Impact of Pancreatic Resection on Survival in Locally Advanced Resectable Gastric Cancer
| Autor: | Ta-Sen Yeh, Jun-Te Hsu, Tsung-Hsing Chen, Chia-Jung Kuo, Wen-Chi Chou, Tse-Ching Chen, Puo-Hsien Le, Chi-Ming Tang, Shang-Yu Wang, Shih-Chun Chang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty medicine.medical_treatment Perineural invasion Locally advanced lcsh:RC254-282 Gastroenterology survival Article Lesion 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Pancreatic resection Lymph node pancreatic resection business.industry Cancer multiorgan resection lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Gastrectomy gastric adenocarcinoma medicine.symptom business Complication |
| Zdroj: | Cancers Cancers, Vol 13, Iss 1289, p 1289 (2021) Volume 13 Issue 6 |
| ISSN: | 2072-6694 |
| Popis: | Whether gastric adenocarcinoma (GC) patients with adjacent organ invasion (T4b) benefit from aggressive surgery involving pancreatic resection (PR) remains unclear. This study aimed to clarify the impact of PR on survival in patients with locally advanced resectable GC. Between 1995 and 2017, patients with locally advanced GC undergoing radical-intent gastrectomy with and without PR were enrolled and stratified into four groups: group 1 (G1), pT4b without pancreatic resection (PR) group 2 (G2), pT4b with PR group 3 (G3), positive duodenal margins without Whipple’s operation and group 4 (G4), cT4b with Whipple’s operation. Demographics, clinicopathological features, and outcomes were compared between G1 and G2 and G3 and G4. G2 patients were more likely to have perineural invasion than G1 patients (80.6% vs. 50%, p < 0.001). G4 patients had higher lymph node yield (40.8 vs. 31.3, p = 0.002), lower nodal status (p = 0.029), lower lymph node ratios (0.20 vs. 0.48, p < 0.0001) and higher complication rates (45.2% vs. 26.3%, p = 0.047) than G3 patients. The 5-year disease-free survival (DFS) and overall survival (OS) rates were significantly longer in G1 than in G2 (28.1% vs. 9.3%, p = 0.003 32% vs. 13%, p = 0.004, respectively). The 5-year survival rates did not differ between G4 and G3 (DFS: 14% vs. 14.4%, p = 0.384 OS: 12.6% vs. 16.4%, p = 0.321, respectively). In conclusion, patients with T4b lesion who underwent PR had poorer survival than those who underwent resection of other adjacent organs. Further Whipple’s operation did not improve survival in pT3–pT4 GC with positive duodenal margins. |
| Databáze: | OpenAIRE |
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