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gastrectomy d1 d2

Maria Teresa Mita, Federico Marchesi, Stefano Cecchini, Francesco Tartamella, Matteo Ricco', Hariscine Keng Abongwa, Luigi Roncoroni
BACKGROUND: Gastric cancer mortality rates have remained relatively unchanged over the past decades, in spite of progressive decrease in incidence. Nodal status represents a key factor for prognostic assessment, allowing a tailored-made adjuvant therapy for the patients. The aim of this study is to evaluate the prognostic influence of different nodal involvement indicators on the overall survival in a large series of patients submitted to gastrectomy at our Institution. METHODS: we retrospectively collected data from 634 newly diagnosed patients with gastric cancer who underwent curative gastrectomy, with D1/D2 lymphadenectomy during the last 20 years...
2016: Acta Bio-medica: Atenei Parmensis
Takao Hara, Tsuyoshi Etoh, Yoshitake Ueda, Yuki Shitomi, Hidefumi Shiroshita, Norio Shiraishi, Tsutomu Daa, Masafumi Inomata
BACKGROUND: Endoscopic resection is accepted as the standard treatment for early mucosal gastric cancer, and its indications have recently been expanded while its long-term outcomes are still unclear. Herein, we present a didactic case of undifferentiated-type mucosal gastric cancer fulfilling the expanded indication and curative criteria for endoscopic submucosal dissection (ESD), having synchronous multiple lymph node metastases. CASE PRESENTATION: A 40-year-old woman was found to have a Helicobacter pylori infection at a standard health check with no abdominal symptoms...
December 2016: Surgical Case Reports
Yasuhiro Kodera
The incidence of gastric cancer and the number of gastric cancer patients that a surgeon treats annually are so vastly different between countries and regions that it is not easy to define which type of gastric cancer surgery should be considered the global standard. Nevertheless, a consensus that D2 dissection is the most appropriate way to treat resectable advanced gastric cancer has arguably been reached after long-term follow-up and flexible interpretation of the Dutch D1 versus D2 trial and evidence from the Japan Clinical Oncology Group 9501 study which denied survival benefit of more extensive lymphadenectomy...
August 30, 2016: Japanese Journal of Clinical Oncology
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...
2016: Chinese Journal of Cancer
Masatoshi Nakagawa, Yoon Young Choi, Ji Yeong An, Sang Hyuk Seo, Hyun Beak Shin, Hui Jae Bang, Shuangxi Li, Hyung Il Kim, Jae Ho Cheong, Woo Jin Hyung, Sung Hoon Noh
East Asian surgeons generally report lower morbidity and mortality rates for gastrectomy with D2 lymphadenectomy than do surgeons in Western countries; however, the disparity remains unexplained. The aim of this article was to determine the feasibility and safety regarding cases in which East Asian surgeons perform such procedures in Caucasian patients (CPs). Twelve CPs underwent gastrectomy with lymphadenectomy for gastric cancer at Yonsei University Severance Hospital, Seoul, Korea between June 2011 and April 2014...
September 2016: Yonsei 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...
June 1, 2016: European Journal of Surgical Oncology
Takaki Yoshikawa, Toru Aoyama, Kazuaki Tanabe, Kazuhiro Nishikawa, Yuichi Ito, Tsutomu Hayashi, Haruhiko Cho, Yumi Miyashita, Akira Tsuburaya, Junichi Sakamoto
BACKGROUND: It was unclear whether the transhiatal approach and D2 total gastrectomy after neoadjuvant chemotherapy (NAC) for adenocarcinoma of the esophago-gastric (AEG) junction are as feasible and safe as D2 gastrectomy following NAC. PATIENTS AND METHODS: We clarified the short-term surgical results in AEG and non-AEG patients in a subset analysis of the COMPASS trial. RESULTS: Eighty-three patients, 24 with AEG and 59 with non-AEG, were registered in the study...
2016: Digestive Surgery
Nebojsa Ignjatovic, Dragan Stojanov, Miodrag Djordjevic, Jelena Ignjatovic, Daniela Benedeto Stojanov, Bobana Milojkovic
Perforation represents a rare and severe complication of gastric cancer (GC) with a large hospital mortality (8-82%). The aim of this study is to evaluate the clinical-pathological features in patients with perforated gastric cancer (PGC) and to advise the surgical treatment options. A total of 11 patients with PGC were retrospectively reviewed among 376 consecutive cases of GC operated. The clinical-pathological features including tumor stage, survival, and the type of treatment were observed. The perforation was more frequent in stage III (8 patients) and in stage IV (3 patients), but none of the cases in stage I and II GC were observed...
July 2, 2016: Bosnian Journal of Basic Medical Sciences
Hylke J F Brenkman, Leonie Haverkamp, Jelle P Ruurda, Richard van Hillegersberg
AIM: To evaluate the current status of gastric cancer surgery worldwide. METHODS: An international cross-sectional survey on gastric cancer surgery was performed amongst international upper gastro-intestinal surgeons. All surgical members of the International Gastric Cancer Association were invited by e-mail to participate. An English web-based survey had to be filled in with regard to their surgical preferences. Questions asked included hospital volume, the use of neoadjuvant treatment, preferred surgical approach, extent of the lymphadenectomy and preferred anastomotic technique...
April 21, 2016: World Journal of Gastroenterology: WJG
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
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
Ron Lavy, Yehuda Hershkovitz, Bar Chikman, Zahar Shapira, Natan Poluksht, Nirit Yarom, Judith Sandbank, Ariel Halevy
BACKGROUND: Despite the ongoing decrease in the incidence of gastric cancer, this disease is still a major cause of death. It is still debatable whether D2 lymphadenectomy improves survival and whether this procedure should be performed routinely or selectively. OBJECTIVES: To compare the pathological and short-term results following radical D2-type gastric resection and lymphadenectomy versus the more limited D1 type resection and lymphadenectomy. METHODS: We conducted a retrospective study on 4 years experience treating 164 patients suffering from gastric cancer...
December 2015: Israel Medical Association Journal: IMAJ
Junichi Hamada, Shuhei Komatsu, Toshiyuki Kosuga, Daisuke Ichikawa, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Tomohiro Arita, Ryo Morimura, Yasutoshi Murayama, Hisashi Ikoma, Yoshiaki Kuriu, Masayoshi Nakanishi, Eigo Otsuji
BACKGROUND: According to the 14th Japanese Classification of Gastric Carcinoma(JCGC), station No. 1 lymphadenectomy for distal gastrectomy was included in the D1 level, though the 13th JCGC classified station No. 1 lymphadenectomy to the D2 level in patients with primary lower-third gastric cancer (LGC). This study was designed to re-evaluate the therapeutic value of lymphadenectomy, and to clarify the possible risk factors for station No. 1 lymph node metastasis (LNM) in LGC. METHODS: Between 1997 and 2014, 1,875 consecutive patients with gastric cancer underwent curative gastrectomy with radical lymphadenectomy...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hironobu Goto, Takashi Yasuda, Taro Oshikiri, Shingo Kanaji, Kentaro Kawasaki, Tatsuya Imanishi, Masato Oyama, Keitaro Kakinoki, Tadayuki Ohara, Hiroyoshi Sendo, Yasuhiro Fujino, Masahiro Tominaga, Yoshihiro Kakeji
INTRODUCTION: Laparoscopic distal gastrectomy (LDG) with D1+ lymph node dissection (LND) for early gastric cancer has been widely accepted. However, LDG with D2 LND for advanced gastric cancer remains in limited use. The aim of this retrospective study was to clarify the safety of LDG with D2 LND for gastric cancer. METHODS: From January 2010 to September 2014, 296 patients underwent LDG; those who received D1+ LND (n = 230) or D2 LND (n = 66) were included in this study...
May 2016: Asian Journal of Endoscopic Surgery
Osamu Kinoshita, Daisuke Ichikawa, Yusuke Ichijo, Shuhei Komatsu, Kazuma Okamoto, Mitsuo Kishimoto, Akio Yanagisawa, Eigo Otsuji
AIM: To investigate the effect of preoperative chemotherapy (pre-CTx) for metastatic lymph nodes (MLNs) of gastric cancer (GC). METHODS: A retrospective cohort of patients with advanced GC, who underwent pre-CTx followed by gastrectomy, was reviewed. The histological tumor regression grade (TRG), which considered the percentage of residual cancer in the visible tumor bed, was applied to primary tumors and individual MLNs: G1a (complete response), G1b (< 10%), G2 (10%-50%) and G3 (> 50%)...
December 28, 2015: World Journal of Gastroenterology: WJG
Shinkyo Yoon, Changhoon Yoo, Min-Hee Ryu, Myoung Joo Kang, Baek-Yeol Ryoo, Sook Ryun Park, Jeong Hwan Yook, Sung Tae Oh, Moon-Won Yoo, Byung Sik Kim, Yoon-Koo Kang
OBJECTIVE: Postoperative chemotherapy with S-1 or capecitabine plus oxaliplatin is a standard treatment for resectable gastric cancer (GC). However, survival outcomes of stage IIIB-IV (M0) GC cases are still poor. We investigated the efficacy and safety of docetaxel, capecitabine, and cisplatin (DXP) in patients with stage IIIB-IV GC. METHODS: This was a single-arm phase 2 study that included patients with stage IIIB-IV GC who underwent D2 gastrectomy. Patients received six cycles of docetaxel [60 mg/m(2) on day 1 (D1)], capecitabine (1,875 mg/m(2)/day on D1-14), and cisplatin (60 mg/m(2) on D1) every 3 weeks...
December 11, 2015: Gastric Cancer
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
W O de Steur, H H Hartgrink, J L Dikken, H Putter, C J H van de Velde
BACKGROUND: Current guidelines indicate that D2 resection is the standard of care for patients with locally advanced gastric cancer. To assess the impact of quality assurance of lymph node removal, non-compliance and contamination in the D1 and D2 study arms of the Dutch Gastric Cancer Trial were investigated with respect to recurrence and survival. METHODS: The location and numbers of lymph nodes detected at pathological investigation in the Dutch Gastric Cancer Trial were compared according to the guidelines of the Japanese Research Society for the study of Gastric Cancer...
October 2015: British Journal of Surgery
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