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splenectomy in gástric cancer

Yoshiki Taniguchi, Yukinori Kurokawa, Jota Mikami, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Makoto Yamasaki, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori, Yuichiro Doki
PURPOSE: Postoperative pancreatic fistula (PPF) sometimes occurs after gastrectomy. We examined the risk factors for severe PPF and evaluated the predictive value of amylase concentration in drainage fluid. METHODS: We retrospectively reviewed 591 patients who underwent curative gastrectomy for gastric cancer. A multivariate analysis was conducted to identify the risk factors for severe PPF. Receiver operating characteristic curves were used to identify the appropriate amylase cut-off value to predict severe PPF...
April 1, 2017: Surgery Today
E Norero, E A Vega, C Diaz, G Cavada, M Ceroni, C Martínez, E Briceño, F Araos, P Gonzalez, S Baez, E Vinuela, M Caracci, A Diaz
BACKGROUND: Gastrectomy represents the main treatment for gastric adenocarcinoma. This procedure is associated with substantial morbidity and mortality. The aim of this study was to evaluate the postoperative mortality changes across the study period and to identify predictive factors of 30-day mortality after elective gastrectomy for gastric cancer. METHODS: This was a retrospective cohort study of a prospective database from a single centre. Patients treated with an elective gastrectomy from 1996 to 2014 for gastric adenocarcinoma were included...
February 10, 2017: European Journal of Surgical Oncology
Takahiro Einama, Hironori Abe, Shunsuke Shichi, Hiroki Matsui, Ryo Kanazawa, Kazuaki Shibuya, Takashi Suzuki, Fumihiko Matsuzawa, Taku Hashimoto, Nakachi Kohei, Shigenori Homma, Hideki Kawamura, Akinobu Taketomi
In gastric cancer, primary systemic chemotherapy is the standard approach for the management of patients with initially unresectable metastasis, and it occasionally leads to a reduction in the size of the lesion, which facilitates surgical resection. The aim of this study was to examine the prognosis of patients who were able to undergo complete resection following chemotherapy. A total of 10 patients who underwent radical surgery for stage IV primary gastric cancer after chemotherapy between 2009 and 2015 at the Department of Surgery of Hokkaido Social Work Association Obihiro Hospital (Obihiro, Japan) were retrospectively investigated...
February 2017: Molecular and Clinical Oncology
İlter Özer, Erdal Birol Bostancı, Murat Ulaş, Yusuf Özoğul, Musa Akoğlu
Gastric cancer is one of the most common causes of cancer-related death. It requires multimodal treatment and surgery is the most effective treatment modality. Radical surgery includes total or subtotal gastrectomy with lymph node dissection. The extent of lymphadenectomy still remains controversial. Eastern surgeons have performed D2 or more extended lymphadenectomy while their Western colleagues have performed more limited lymph node dissection. However, the trend has been changing in favour of D2 lymph node dissection in both hemispheres...
January 2017: Balkan Medical Journal
Indira Mehmedagic, Sefik Hasukic, Mirha Agic, Nedzad Kadric, Ismar Hasukic
INTRODUCTION: Gastric cancer is the second most important neoplasm in the world. Surgical resection is the treatment of choice for gastric cancer, and recognized by the International Union against Cancer (International Union Against Cancer - UICC) TNM classification of the parameters of the tumor and lymph node. Prognostic factors related to characteristics of the tumor by histopathologic findings have an impact on the planning of the operation. According to the results of most studies it is possible to predict survival and recurrence based on histological type and TNM classification of tumors on the one hand and the surgical procedure on the other...
December 2016: Medical Archives
Tomiyuki Miura, Noriaki Nakamura, Kousuke Ogawa, Yuichiro Watanabe, Kouji Yonekura, Takahiro Sanada, Hiroshi Kuwabara, Narihide Goseki
We report a case where resection was performed for pancreatic metastasis from renal cell carcinoma 21 years after nephrectomy. A 72-year-old man had undergone total gastrectomy with distal pancreatomy and splenectomy for gastric cancer, and right nephrectomy for primary renal cell carcinoma in 1993. Incidentally, a CT scan performed in 2014 revealed a tumor in the head of the pancreas. Enhanced MRI suggested that the tumor contained some fat tissue. The tumor in the pancreatic body had sharp margins; therefore, we performed subtotal pancreatectomy...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hiroshi Noro, Yoshikazu Morimoto, Shohei Takaichi, Chihyon Son, Kazuya Iwamoto, Emiko Kono, Keigo Yasumasa, Takafumi Hirao, Hitoshi Mizuno, Nobutaka Hatanaka, Yoshio Yamasaki
Gastric cancer with portal tumor embolus is rare and there is no definite strategy for its surgical resection. We report 2 cases ofgastric cancer with portal vein tumor embolus treated using gastrectomy and thrombectomy. Case 1: The patient was a 56- year-old man. We performed total gastrectomy, distal pancreatectomy, splenectomy, and thrombectomy. The patient was treated with 4 courses ofS -1 plus CDDP chemotherapy followed by S-1 administration. Eight months after surgery, CT revealed metastasis in the left adrenal gland and he died 2 years after surgery...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yuko Shimada, Tsutomu Hayashi, Keisuke Minamizawa, Taisuke Shibuya, Daiji Nemoto, Hideto Yokoi, Tomoko Wada, Takuo Watanabe, Ryo Takagawa, Hitoshi Murakami, Seiji Hasegawa, Tadao Fukushima, Hideyuki Ike, Yasushi Rino, Munetaka Masuda
A 75-year-old man admitted for left lateral abdominal pain was found to have advanced poorly differentiated gastric adenocarcinoma with abdominal para-aortic and Virchow's lymph node metastases, which was diagnosed to be clinical Stage IV (T3N3H0M1[LYM]). As curative surgery was not deemed possible, we started chemotherapy administration using S-1 (120mg/day)administered orally for 3 weeks and cisplatin(CDDP 100mg/body)administered intravenously on day 8. After 6 courses of chemotherapy, a CT scan showed that all lymph nodes metastases had disappeared, resulting in downstaging to clinical Stage II (T3[SE]N0H0P0M0)...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Xingyu Feng, Renjie Li, Peng Zhang, Tao Chen, Haibo Qiu, Yongjian Zhou, Chunyan Du, Xiaonan Yin, Fang Pan, Guoliang Zheng, Xiaowei Sun, Jiang Yu, Zhijing Chen, Yan Zhao, Xiufeng Liu, Jian Li, Bo Zhang, Ye Zhou, Changming Huang, Zhiwei Zhou, Guoxin Li, Kaixiong Tao, Yong Li
OBJECTIVE: To retrospectively analyze the clinicopathology of patients with gastric gastrointestinal stromal tumor(gGIST) who underwent radical excision within 18 years in 10 domestic medical centers in order to understand the status of domestic surgical treatment of gGIST. METHODS: Clinicopathological data of gGIST patients undergoing radical excision in 10 medical centers from January 1998 to January 2016 were collected, and their operational conditions, postoperative adjuvant therapy, gene detection and survival were analyzed retrospectively...
November 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Elena Arabadzhieva, Atanas Yonkov, Sasho Bonev, Dimitar Bulanov, Ivanka Taneva, Alexandrina Vlahova, Tihomir Dikov, Violeta Dimitrova
BACKGROUND: Although gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, they comprise less than 1% of all gastrointestinal tumors. Neuroendocrine tumors (NET) of the gastro-enteropancreatic system are also rare, representing about 2% of all gastrointestinal neoplasms. Pancreatic localization of NET is extremely uncommon-these tumors are only 1-5% of all pancreatic cancers. CASE PRESENTATION: We describe an unusual case with triple tumor localization-a gastric tumor, a formation in the pancreas, which involves the retroperitoneal space, and a uterine leiomyoma...
November 15, 2016: World Journal of Surgical Oncology
Dun Pan, Hui Chen, Liang-Qing Li, Zong-Fang Li
BACKGROUND For patients with stage IV gastric cancer, it is unclear whether splenectomy combined with palliative surgery is needed to reduce tumor load and relieve symptoms. The objective of the present study was to investigate the effect of splenectomy combined with palliative resection for stage IV gastric carcinoma on immunological dysfunction and patient prognosis. MATERIAL AND METHODS We retrospectively analyzed medical records of 106 stage IV gastric cancer patients who underwent palliative surgery; of these, 49 patients were treated with palliative resection for gastric carcinoma combined with splenectomy, while the other 57 patients retained their spleens...
November 6, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Xin Ji, Tao Fu, Zhao-De Bu, Ji Zhang, Xiao-Jiang Wu, Xiang-Long Zong, Zi-Yu Jia, Biao Fan, Yi-Nan Zhang, Jia-Fu Ji
BACKGROUND: Surgery for advanced gastric cancer (AGC) often includes dissection of splenic hilar lymph nodes (SHLNs). This study compared the safety and effectiveness of different approaches to SHLN dissection for upper- and/or middle-third AGC. METHODS: We retrospectively compared and analyzed clinicopathologic and follow-up data from a prospectively collected database at the Peking University Cancer Hospital. Patients were divided into three groups: in situ spleen-preserved, ex situ spleen-preserved and splenectomy...
October 3, 2016: BMC Cancer
Han Liang, Jingyu Deng
Based upon studies from randomized clinical trials, the extended (D2) lymph node dissection is now recommended as a standard procedure for local advanced gastric cancer worldwide. However, the rational extent lymphadenectomy for local advanced gastric cancer has remained a topic of debate in the past decades. Due to the limitation of low metastatic rate in para-aortic nodes (PAN) in JCOG9501, the clinical benefit of D2+ para-aortic nodal dissection (PAND) for patients with stage T4 and/or stage N3 disease, which is very common in China and other countries except Japan and Korea, cannot be determined...
August 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Hironori Shiozaki, Yusuke Shimodaira, Elena Elimova, Roopma Wadhwa, Kazuki Sudo, Kazuto Harada, Jeannelyn S Estrella, Prajnan Das, Brian Badgwell, Jaffer A Ajani
Surgical management of gastric cancer improves survival. However, for some time, surgeons have had diverse opinions about the extent of gastrectomy. Researchers have conducted many clinical studies, making slow but steady progress in determining the optimal surgical approach. The extent of lymph node dissection has been one of the major issues in surgery for gastric cancer. Many trials demonstrated that D2 dissection resulted in greater morbidity and mortality than D1 dissection. However, long-term outcomes demonstrated that D2 dissection resulted in longer survival than D1 dissection...
July 26, 2016: Chinese Journal of Cancer
Sayaka Arisaka, Ryuji Kosaka, Chikara Kunisaki, Yasushi Ichikawa, Hirotoshi Akiyama, Mitsuko Furuya, Kenichi Ohashi, Itaru Endo
A 70-year-old man with left abdominal pain was referred to our hospital, and was diagnosed with type 1 advanced gastric cancer with lymph node metastasis. Neoadjuvant chemotherapy(NAC)with docetaxel and S-1 combination was administered. After 2 courses of chemotherapy, total gastrectomy with D2 lymph node dissection, splenectomy, and cholecystectomy were performed. Pathologically, viable cancer cells were not evident in the primary lesion and lymph nodes. The pathological response of NAC was judged to be Grade 3...
July 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Shinsuke Sato, Erina Nagai, Yusuke Taki, Masaya Watanabe, Michiro Takahashi, Yusuke Kyoden, Ko Ohata, Hideyuki Kanemoto, Noriyuki Oba, Keisei Taku, Makoto Suzuki, Masakazu Takagi
Gastric cancer patients with main portal vein tumor thrombus usually have a short survival time, owing to its aggressive behavior. Herein, we report a long-surviving case of gastric cancer with main portal vein tumor thrombus. A 78-year-old man presenting with anorexia and body weight loss was diagnosed with gastric cancer. The patient was referred to our hospital for further examination and treatment. Endoscopy revealed a type 3 tumor (8.0 cm in length) in the body of the stomach. Biopsy led to the diagnosis of moderately differentiated adenocarcinoma...
August 2016: Clinical Journal of Gastroenterology
Takeshi Sano, Mitsuru Sasako, Junki Mizusawa, Seiichiro Yamamoto, Hitoshi Katai, Takaki Yoshikawa, Atsushi Nashimoto, Seiji Ito, Masahide Kaji, Hiroshi Imamura, Norimasa Fukushima, Kazumasa Fujitani
OBJECTIVE: To clarify the role of splenectomy in total gastrectomy for proximal gastric cancer. BACKGROUNDS: Splenectomy in total gastrectomy is associated with increased operative morbidity and mortality, but its survival benefit is unclear. Previous randomized controlled trials were underpowered and inconclusive. METHODS: We conducted a multiinstitutional randomized controlled trial. Proximal gastric adenocarcinoma of T2-4/N0-2/M0 not invading the greater curvature was eligible...
February 2017: Annals of Surgery
Keishiro Aoyagi, Junya Kizaki, Taro Isobe, Yoshito Akagi
BACKGROUND: Many neuroendocrine carcinomas exhibit medullary infiltration and expanded proliferation. Differentiated tubular adenocarcinoma is frequently seen in the superficial region in many neuroendocrine carcinoma cases. However, the present case showed non-medullary infiltration and signet ring cell carcinoma in the superficial region, with intramural metastases distributed throughout the whole of the stomach. CASE REPORT: A 67-year-old man was referred to our institution for treatment of gastric cancer...
April 22, 2016: American Journal of Case Reports
V V Oleksenko, S V Efetov, K A Aliev
AIM: To analyze immediate and remote results of surgical treatment of 480 patients with gastric cancer who underwent total gastrectomy. MATERIAL AND METHODS: The study group included 371 patients who had spleen-preserving D2 lymphodissection during gastrectomy and control group consisted of 109 patients after D2 lymphodissection with splenectomy. Duration of surgery was 183.7±33.8 and 184.1±30.9 min in study and control groups respectively (p=0.72), blood loss - 330...
2015: Khirurgiia
Maurizio Degiuli, Giovanni De Manzoni, Alberto Di Leo, Domenico D'Ugo, Erica Galasso, Daniele Marrelli, Roberto Petrioli, Karol Polom, Franco Roviello, Francesco Santullo, Mario Morino
D2 procedure has been accepted in Far East as the standard treatment for both early (EGC) and advanced gastric cancer (AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials (RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique...
March 14, 2016: World Journal of Gastroenterology: WJG
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