Recurrence Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis of 1,417 Patients

Song, Ji‐Won; Lee, Hyuk‐Joon; Cho, Gyu Seok; Han, Sang‐Uk; Kim, Min-Chan; Ryu, Seung Wan; Kim, Wook; Song, Kyo Young; Kim, Hyung‐Ho; Hyung, Woo Jin

doi:10.1245/s10434-010-0932-4

Cited by 127 publications

(87 citation statements)

References 36 publications

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“…The 5-year survival rate of 98.2% for both OS and RFS is comparable with that of previous retrospective studies assessing laparoscopic gastrectomy [10][11][12]. For open surgery, Nashimoto et al [13] Kim et al [12] reported the OS after matching for the operation method and surgeons did not show any significant differences between open gastrectomy and laparoscopic gastrectomy for all stages of cancer.…”

Section: Discussionsupporting

confidence: 72%

Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

et al. 2017

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Background Laparoscopic gastrectomy has become a common surgical treatment for gastric cancer in eastern Asian countries. However, a large-scale prospective study to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) regarding long-term outcomes has never been reported. We have already reported the shortterm outcomes of this study. Here we report long-term outcomes as the secondary endpoints of this study after a 5-year follow-up period. Methods This study comprised patients with clinical stage I gastric cancer who were able to undergo a distal gastrectomy. LADG with D1 plus suprapancreatic lymph node dissection was performed by credentialed gastric surgeons who had each conducted at least 30 LADG and 30 open gastrectomy procedures. The primary endpoint was the proportion of patients who developed either anastomotic leakage or pancreatic fistula. The secondary endpoints included overall survival and relapse-free survival. Results From November 2007 to September 2008, 176 eligible patients were enrolled, comprising 140 patients with pathological stage IA disease, 23 patients with pathological stage IB disease, 9 patients with pathological stage II disease, and 4 patients with pathological stage IIIA disease. No patients had recurrent disease, and three of the patients died within the follow-up period. The 5-year overall survival was 98.2% (95% confidence interval 94.4-99.4%) and the 5-year relapse-free survival was 98.2% (95% confidence interval 94.4-99.4%). Conclusions The long-term outcomes of stage I gastric cancer patients undergoing LADG seem comparable to those of patients undergoing an open procedure, although this result should be confirmed by a randomized control trial. We have already completed accrual of 921 patients for a multicenter randomized phase III trial (JCOG0912) to confirm the noninferiority of LADG compared with open gastrectomy in terms of relapse-free survival.

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Section: Discussionsupporting

confidence: 72%

Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

et al. 2017

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“…23 Also, previous studies about surgery cases reported that the rate of recurrent gastric cancer within 2 and 3 years after gastrectomy were 68∼75% and 89∼90%, retrospectively. [24][25][26] Even though recurrent gastric cancer can be developed 5∼10 years after ESD, the median follow-up period of ＞3 years (37.2±23.6 months) was not short to identify the incidence of recurrent gastric cancer in young patients. However, to evaluate the overall and disease-specific survival rates for young patients with EGC after curative resection, a lifetime observation study is needed in this study cohort.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Endoscopic Submucosal Dissection in Patients under 40 Years Old with Early Gastric Cancer

Hahn

Lee

Park

et al. 2016

Korean J Helicobacter Up Gastrointest Res

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Background/Aims: The clinicopathologic features of gastric cancer in young patients are different from those of older patients. However, endoscopic submucosal dissection (ESD) is performed regardless of age. The purpose of this study was to characterize younger patients (≤40 years) who underwent ESD for early gastric cancer (EGC) and analyze the results of ESD. Materials and Methods: From January 2006 to June 2014, 55 patients aged 40 years or younger with newly diagnosed EGC underwent ESD at two tertiary hospitals. The clinicopathologic features of EGC and clinical outcomes of ESD in these young patients were reviewed retrospectively. Results: A total 55 patients with 57 EGC lesions underwent ESD. Female sex, superficial flat or depressed lesions, and undifferentiated histology were more common in younger patients than in older patients in our institutional ESD cohort. The en bloc resection rate was 92.7% and the complete resection rate was 94.5%. Although there was a high proportion of undifferentiated cancer in the younger patient group, the curative resection rate was 72.7%. Among 15 patients with non-curative resection, 4 patients underwent additional surgery and 1 patient underwent argon plasma coagulation at the ESD ulcer margin. Eight patients were placed under close surveillance without additional treatment, and no recurrent tumors developed, with a median follow-up period of 37.2±23.6 months. Conclusions: Younger EGC patients who underwent ESD showed the typical characteristics seen in younger patients with gastric cancer. ESD in younger EGC patients showed comparable outcomes to those in patients with undifferentiated EGC in general.

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“…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.

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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.

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Recurrence Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis of 1,417 Patients

Cited by 127 publications

References 36 publications

Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

Clinical Outcomes of Endoscopic Submucosal Dissection in Patients under 40 Years Old with Early Gastric Cancer

Current practice for gastric cancer treatment in Ukraine

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