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gastrectomy D1 vs D2

Eugenia Cordero-García, Allan Ramos-Esquivel, Warner Alpízar-Alpízar
Background: Gastric cancer is one of the major causes of cancer-related deaths in several Latin-American countries, including Costa Rica. However, determinants of poor outcomes are fairly unknown for patients from this region. The aim of this study was to determine prognostic variables of overall survival (OS) in a cohort of Hispanic patients after curative-intent surgery for gastric cancer. Methods: We retrospectively evaluated the clinical records of 236 consecutive patients who underwent surgery for advanced gastric cancer at four major hospitals in Costa Rica...
February 2018: Journal of Gastrointestinal Oncology
Chun-Dong Zhang, Liang Zong, Fei-Long Ning, Xian-Tao Zeng, Dong-Qiu Dai
The present study was conducted to investigate the prognosis and survival of patients with locally advanced gastric cancer who underwent distal subtotal gastrectomy with modified D2 (D1+) and D2 lymphadenectomy, under 70 years of age. The five-year overall survival rates of 390 patients were compared between those receiving D1+ and D2 lymphadenectomy. Univariate and multivariate analyses were used to identify factors that correlated with prognosis and lymph node metastasis. Tumor size (P=0.039), pT stage (P=0...
January 2018: Oncology Letters
Alexandre Gosselin-Tardif, Jessica Lie, Ioana Nicolau, Juan Carlos Molina, Jonathan Cools-Lartigue, Liane Feldman, Jonathan Spicer, Carmen Mueller, Lorenzo Ferri
PURPOSE: Despite evidence of oncologic benefits from extended (D2) lymphadenectomy in gastric cancer from many East Asian studies, there is persistent debate over its use in the West, mainly due to perceived high rates of morbidity and mortality. This study evaluates the safety and efficacy of D2 dissection in a high-volume North American center. METHODS: A prospectively entered database of all patients undergoing gastrectomy for cancer at a North American referral center from 2005 to 2016 was reviewed...
March 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Q Hong, Y Wang, J J Wang, C G Hu, Y J Fang, X X Fan, T Liu, Q Tong
Objective: To evaluate the application value of carbon lymph node tracing technique by preoperative endoscopic subserosal injection in laparoscopic radical gastrectomy. Methods: From June 2013 to February 2015, seventy eight patients with gastric cancer were enrolled and randomly divided into trial group and control group. Subserosal injection of carbon nanoparticles around the tumor was performed by preoperative endoscopic subserosal injection one day before the operation in trial group, while the patients routinely underwent laparoscopic gastrectomy in control group...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yingxue Hao, Peiwu Yu, Feng Qian, Yongliang Zhao, Yan Shi, Bo Tang, Dongzhu Zeng, Chao Zhang
Laparoscopy-assisted gastrectomy (LAG) has gained international acceptance for the treatment of early gastric cancer (EGC). However, the use of laparoscopic surgery in the management of advanced gastric cancer (AGC) has not attained widespread acceptance. This retrospective large-scale patient study in a single center for minimally invasive surgery assessed the feasibility and safety of LAG for T2 and T3 stage AGC. A total of 628 patients underwent LAG and 579 patients underwent open gastrectomy (OG) from Jan 2004 to Dec 2011...
June 2016: Medicine (Baltimore)
S Rausei, L Ruspi, F Rosa, P Morgagni, D Marrelli, A Cossu, F C M Cananzi, R Lomonaco, A Coniglio, A Biondi, C Cipollari, L Graziosi, U Fumagalli, F Casella, P Bertoli, A di Leo, S Alfieri, G Vittimberga, F Roviello, E Orsenigo, V Quagliuolo, S Montemurro, G Baiocchi, R Persiani, M Bencivenga, A Donini, R Rosati, A Sansonetti, L Ansaloni, A Zanoni, F Galli, G Dionigi
BACKGROUND: Gastrectomy with extended lymphadenectomy is considered the gold standard treatment for advanced gastric cancer, with no age- or comorbidity-related limitations. We evaluated the safety and efficacy of curative gastrectomy with extended nodal dissection, verifying survival in elderly and highly co-morbid patients. METHODS: In a retrospective multicenter study, we examined 1322 non-metastatic gastric-cancer patients that underwent curative gastrectomy with D2 versus D1 lymphadenectomy from January 2000 to December 2009...
December 2016: European Journal of Surgical Oncology
Reese W Randle, Douglas S Swords, Edward A Levine, Nora F Fino, Malcolm H Squires, George Poultsides, Ryan C Fields, Mark Bloomston, Sharon M Weber, Timothy M Pawlik, Linda X Jin, Gaya Spolverato, Carl Schmidt, David Worhunsky, Clifford S Cho, Shishir K Maithel, Konstantinos I Votanopoulos
BACKGROUND AND OBJECTIVES: The optimal extent of lymphadenectomy in the treatment of gastric adenocarcinoma is debated. We compared gastrectomy outcomes following limited (D1) or extended (D2) lymphadenectomy. METHODS: Using the multi-institutional US Gastric Cancer Collaborative database, we reviewed the morbidity, mortality, recurrence, and overall survival (OS) of patients receiving D1 or D2 lymphadenectomies. RESULTS: Between 2000 and 2012, 266 and 461 patients received a D1 and D2 lymphadenectomy, respectively...
June 2016: Journal of Surgical Oncology
Peter J Kneuertz, Wayne L Hofstetter, Yi-Ju Chiang, Prajnan Das, Mariela Blum, Elena Elimova, Paul Mansfield, Jaffer Ajani, Brian Badgwell
BACKGROUND: The optimal surgical approach for gastroesophageal junction (GEJ) cancer treated with preoperative therapy remains controversial. We compared the outcomes of patients who underwent either esophagectomy or gastrectomy and identified variables associated with overall survival (OS). METHODS: We reviewed records of patients with Siewert types II and III GEJ adenocarcinoma who were treated with preoperative therapy followed by resection from 1995 to 2013...
February 2016: Annals of Surgical Oncology
Weiling He, Jian Tu, Zijun Huo, Yuhuang Li, Jintao Peng, Zhenwen Qiu, Dandong Luo, Zunfu Ke, Xinlin Chen
AIM: To evaluate methodological quality and the extent of concordance among meta-analysis and/or systematic reviews on surgical interventions for gastric cancer (GC). METHODS: A comprehensive search of PubMed, Medline, EMBASE, the Cochrane library and the DARE database was conducted to identify the reviews comparing different surgical interventions for GC prior to April 2014. After applying included criteria, available data were summarized and appraised by the Oxman and Guyatt scale...
2015: International Journal of Clinical and Experimental Medicine
Giuseppe Verlato, Daniele Marrelli, Simone Accordini, Maria Bencivenga, Alberto Di Leo, Alberto Marchet, Roberto Petrioli, Giacomo Zoppini, Michele Muggeo, Franco Roviello, Giovanni de Manzoni
While in chronic diseases, such as diabetes, mortality rates slowly increases with age, in oncological series mortality usually changes dramatically during the follow-up, often in an unpredictable pattern. For instance, in gastric cancer mortality peaks in the first two years of follow-up and declines thereafter. Also several risk factors, such as TNM stage, largely affect mortality in the first years after surgery, while afterward their effect tends to fade. Temporal trends in mortality were compared between a gastric cancer series and a cohort of type 2 diabetic patients...
June 7, 2015: World Journal of Gastroenterology: WJG
A Biondi, D D'Ugo, F C M Cananzi, V Papa, A Borasi, F Sicoli, M Degiuli, G Doglietto, R Persiani
BACKGROUND: According to the TNM classification, the analysis of 16 or more lymph nodes is required for the appropriate staging of gastric cancer. The aim of this study was to evaluate whether this number of resected lymph nodes also affects survival. METHODS: This was a multicenter retrospective study based on an analysis of 992 patients with gastric adenocarcinoma who underwent curative resection between January 1980 and December 2009. Patients were classified according to the number of resected lymph nodes (<16 and ≥16 lymph nodes), the anatomical extent of lymph node dissection (D2 vs...
June 2015: European Journal of Surgical Oncology
G de Manzoni, G Verlato, M Bencivenga, D Marrelli, A Di Leo, S Giacopuzzi, C Cipollari, F Roviello
BACKGROUND: In gastric cancer the incidence of loco-regional recurrences decreases when lymphadenectomy is expanded from D1 to D2. The present study aimed at evaluating whether the pattern of recurrence in advanced gastric cancer (AGC) is further modified when lymphadenectomy is expanded from D2 to D3. METHODS: 568 patients undergoing curative gastrectomy for AGC (274 D2 and 294 D3) were considered; none of them received preoperative chemotherapy. MantelHaenszel test of homogeneity was used to verify whether the relation between extension of lymphadenectomy and recurrence varied as a function of each risk factor considered...
April 2015: European Journal of Surgical Oncology
Yue-Xiang Liang, Jing-Yu Deng, Han-Han Guo, Xue-Wei Ding, Xiao-Na Wang, Bao-Gui Wang, Li Zhang, Han Liang
AIM: To elucidate the prognostic value of age for gastric cancer and identify the optimal treatment for elderly gastric cancer patients. METHODS: We enrolled 920 patients with gastric cancer who underwent gastrectomy between January 2003 and December 2007 in our center. Patients were categorized into three groups: younger group (age < 50 years), middle-aged group (50-69 years), and elderly group (≥ 70 years). Clinicopathological features were compared among the three groups and potential prognostic factors were analyzed...
October 21, 2013: World Journal of Gastroenterology: WJG
Kazumasa Fujitani
This review presents the current status of adjuvant and neoadjuvant treatment options for primary resectable gastric cancer in the East, with updated data from recent studies. Marked disparities between the East and the West in standard surgical procedures (D2 vs. D1/0 lymphadenectomy) and their outcomes result in significant geographical variation in preferred adjuvant treatments. Currently, oral fluoropyrimidine-based postoperative adjuvant chemotherapy, 1 year of S-1 chemotherapy, or capecitabine plus oxaliplatin for 6 months are the standards of care after curative resection with D2 lymphadenectomy for stage II/III gastric cancer in the East, though there is still some room for improvement...
2013: Digestive Surgery
Motokazu Sugimoto, Takahiro Kinoshita, Hidehito Shibasaki, Yuichiro Kato, Naoto Gotohda, Shinichiro Takahashi, Masaru Konishi
BACKGROUND: Laparoscopic distal gastrectomy for gastric cancer has been firmly established in recent decades but still is a difficult procedure, especially for obese patients, as with open surgery. This study aimed to evaluate the perioperative outcome of total laparoscopic distal gastrectomy (TLDG) for early gastric cancer patients with a body mass index (BMI) exceeding 25 kg/m(2) and to consider countermeasures to this. METHODS: Perioperative outcomes were compared between 42 patients with a BMI exceeding 25 kg/m(2) [overweight or obese group (OWG)] and 174 patients with a BMI lower than 25 kg/m(2) [normal or underweight group (NWG)] who underwent TLDG between September 2010 and December 2012...
November 2013: Surgical Endoscopy
Hui Wu, Ping-ping Xu, Yu-long He, Jian-bo Xu, Shi-rong Cai, Xin-hua Zhang, Liang Wang, Dong-jie Yang, Wen-hua Zhan
OBJECTIVE: To evaluate the impact of surgical modality for gastric cancer on operational trauma. METHODS: A total of 1499 cases of gastric cancer undergoing surgical procedures were divided into the groups of radical resection (RR, n = 1344) and palliative resection group (NRR, n = 155) according to their surgical modalities. And they were further divided into sub-groups according to the profiles of gastrectomy, extent of lymphadenectomy and multi organic resection...
October 16, 2012: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Oh Jeong, Mi Ran Jung, Gwang Yong Kim, Han Soo Kim, Seong Yeop Ryu, Young Kyu Park
BACKGROUND: To evaluate the technical feasibility and safety of laparoscopic total gastrectomy (LTG) for gastric carcinoma, this study compared short-term surgical outcomes between LTG and open total gastrectomy (OTG) using the propensity score matching method. STUDY DESIGN: After generating propensity scores given the covariates of age, sex, body mass index, comorbidity, American Society of Anesthesiologists (ASA) score, operators, and tumor stage, 122 patients with LTG were matched to 122 OTG patients using the nearest available score matching...
February 2013: Journal of the American College of Surgeons
Alessandro Bittoni, Luca Faloppi, Riccardo Giampieri, Stefano Cascinu
Several factors concur in determining outcome for locally advanced gastric cancer patients. Shockingly, geographic origin of the patient seems to play a major role. In Eastern countries, the high level of surgery that can be expected grants a high percentage of success in a strategy that employs surgery as immediate treatment followed by adjuvant chemotherapy, mainly based on oral fluoropyrimidines (S-1 or Capecitabine), with satisfactory results. In Western countries, the expertise of the surgeon maintains its role as predictor of high likelihood of cure...
2012: Recent Results in Cancer Research
Adam Uslu, Hasan Bati, Hakan Postaci, Ahmet Nart, Nukhet Eliyatkin, Halit Yetis, Baris Corumlu, Ahmet Aykas, Baha Zengel
AIMS: The primary objective of this study was to clarify the influence of histotype on the outcome of D1/D2 gastrectomized patients with pathologically proven R0 resection. The secondary objective was to demonstrate overall survival (OS), disease-free survival (DFS), and locoregional recurrence rates following standard curative surgery. PATIENTS AND METHODS: All patients had either pure signet-ring cell carcinoma (SRCC)/poorly differentiated adenocarcinoma (PDC) or moderately differentiated adenocarcinoma (MDC) of the stomach, preoperative radiologic evidence of locoregional disease, and no history of neoadjuvant therapy...
2012: Digestion
Jing Liu, Jing-Hui Li, Ru-Jun Zhai, Bo Wei, Ming-Zhe Shao, Lin Chen
BACKGROUND: The prognosis for patients with gastric cancer and synchronous liver metastases is very poor. However, a standard therapeutic strategy has not been well established. The clinical benefit and prognostic factors after hepatic surgical treatment for liver metastases from gastric cancer remain controversial. METHODS: Records of 105 patients who underwent gastrectomy regardless of hepatic surgical treatment for gastric cancer with synchronous liver-only metastases in our center between 1995 and 2010 were retrospectively reviewed...
January 2012: Chinese Medical Journal
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