The role of surgery in the treatment of recurrent gastric cancer

Song, Kyo Young; Park, Seungman; Kim, Seung-Nam; Park, Cho‐Hyun

doi:10.1016/j.amjsurg.2007.05.056

Cited by 50 publications

(45 citation statements)

References 22 publications

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“…Recurrence is the most intimidatory factor in patients with gastric cancer and unfortunately, most of it has multiple sites at the time of diagnosis. The standard treatment for recurrence has not been well established, but, on the other hand few studies had demonstrated that, in cases of localized recurrence, complete resection, when achievable, may be beneficial to the patient's survival [29,30]. Interestingly, there were four cases of reoperation for localized recurrences.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Lee

Kim

2009

Journal of Surgical Oncology

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Background and Objectives: The purpose of this retrospective study is to suggest the possibility of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) through long-term outcomes. Methods: Of 283 patients with gastric cancer who underwent LAG with extraperigastric (D2) lymphadenectomy between January 2004 and February 2009, 106 were pathologically confirmed with AGC and analyzed. Results: There were 75 men and 31 women, with a mean age of 61.4 AE 11.7 years. There were 32 total gastrectomies and 74 distal gastrectomies with D2 lymphadenectomy. The mean tumor size was 4.8 AE 2.6 cm. The mean numbers of retrieved and metastatic lymph nodes were 34.3 AE 15.3 and 5.4 AE 8.7, respectively. There was no lymph node metastasis in 44 patients (41.5%), and there were 35 grade T2a, 51 T2b, and 20 T3 lesions. There were 10 operation-related morbidities (9.4%) and one postoperative death (0.9%) from hepatic failure. The overall and disease-free survival rates were 81.4% and 72.4%, respectively. Tumors recurred in 17 patients (16.0%) during the follow-up periods (median 21.5 months; range 2-60). Conclusions: LAG for AGC might be considered as a minimally invasive treatment in selected cases, but further study comparing it with open gastrectomy will be needed.

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Section: Discussionmentioning

confidence: 99%

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Lee

Kim

2009

Journal of Surgical Oncology

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“…The mean tumor size was 3.9 ± 2.7 cm (range 0. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The median follow-up period was 56 months.…”

Section: Characteristics Of Study Populationmentioning

confidence: 99%

“…Curative resection has proven to be the only successful treatment modality for locally confined gastric cancer [3]. Although the initial operation is potentially curative, a considerable proportion of patients with this tumor develop recurrent tumors [4], which indicates the importance of follow-up studies in these patients.…”

Section: Introductionmentioning

confidence: 99%

Bone recurrence after curative resection of gastric cancer

Park

Song

et al. 2012

Gastric Cancer

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Background Standard follow up for bone recurrence has not yet been established for gastric cancer after surgical resection. The aim of this study was to investigate the incidence of and related risk factors for bone recurrence after surgical resection of gastric cancer. Methods A cohort of 3035 gastric cancer patients after curative resection was reviewed. We analyzed the patients who had bone scintigraphy before the surgery as well as during the follow-up period. The incidence of and the risk factors for bone recurrence after surgical resection of gastric cancer were investigated. Results In a total of 1683 patients analyzed, bone recurrence was detected in 30 patients (1.8 %). The incidence of bone recurrence was significantly higher in advanced gastric cancers than in early lesions (3.5 vs. 0.4 %, p \ 0.01). The most common recurrence site was the spine, followed by pelvic bone and rib. Most patients had multiple bone metastases. The median time for recurrence was 28 months (range 4-111) from the surgery. In univariate analysis, the recurrence rate was higher in the tumors with large size, undifferentiated pathology, location in the body, and advanced stage. In multivariate analysis, lymph node metastasis (N2/N3 vs. N0/N0I) was the most predictable risk factor for bone recurrence [hazard ratio [HR] 1.44 (95% confidence interval [CI] 1.217-1.694)] and depth of invasion (T2-4 vs. T1) was also independently associated with bone recurrence. Conclusions The incidence of bone recurrence was low after curative surgery in patients with gastric cancer. Intensive follow up with bone scintigraphy seems to be unnecessary in these patients.

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“…Curative resection has proven to be the only successful treatment modality for locally confined gastric cancer [3] . Anemia is a frequent complication after gastrectomy and deficiencies of iron, vitamin B12, or folate, either alone or in combination, have been reported after gastric surgery [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study

Lim

Kim²,

Kim³

et al. 2012

WJG

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AIM:To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer. METHODS:The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed. Patients with anemia in the preoperative workup, cancer recurrence, undergoing systemic chemotherapy, with other medical conditions that can cause anemia, or treated during follow up with red cell transfusions or supplements for anemia were excluded. Anemia was defined by World Health Organization criteria (Hb < 12 g/dL in women and < 13 g/dL in men). Iron deficiency was defined as serum ferritin < 20 μg/dL. Vitamin B12 deficiency was defined as serum vitamin B12 < 200 pg/mL. Iron deficiency anemia was defined as anemia with concomitant iron deficiency. Anemia from vitamin B12 deficiency was defined as megaloblastic anemia (mean cell volume > 100 fL) with vitamin B12 deficiency. The profile of anemia over 48 mo of follow-up was analyzed. RESULTS:One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed. The incidence of anemia was 24.5% at 3 mo after surgery and increased up to 37.1% at 48 mo after surgery. The incidence of iron deficiency anemia increased during the follow up and became the major cause of anemia at 48 mo after surgery. Anemia of chronic disease and megaloblastic anemia were uncommon. The incidence of anemia in female patients was significantly higher than in male patients at 12 (40.0% vs 22.0%, P = 0.033), 24 (45.0% vs 25.0%, P = 0.023), 36 (55.0% vs 28.0%, P = 0.004), and 48 mo (52.0% vs 31.0%, P = 0.022) after surgery. Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery (60.7% vs 31.3%, P = 0.008). The incidence of iron deficiency was significantly higher in female patients than in male patients at 6 (35.4% vs 13.3%, P = 0.002), 12 (45.8% vs 16.8%, P < 0.001), 18 (52.1% vs 22.3%, P < 0.001), 24 (60.4% vs 20.9%, P < 0.001), 36 (62.5% vs 29.2%, P < 0.001), and 48 mo (66.7% vs 34.7%, P = 0.001) after surgery. CONCLUSION:Anemia was frequent after gastrectomy for early gastric cancer, with iron deficiency being the major cause. Evaluation for anemia including iron status should be performed after gastrectomy and appropriate iron replacement should be considered.

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The role of surgery in the treatment of recurrent gastric cancer

Cited by 50 publications

References 22 publications

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Long‐term outcomes after laparoscopy‐assisted gastrectomy for advanced gastric cancer: Analysis of consecutive 106 experiences

Bone recurrence after curative resection of gastric cancer

Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study

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