Resecabilidad y mortalidad operatoria de la gastrectomía subtotal y total en pacientes con cáncer gástrico avanzado, entre 1969 y 2004

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Survival of patients with advanced gastric cancer subjected to palliative surgery Background: Most patients with gastric cancer consult when the tumor is an advanced stage. Aim: To assess the survival of patients with gastric cancer in stage IIIc or IV subjected to surgery. Patients and Methods: Prospective study of patients with gastric cancer in stages IIIc (spreading to nearby organs or serosa) or IV (spreading to distant organs), who consulted between 2004 and 2012. A surgical exploration was carried out in all patients performing a palliative total or subtotal gastrectomy, a gastrojejunal anastomosis or only an exploration. Twenty five patients received adjuvant chemotherapy. All were followed until their death. Results: A surgical resection was performed in 61 patients (64%) with an operative mortality of 5 and 0% for total and subtotal gastrectomy, respectively. The mortality of non-resected patients was 6.4% with a maximal survival of 15 months after surgery. No significant differences in survival were observed between patients with hepatic or peritoneal metastases. Adjuvant chemotherapy significantly improved survival among patients subjected to gastric resection. Conclusions: Among patients with gastric cancer, palliative gastrectomy may improve quality of life and adjuvant chemotherapy apparently improves survival.

Section: Discussionunclassified

Sobrevida De Pacientes Con Cáncer Gástrico Etapas Iiic Y Iv Sometidos a Cirugía: Parte Ii De Estudio Prospectivo 2004-2012

et al. 2014

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“…El presente estudio no se ha referido a la resecabilidad del tumor, que claramente ha aumentado en forma muy signifi cativa, como se ha publicado anteriormente 7 . Este aumento de la resecabilidad es uno de los importantes progresos en el tratamiento del cáncer gástrico.…”

Section: Discussionunclassified

“…La notable disminución de la mortalidad operatoria de nuestro grupo de trabajo se muestra en la Tabla 6, con la evolución en los últimos 40 años de esta en gastrectomía subtotal y total [7][8][9][10][11][12][13] . En el primer trabajo 8 , se describe una mortalidad de 50% para la gastrectomía total y de 19% para la subtotal.…”

Section: Discussionunclassified

Morbilidad y mortalidad operatoria de la gastrectomía subtotal y total por cáncer gástrico 2004 a 2010: Parte I de un estudio prospectivo

et al. 2011

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Complications and mortality of total and subtotal gastrectomy for gastric cancer Background: Surgery for gastric cancer may have high rates of complications and mortality. Aim: To analyze operative mortality of total and subtotal gastrectomy in the period 2004-2010. Material and Methods: Prospective study 345 patients with gastric cancer, mean age 62 years, 64% males, subjected to a total or subtotal R0, R1 or R2 gastrectomy. All patients were assessed in the postoperative period and all complications were recorded. Results: Total and subtotal gastrectomies were performed in 224 and 69 patients respectively. Postoperative complications consisted in anastomotic leaks, duodenal stump leaks, hemoperitoneum, pulmonary infections and intestinal obstruction. Mortality of total gastrectomy R1 or R2 was 2.1% whereas palliative gastrectomy, to improve quality of life, had 15% mortality. Subtotal gastrectomy had 1.4% mortality. Conclusions: There has been a reduction in operative mortality of gastrectomy for gastric cancer, however the rate of complications has not changed.

“…El argumento a favor de realizar una GT en los cánceres antrales, es que esta cirugía permitiría eventualmente, un mejor control local de la enfermedad, especialmente en los mal diferenciados e indiferenciados, asegurando la obtención de límites de sección libres de enfermedad. Los argumentos a favor de la GST, es que ésta presenta una menor morbimortalidad y una mejor calidad de vida que la GT, sin disminuir la sobrevida a 5 años (65,3% para GST, 62,4% para la GT (p < 0,05) [6][7][8] .…”

Section: Discussionunclassified

Gastrectomía subtotal en el cáncer gástrico antral mal diferenciado e indiferenciado

Cárcamo³

et al. 2010

Subtotal gastrectomy for poorly differentiated and undifferentiated antral gastric cáncer Background: Total gastrectomy is recommended by some groups for poorly differentiated gastric cancer due to the multicentric nature of this tumor. Aim: To assess if subtotal gastrectomy achieves a good disease control in patients with undifferentiated or poorly differentiated gastric cancer. Material and Methods: Retrospective review of medical records of patients with undifferentiated or poorly differentiated gastric cancer, subjected to a subtotal gastrectomy between 1988 and 2006. Five years survival was calculated. Results: Fifty two patients aged 23 to 80 years were identifi ed (30 males). Three had undifferentiated and 49 poorly differentiated tumors. One patient had a positive proximal margin. After a median follow up of 52 months, fi ve years survival was 47%. Thirteen percent were lost from follow up. Conclusions: Five years survival of patients with undifferentiated or poorly differentiated gastric cancer and subjected to subtotal gastrectomy, was 47%.