Resection line involvement after gastric cancer surgery: clinical outcome in nonsurgically retreated patients
| Autor: | Paolo Morgagni, Alberto Marchet, A. Di Leo, Domenico Garcea, F. Roviello, G. De Manzoni, V. Panizzo, Corrado Pedrazzani, L. Saragoni, Donato Nitti, G. Natalini, F. De Santis, Daniele Marrelli, Emanuela Scarpi, Hayato Kurihara |
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| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Neoplasm Residual Adolescent medicine.medical_treatment Resection line involvement Cohort Studies Young Adult Gastric cancer Surgical treatment Local recurrence Prognosis Gastrectomy Stomach Neoplasms medicine Humans Neoplasm Invasiveness Radical surgery Stomach cancer Survival rate Lymph node Aged Retrospective Studies business.industry Cancer Middle Aged medicine.disease Early Gastric Cancer Surgery Survival Rate Treatment Outcome medicine.anatomical_structure Italy Lymph Node Excision business Abdominal surgery |
| Popis: | Resection line infiltration (RLI) after surgical treatment represents an unfavorable prognostic factor in advanced gastric cancer. We performed a retrospective analysis of 89 patients with resection line involvement who did not undergo reoperation. On behalf of the Italian Research Group for Gastric Cancer, we present the characteristics and outcome of 89 patients who were submitted to surgical resection for gastric cancer from 1988 to 2001 and did not undergo reoperation because of disease extension or associated pathologies. RLI was significantly higher in patients with T4 tumors and diffuse histological type. Anastomotic leakages were observed in 4.8% of infiltrated esophageal resection margins, whereas 1.9% of infiltrated duodenal resection lines showed duodenal fistulas. Five-year overall survival of patients with RLI was 29%. Prognosis was not affected by RLI in early forms (100% 5-year survival); however, 5-year survival in T2 and T3 stages was significantly lower with respect to the same stages without residual tumor. The influence of RLI on prognosis was confirmed in N0 as well as in N1 and N2 patients. RLI also was an independent prognostic at multivariate analysis (odds ratio = 1.5; 95% confidence interval, 1.08–2.08; P = 0.0144). RLI significantly affects long-term survival of advanced gastric cancer. The impact on prognosis is independent of lymph node involvement. Patients in good general condition for whom radical surgery is possible should be considered for reoperation. |
| Databáze: | OpenAIRE |
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