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Early gastric cancer surgery

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https://www.readbyqxmd.com/read/28424913/can-further-gastrectomy-be-avoided-in-patients-with-incomplete-endoscopic-resection
#1
Hee Sung Kim, Ji Yong Ahn, Seon Ok Kim, Byung Sik Kim
BACKGROUND: Endoscopic resection (ER) is a widely accepted treatment for patients with early gastric cancer (EGC) with no lymph node metastasis. Occasionally, however, additional surgery is needed due to an incomplete resection. The purpose of this study was to detect clinical factors which might identify patients at greater risk of additional surgery after ER and to suggest an alternative treatment strategy for these patients. METHODS: This study retrospectively analyzed 350 patients with gastric cancer who underwent radical gastrectomy and lymphadenectomy after ER in a single institution between July 2004 and July 2014...
April 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28415834/the-surgical-treatment-of-gastric-cancer-in-the-era-of-minimally-invasive-surgery
#2
Shuchang Wang, Tian-Long Ling, Enhao Zhao, Hui Cao
Minimally invasive surgery is regarded as an alternative to conventional open surgery in gastric cancer. More and more surgeons devote their efforts to reduce surgical incision and acquire better recovery. Nowadays, laparoscopic distal gastrectomy has been the standard method for early stage cancer with remarkable advantage in short-term outcomes and is widely accepted by patients. The indication of laparoscopic gastrectomy has been extended to local advanced gastric cancer. However, the oncological safety has long been debated...
April 14, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28415645/peritoneal-carcinomatosis-limits-of-diagnosis-and-the-case-for-liquid-biopsy
#3
REVIEW
James R W McMullen, Matthew Selleck, Nathan R Wall, Maheswari Senthil
Peritoneal Carcinomatosis (PC) is a late stage manifestation of several gastrointestinal malignancies including appendiceal, colorectal, and gastric cancer. In PC, tumors metastasize to and deposit on the peritoneal surface and often leave patients with only palliative treatment options. For colorectal PC, median survival is approximately five months, and palliative systemic therapy is able to extend this to approximately 12 months. However, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) with a curative intent is possible in some patients with limited tumor burden...
March 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28413395/a-case-of-advanced-gastric-cancer-with-para-aortic-lymph-node-metastasis-treated-with-preoperative-folfox-chemotherapy-followed-by-radical-subtotal-gastrectomy-and-d2-lymph-node-dissection
#4
Byoung Jo Suh
We report the case of a 73-year-old female who was diagnosed with advanced gastric cancer. Esophagogastroduodenoscopy was used to diagnose Borrmann type 3 advanced gastric cancer located at the gastric antrum. A biopsy revealed poorly differentiated adenocarcinoma. Abdominopelvic computed tomography (CT) and (18)F-fluorodeoxyglucose positron emission tomography-CT (FDG-PET-CT) scans demonstrated multiple lymph node metastases, including the para-aortic lymph nodes. Systemic chemotherapy with 5-fluoruracil (5-FU), oxaliplatin, and leucovorin (FOLFOX) was initiated...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28397873/a-scoring-system-to-stratify-curability-after-endoscopic-submucosal-dissection-for-early-gastric-cancer-ecura-system
#5
Waku Hatta, Takuji Gotoda, Tsuneo Oyama, Noboru Kawata, Akiko Takahashi, Yoshikazu Yoshifuku, Shu Hoteya, Masahiro Nakagawa, Masaaki Hirano, Mitsuru Esaki, Mitsuru Matsuda, Ken Ohnita, Kohei Yamanouchi, Motoyuki Yoshida, Osamu Dohi, Jun Takada, Keiko Tanaka, Shinya Yamada, Tsuyotoshi Tsuji, Hirotaka Ito, Yoshiaki Hayashi, Naoki Nakaya, Tomohiro Nakamura, Tooru Shimosegawa
OBJECTIVES: Although radical surgery is recommended for patients not meeting the curative criteria for endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) because of the potential risk of lymph node metastasis (LNM), this recommendation may be overestimated and excessive. We aimed to establish a simple scoring system for decision making after ESD. METHODS: This multicenter retrospective study consisted of two stages. First, the risk-scoring system for LNM was developed using multivariate logistic regression analysis in 1,101 patients who underwent radical surgery after having failed to meet the curative criteria for ESD of EGC...
April 11, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28397011/long-term-outcome-of-endoscopic-submucosal-dissection-is-comparable-to-that-of-surgery-for-early-gastric-cancer-a-propensity-matched-analysis
#6
Hye Kyung Jeon, Gwang Ha Kim, Bong Eun Lee, Do Youn Park, Geun Am Song, Dae Hwan Kim, Tae Yong Jeon
BACKGROUND: Data concerning the long-term outcomes of endoscopic submucosal dissection (ESD) versus surgery for early gastric cancer (EGC) are limited. We aimed to compare the long-term outcomes of ESD and surgery for patients with EGC. METHODS: Data were reviewed from patients treated by ESD or surgery for EGC in 2005-2010. The primary outcome was overall survival (OS). Secondary outcomes were disease-specific survival (DSS), disease-free survival (DFS), recurrence-free survival (RFS), treatment-related complications, and hospital stay duration...
April 10, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28380037/comparison-of-the-current-ajcc-tnm-numeric-based-with-a-new-anatomical-location-based-lymph-node-staging-system-for-gastric-cancer-a-western-experience
#7
Gennaro Galizia, Eva Lieto, Annamaria Auricchio, Francesca Cardella, Andrea Mabilia, Anna Diana, Paolo Castellano, Ferdinando De Vita, Michele Orditura
BACKGROUND: In gastric cancer, the current AJCC numeric-based lymph node staging does not provide information on the anatomical extent of the disease and lymphadenectomy. A new anatomical location-based node staging, proposed by Choi, has shown better prognostic performance, thus soliciting Western world validation. STUDY DESIGN: Data from 284 gastric cancers undergoing radical surgery at the Second University of Naples from 2000 to 2014 were reviewed. The lymph nodes were reclassified into three groups (lesser and greater curvature, and extraperigastric nodes); presence of any metastatic lymph node in a given group was considered positive, prompting a new N and TNM stage classification...
2017: PloS One
https://www.readbyqxmd.com/read/28378075/predictive-factors-for-lymph-node-metastasis-in-early-gastric-cancer-with-lymphatic-invasion-after-endoscopic-resection
#8
Ji Won Park, Sangjeong Ahn, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Kyoung-Mee Kim, Jae J Kim
BACKGROUND: Lymph node (LN) metastasis is found in only about 5-10% of the patients who undergo additional surgery after non-curative endoscopic resection. Lymphatic invasion after endoscopic submucosal dissection (ESD) is regarded as non-curative resection due to risk of reginal LN metastasis. This study was aimed to identify clinicopathologic predictive factors for LN metastasis in early gastric cancer (EGC) with lymphatic invasion after endoscopic resection. METHODS: Among a total of 2036 patients who underwent endoscopic resection for EGC at Samsung Medical Center from April 2000 to May 2011, 146 patients were diagnosed with lymphatic invasion...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28337361/the-effect-of-endoscopic-resection-on-short-term-surgical-outcomes-in-patients-with-additional-laparoscopic-gastrectomy-after-non-curative-resection-for-gastric-cancer
#9
Eun-Gyeong Lee, Keun-Won Ryu, Bang-Wool Eom, Hong-Man Yoon, Yong-Il Kim, Soo-Jeong Cho, Jong-Yeul Lee, Chan-Gyoo Kim, Il-Ju Choi, Young-Woo Kim
PURPOSE: Endoscopic submucosal dissection (ESD) in early gastric cancer causes an artificial gastric ulcer and local inflammation that has a negative intraprocedural impact on additional laparoscopic gastrectomy in patients with noncurative ESD. In this study, we analyzed the effect of ESD on short-term surgical outcomes and evaluated the risk factors. MATERIALS AND METHODS: From January 2003 to January 2013, 1,704 patients of the National Cancer Center underwent laparoscopic gastrectomy with lymph node dissection because of preoperative stage Ia or Ib gastric cancer...
March 2017: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/28336107/enriched-enteral-nutrition-may-improve-short-term-survival-in-stage-iv-gastric-cancer-patients-a-randomized-controlled-trial
#10
Stanislaw Klek, Lucyna Scislo, Elzbieta Walewska, Ryszard Choruz, Aleksander Galas
OBJECTIVE: The aim of the study was to determine whether the postoperative use of enteral nutrition enriched with arginine, glutamine, and omega-3 fatty acids influences survival in patients diagnosed with stomach cancer. For the purpose of the study, the second wave of the trial performed in 2003 to 2009 was done. METHODS: Ninety-nine patients who underwent surgery for gastric cancer (27 F, 72 M, mean age: 62.9 y) met the inclusion criteria. Of those, 54 were randomized to standard and 45 to enriched enteral nutrition (EEN)...
April 2017: Nutrition
https://www.readbyqxmd.com/read/28331173/laparoscopic-gastrectomy-with-enhanced-recovery-after-surgery-protocol-single-center-experience
#11
Magdalena Pisarska, Michał Pędziwiatr, Piotr Major, Michał Kisielewski, Marcin Migaczewski, Mateusz Rubinkiewicz, Piotr Budzyński, Krzysztof Przęczek, Anna Zub-Pokrowiecka, Andrzej Budzyński
BACKGROUND Surgery remains the mainstay of gastric cancer treatment. It is, however, associated with a relatively high risk of perioperative complications. The use of laparoscopy and the Enhanced Recovery After Surgery (ERAS) protocol allows clinicians to limit surgically induced trauma, thus improving recovery and reducing the number of complications. The aim of the study is to present clinical outcomes of patients with gastric cancer undergoing laparoscopic gastrectomy combined with the ERAS protocol. MATERIAL AND METHODS Fifty-three (21 female/32 male) patients who underwent elective laparoscopic total gastrectomy due to cancer were prospectively analyzed...
March 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28325187/postgastrectomy-syndromes-and-nutritional-considerations-following-gastric-surgery
#12
REVIEW
Jeremy L Davis, R Taylor Ripley
Postgastrectomy syndromes result from altered form and function of the stomach. Gastrectomy disrupts reservoir capacity, mechanical digestion and gastric emptying. Early recognition of symptoms with prompt evaluation and treatment is essential. Many syndromes resolve with minimal intervention or dietary modifications. Re-operation is not common but often warranted for afferent and efferent loop syndromes and bile reflux gastritis. Preoperative nutritional assessment and treatment of common vitamin and mineral deficiencies after gastrectomy can reduce the incidence of chronic complications...
April 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28288840/additive-endoscopic-resection-may-be-sufficient-for-patients-with-a-positive-lateral-margin-after-endoscopic-resection-of%C3%A2-early-gastric-cancer
#13
Hae Won Kim, Jie-Hyun Kim, Jun Chul Park, Mi Young Jeon, Yong Chan Lee, Sang Kil Lee, Sung Kwan Shin, Hyun Soo Chung, Sung Hoon Noh, Jong Won Kim, Seung Ho Choi, Jae Jun Park, Young Hoon Youn, Hyojin Park
BACKGROUND AND AIMS: No well-established treatment strategies exist for lateral margin positivity (LM+) alone after endoscopic resection (ER) of early gastric cancer (EGC). Thus, we aimed to clarify a treatment strategy for non-curative resection (non-CR) with LM+ alone after ER in EGC. METHODS: Among 2065 patients with EGC treated by ER, 76 (3.6%) with only LM+ after non-CR of EGC were reviewed retrospectively. Of these, 28 underwent gastrectomy, 25 underwent argon plasma coagulation (APC), and 23 underwent repeat ER (re-ER)...
March 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28279465/the-asian-perspective-on-the-surgical-and-adjuvant-management-of-esophagogastric-cancer
#14
REVIEW
Yukinori Kurokawa, Mitsuru Sasako
In East Asia, D2 dissection has been routine surgical procedure for curable advanced gastric cancer. More extended surgery than D2 is reserved for borderline resectable disease with extended nodal metastasis. The addition of radiation therapy to adjuvant chemotherapy failed to improve the outcome after D2 dissection. Because many patients are diagnosed in East Asia with early-stage disease, postoperative adjuvant chemotherapy is preferred, and S-1 monotherapy or capecitabine-oxaliplatin is standard care. Neoadjuvant chemotherapy may be preferred for stage III tumors; for borderline resectable tumors, preoperative chemotherapy is under study given the limitations of postoperative adjuvant chemotherapy in high-risk patients...
April 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28247105/neoadjuvant-chemotherapy-for-gastric-adenocarcinoma-in-japan
#15
REVIEW
Yasuhiro Kodera
Surgery had been and remains a mainstay in the treatment of gastric cancer. The Japanese surgical oncologists employed surgery-first approach to treat gastric cancer because of the widespread use of D2 lymph node dissection and the high incidence of oncologically resectable cancer, and early attempts at the multimodality treatment strategy featured surgery followed by postoperative chemotherapy. Although evidence to treat Stage II/III gastric cancer with this strategy is now abundant in the Far East, poor compliance of the post-gastrectomy patients to intense combination chemotherapies has been a limitation associated with this strategy...
February 28, 2017: Surgery Today
https://www.readbyqxmd.com/read/28246501/how-do-surgical-stress-and-low-perioperative-serum-protein-and-albumin-impact-upon-short-term-morbidity-and-mortality-in-gastric-cancer-surgery
#16
Alexandru Munteanu, Doru Munteanu, Stefan Tigan, Adrian Bartos, Cornel Iancu
BACKGROUND: Patients undergoing surgery for gastric cancer may be expected to develop a certain range of postoperative complications. This retrospective cohort study determined if gauging the serum value of total proteins and albumins before and especially after surgery can predict an undesired short term outcome in patients with gastric resections for cancer, as we have not found studies debating the link between low postoperative total proteins or albumins and early postoperative morbidity...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/28241187/mismatch-repair-deficiency-microsatellite-instability-and-survival-an-exploratory-analysis-of-the-medical-research-council-adjuvant-gastric-infusional-chemotherapy-magic-trial
#17
Elizabeth C Smyth, Andrew Wotherspoon, Clare Peckitt, David Gonzalez, Sanna Hulkki-Wilson, Zakaria Eltahir, Matteo Fassan, Massimo Rugge, Nicola Valeri, Alicia Okines, Madeleine Hewish, William Allum, Sally Stenning, Matthew Nankivell, Ruth Langley, David Cunningham
Importance: Mismatch repair (MMR) deficiency (MMRD) and microsatellite instability (MSI) are prognostic for survival in many cancers and for resistance to fluoropyrimidines in early colon cancer. However, the effect of MMRD and MSI in curatively resected gastric cancer treated with perioperative chemotherapy is unknown. Objective: To examine the association among MMRD, MSI, and survival in patients with resectable gastroesophageal cancer randomized to surgery alone or perioperative epirubicin, cisplatin, and fluorouracil chemotherapy in the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial...
February 23, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28226358/-laparoscopic-segmental-gastrectomy-for-early-gastric-cancer
#18
Lai Xu, Beizhan Niu, Xiyu Sun, Menghua Dai, Yi Xiao
OBJECTIVE: To investigate the feasibility of segmental pylorus-reservation gastrectomy in patients with early gastric cancer. METHOD: A retrospective cohort study on clinical data of 6 patients strictly met the criteria of early gastric cancer locating in the middle of the stomach undergoing laparoscopic segmental gastrectomy from January 2014 to April 2016 at Department of General Surgery, Peking Union Medical College Hospital was carried out. Preoperative clinical staging revealed T1N0M0 for all the cases...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226350/-value-of-endoscopy-application-in-the-management-of-complications-after-radical-gastrectomy-for-gastric-cancer
#19
Yiqun Zhang, Pinghong Zhou
Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226349/-prevention-and-treatment-of-complications-related-to-the-digestive-tract-reconstruction-in-laparoscopic-gastric-cancer-surgery
#20
Junsheng Peng, Shi Chen
With the development of laparoscopic techniques and equipments, laparoscopic-assisted, even total laparoscopic radical surgery for gastric cancer can be performed successfully. However, the incidence of postoperative complications is higher in the laparoscopy group as compared to the open-surgery group, which is still the barrier for the total laparoscopic radical gastrectomy. Similar to open surgery, the major complications of digestive tract reconstruction after laparoscopic radical gastrectomy are anastomotic leakage, anastomotic bleeding, anastomotic stricture and stenosis of input or output loop...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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