Survival outcomes after D1 and D2 lymphadenectomy with R0 resection in stage II–III gastric cancer: Longitudinal follow-up in a single center

Uslu, Adam; Zengel, Baha; İlhan, Enver; Aykaş, Ahmet; Şimşek, Cenk; Üreyen, Orhan; Duran, Ali; Okut, Gökalp

doi:10.5152/turkjsurg.2018.3846

Cited by 9 publications

(8 citation statements)

References 37 publications

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“…The 5-year OS observed in this study, in the 3 stages measured, is similar to that reported in other series in which only patients with AGC treated with protocols that did not consider neoadjuvant were included (Al-Moundhri et al, 2006;Alici et al, 2006;Garrido et al, 2007;Bhandare et al;Uslu et al;Wang et al). Applying the surgery and adjuvant therapy modality is due to the strong evidence regarding the inappropriate internal and external validity of the Macdonald protocol (Manterola et al, 2006), used as a national protocol for treating GC in our country (Macdonald et al); that it has only undergone cosmetic modifications by Ministerio de Salud in its application in the last 15 years.…”

Section: Discussionsupporting

confidence: 87%

“…Novelty of the proposal: The novelty of the proposal is that it is a single-center and regional casuistry of patients of a private health institution; with comparable results with different series from national and international referral centers (Cornejo & Portanova;Díaz de Liaño et al, 2008Ruiz et al;Tapia et al, 2010Tapia et al, , 2011Valenti et al, 2011;de Steur et al, 2013;Chen et al, 2016;Degiuli et al;Randle et al, 2016;Tóth et al, 2016;Yang et al, 2016;Bhandare et al, 2017;Uslu et al, 2018;Wang et al, 2018).…”

Section: Discussionmentioning

confidence: 98%

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Results of Surgical Treatment of Advanced Gastric Cancer. Case Series with Follow-Up

Manterola

Claros²

2020

Int. J. Morphol.

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Gastric cancer (CG) is the second leading cause of cancer deaths. The best treatment option for patients with advanced GC (AGC) is still surgery, which involves performing a gastrectomy and D2 lymphadenectomy (D2L). The aim of this study was to determine postoperative morbidity (POM) and 5-year OS in patients resected by AGC without neoadjuvant. Case series with follow-up of patients with AGC undergoing total or subtotal gastrectomies and D2L, consecutively at RedSalud Mayor Temuco Clinic, between 2008 and 2019. The outcome variables were POM and 5-year OS. Other variables of interest were surgical time, number of resected lymph nodes, hospital stay, and recurrence. Descriptive statistics was used, and Kaplan-Meier curves were calculated. In this analysis 38 patients (71.1 % men), with a median age of 65 years, were operated. The most frequent location was subcardial (50.0 %). The most frequent type of resection was total gastrectomy (60.5 %). The median of surgical time, number of resected lymph nodes and hospital stay; was 190 min, 32 and 6 days respectively. MPO was 18.4 %. With a median follow-up of 28 months, a recurrence of 44.7 % was verified; and 5-year OS for stages IIIA, IIIB and IV were 53.3 %, 46.1 % and 20.0 % respectively (p= 0,007). The results achieved, in terms of POM and OS series were similar to national and international series in which neoadjuvant therapies have not been applied.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Results of Surgical Treatment of Advanced Gastric Cancer. Case Series with Follow-Up

Manterola

Claros²

2020

Int. J. Morphol.

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“…Many recent studies showed oncologic benefit of d2 vs d1 gastrectomies. [33,34]. Long term impact of these findings needs to be evaluated.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic vs open gastrectomy- An updated metanalysis of randomized control trials for short term outcomes

Vasavada

Patel

2020

Preprint

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Introduction: Aim of this metaanalysis was to compare short term outcomes of laparoscopic and open gastrectomy for gastric cancer. Material and methods: EMBASE, MEDLINE, PubMed and the Cochrane Database were searched for randomised control trials comparing outcomes in patients undergoing laparoscopic gastrectomies with those patients undergoing open gastrectomies. The primary outcome was 30 day morbidity and mortality. Secondary outcomes studied included length of stay, blood loss, d2gastrectomies, lymphnode retrieval, operative time, distal gastrectomy, wound complications and intraabdominal complications Systemic review and Metaanalysis were done according to MOOSE and PRISMA guidelines. Results: Morbidity was significantly low in laparoscopic group( P=0.004).There was no significant difference between mortality between the two groups. (P=0.989). There less wound complications in laparoscpic group, no difference intra-abdominal complications in both the groups. Operative time was significantly higher in laparoscopic group.( P< 0.001) wmd 56.904. Hospital stay was similar in laparoscopic group. (P=0.305) wmd −0.533 days. Blood loss was significantly lesser in laparoscopic group.(p <0.001). Laparoscopic group patients had less number of lymph node retrieval compared to laparoscopic group.(p< 0.001). Laparoscopic group also contained similar advanced staged gastric cancer than open gastrectomies. Conclusions: Laparoscopic gastrectomies were associated with better short term outcomes.

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“…Because of the geographic differences in incidence and mortality gastric cancer[13,14] and variations in surgical techniques, the 7 th AJCC staging system based on data mainly from the US may be valid for a particular population[15,16] but not equally applicable to other ethnic groups. [7, 17] The extent of LN metastasis was proven to be an important independent prognostic factor in gastric cancer[18–20] with the evolution of the N subset of the AJCC staging system. Compared with the previous editions, the 7 th edition strengthened the role of the number of positive LNs by subdividing the LN classes into 0, 2, 6 or more rather than the anatomical LN distribution.…”

Section: Discussionmentioning

confidence: 99%

Anatomical location-based nodal staging system is superior to the 7th edition of the American Joint Committee on Cancer staging system among patients with surgically resected, histologically low-grade gastric cancer: A single institutional experience

et al. 2019

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BackgroundA hybrid topographic and numeric lymph node (LN) staging system for gastric cancer, which was recently proposed by Japanese experts as a simple method with a prognostic predictive power comparable to the N staging of the American Joint Committee on Cancer (AJCC) Tumor-node-metastasis classification, has not yet been validated in other Asian countries. This study aimed to examine the prognostic predictability of the hybrid staging system with the current AJCC staging system in gastric cancer.MethodsOverall, 400 patients with gastric cancer who underwent surgery at Changhua Christian Hospital from January 2007 to December 2017 were included in the study. Univariate and multivariate analyses were performed to identify prognostic factors for gastric cancer-related death. Homogeneity and discrimination abilities of the two staging systems were compared using likelihood ratio chi-square test, linear trend chi-square test, Harrell’s c-index, and bootstrap analysis.ResultsOne-third of the LN-positive patients were reclassified into the new N and Stage system. The concordance rates of the two staging systems and the N staging between the two staging systems were 0.810 and 0.729, respectively. Harrell’s c-indices for the stage and N staging were higher in the 7th AJCC staging system than the hybrid staging system (c-index for stage, 0.771 vs 0.764; c-index for nodal stage, 0.713 vs 0.705). Stratification of the patients according to the histological grade revealed that Harrell’s c-indices for the stage and N stage of the hybrid staging system were comparable with those of the 7th AJCC staging system (c-index for AJCC stage vs hybrid stage, 0.800 vs 0.791; c-index for AJCC N stage vs hybrid N stage, 0.746 vs 0.734) among patients with histologically lower grade gastric cancer. The performance of the new nodal staging system was better than that of the 7th AJCC staging system by likelihood ratio and linear trend tests and bootstrap analysis in the low-grade group.ConclusionsThe hybrid anatomical location-based classification may have better prognostic predictive ability than the 7th AJCC staging system for LN metastasis of low-grade gastric cancer. Further studies involving different ethnic populations are necessary for the validation of the new staging system.

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Survival outcomes after D1 and D2 lymphadenectomy with R0 resection in stage II–III gastric cancer: Longitudinal follow-up in a single center

Abstract: When compared to D1-LND, D2-LND with R0 resection have yielded a trend toward a better outcome in patients with primary gastric adenocarcinoma.

Cited by 9 publications

References 37 publications

Results of Surgical Treatment of Advanced Gastric Cancer. Case Series with Follow-Up

Results of Surgical Treatment of Advanced Gastric Cancer. Case Series with Follow-Up

Laparoscopic vs open gastrectomy- An updated metanalysis of randomized control trials for short term outcomes

Anatomical location-based nodal staging system is superior to the 7th edition of the American Joint Committee on Cancer staging system among patients with surgically resected, histologically low-grade gastric cancer: A single institutional experience

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