation statements)

References 31 publications

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“…PPG is a less-invasive function-preserving procedure that has been applied for the cT1N0M0 middle-third EGC with a distal tumor border at least 4 cm proximal to the pylorus according to the Japanese GC treatment guidelines [ 5 ]. The survival and recovery benefits of PPG have already been reported in several retrospective studies [ 30 – 32 ]. However, the performance of PPG remains controversial.…”

Section: Discussionmentioning

confidence: 92%

The risk of lymph node metastasis in gastric cancer conforming to indications of endoscopic resection and pylorus-preserving gastrectomy: a single-center retrospective study

Zhou

et al. 2021

BMC Cancer

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Background Lymph node metastasis (LNM) status is an important prognostic factor that strongly influences the treatment decision of early gastric cancer (EGC). This study aimed to evaluate the pattern and clinical significance of LNM in EGC. Methods A total of 354 patients with carcinoma in situ (n = 42), EGC (n = 312) who underwent radical gastrectomy were enrolled. Their clinicopathological features, pathological reports, and prognostic data were collected and analyzed. Results The incidence of LNM in all patients was 18.36% (65/354). The rates of D1 and D2 station metastases were 12.10% (43/354) and 6.21% (22/354), respectively. The rates of LNM in absolute indication of endoscopic resection and expanded indication were 3.27% (2/61) and 28.55% (4/14), respectively. Skip LNM was observed in 3.67% (13/354) of patients. For those with middle-third tumor, the metastasis rate of the No. 5 lymph node was 3.05% (5/164). The independent risk factors for LNM were tumors measuring > 30 mm, poorly differentiated tumors, and lymphovascular invasion (all P < 0.05; area under the curve, 0.783). The 5-year disease-free survival rates of patients with and without LNM were 96.26 and 79.17%, respectively (P = 0.011). Tumors measuring > 20 mm and LNM were independent predictive factors for poor survival outcome in all patients. Conclusions Patients with EGC conforming to expanded indications have a relatively high risk of LNM and may not be suitable for endoscopic submucosal dissection. Pylorus-preserving gastrectomy for patients with middle-third EGC remains controversial due to the high metastasis rate of the No. 5 lymph node.

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Section: Discussionmentioning

confidence: 92%

The risk of lymph node metastasis in gastric cancer conforming to indications of endoscopic resection and pylorus-preserving gastrectomy: a single-center retrospective study

Zhou

et al. 2021

BMC Cancer

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“…PPG is a lessinvasive function-preserving procedure that has been applied for the cT1N0M0 middle-third EGC with a distal tumor border at least 4 cm proximal to the pylorus according to the Japanese GC treatment guidelines [3]. The survival and recovery bene ts of PPG have already been reported in several retrospective studies [22][23][24]. However, PPG remains controversial.…”

Section: Discussionmentioning

confidence: 99%

The Risk of Lymph Node Metastasis in Early Gastric Cancer Conforming to Indications of Endoscopic Resection and Pylorus-Preserving Gastrectomy: A Single-Center Retrospective Study

Wang

et al. 2020

Preprint

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Background: Lymph node metastasis (LNM) status is an important prognostic factor that strongly influences the treatment decision of early gastric cancer (EGC). This study aimed to evaluate the pattern and clinical significance of LNM in EGC.Methods: Patients with EGC who underwent radical gastrectomy were enrolled. Their clinicopathological features, pathological reports, and prognostic data were collected and analyzed.Results: Three hundred fifty-four patients with EGC were enrolled. The incidence of LNM in patients with EGC was 18.36% (65/354). The rates of D1 and D2 station metastases were 12.1% (43/354) and 6.214% (22/354), respectively. The rates of LNM in absolute indication of endoscopic resection and expanded indication were 3.27% (2/61) and 28.55% (4/14), respectively. Skip LNM was observed in 3.67% (13/354) of patients. For those with middle-third EGC, the metastasis rate of the No. 5 lymph node was 3.05% (5/164). The independent risk factors for LNM were tumors measuring >30 mm, poorly differentiated tumors, and lymphovascular invasion (all P < 0.05，area under the curve = 0.783). Five-year disease-free survival rates of patients with EGC with and without LNM were 96.26% and 79.17%, respectively (P = 0.011). Tumors measuring >20 mm and LNM were independent predictive factors for poor survival outcome in patients with EGC.Conclusions: Patients with EGC conforming to expanded indications have a relatively high risk of LNM and may not be suitable for endoscopic submucosal dissection. Pylorus-preserving gastrectomy for patients with middle-third EGC remains controversial due to the high metastasis rate of the No. 5 lymph node.

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“…Studies have confirmed that the probability of suprapyloric LNM in T1 stage EGC in the middle of the stomach is only 0.2%. Therefore, lymph node dissection in the suprapyloric region can be omitted or only partially dissected to preserve the hepatic branch, the celiac branch, and the pyloric branch of the vagus nerve and the right gastric vessel, so as to seek a balance between the radical resection of the tumor and the function preservation as far as possible, and at the same time reduce the incidence of postoperative gastric emptying and improve the postoperative life quality of patients[ 59 , 60 ]. We also think that anastomotic methods might be associated with gastric emptying disorder occurrence after PPG, that is, manual suture might be better than Stapler.…”

Section: Management After Additional Surgery In Patients With Endoscopic Resectionmentioning

confidence: 99%

Current indications for endoscopic submucosal dissection of early gastric cancer

Zheng

Yin

Liu

et al. 2021

WJGO

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The development of endoscopic treatment technology has further promoted the minimally invasive treatment of early gastric cancer (EGC). Endoscopic treatment has achieved better therapeutic effects in terms of safety and prognosis and is the preferred treatment method for patients who meet the indications for endoscopic treatment. However, the consequent problem is that some patients receiving endoscopic treatment may undergo non-curative resection, and the principle of follow-up management for non-curative resection patients deserves further attention. In addition, there are still debates on how to improve the accuracy of clinical staging, select a reasonable treatment method for patients who meet the expanded indications for endoscopic treatment, manage patients with positive endoscopic surgical margins, conduct research on function-preserving surgery, and manage the treatment of EGC under the current situation in China. Consequently, we aim to review current indications for endoscopic submucosal dissection of EGC in order to better inform treatment options.

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Postoperative quality of life after laparoscopy‐assisted pylorus‐preserving gastrectomy compared with laparoscopy‐assisted distal gastrectomy for early gastric cancer

Cited by 21 publications

References 31 publications

The risk of lymph node metastasis in gastric cancer conforming to indications of endoscopic resection and pylorus-preserving gastrectomy: a single-center retrospective study

The risk of lymph node metastasis in gastric cancer conforming to indications of endoscopic resection and pylorus-preserving gastrectomy: a single-center retrospective study

The Risk of Lymph Node Metastasis in Early Gastric Cancer Conforming to Indications of Endoscopic Resection and Pylorus-Preserving Gastrectomy: A Single-Center Retrospective Study

Current indications for endoscopic submucosal dissection of early gastric cancer

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