Extended lymphadenectomy in elderly and/or highly co-morbid gastric cancer patients: A retrospective multicenter study
| Autor: | P. Bertoli, Luca Ansaloni, F. Roviello, Chiara Cipollari, Stefano Rausei, Andrea Sansonetti, Paolo Morgagni, Alberto Biondi, Andrea Cossu, Laura Ruspi, Fausto Rosa, Gianlorenzo Dionigi, Uberto Fumagalli, Ferdinando Carlo Maria Cananzi, A. Di Leo, Daniele Marrelli, Luigina Graziosi, Sergio Alfieri, Federica Galli, Francesco Casella, Giovanni Vittimberga, Andrea Zanoni, R. Lomonaco, Riccardo Rosati, Vittorio Quagliuolo, Mattia Bencivenga, Severino Montemurro, Elena Orsenigo, Annibale Donini, Arianna Coniglio, Gian Luca Baiocchi, Roberto Persiani |
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| Přispěvatelé: | Rausei, S., Ruspi, L., Rosa, F., Morgagni, P., Marrelli, D., Cossu, A., Cananzi, F. C. M., Lomonaco, R., Coniglio, A., Biondi, A., Cipollari, C., Graziosi, L., Fumagalli, U., Casella, F., Bertoli, P., di Leo, A., Alfieri, S., Vittimberga, G., Roviello, F., Orsenigo, E., Quagliuolo, V., Montemurro, S., Baiocchi, G., Persiani, R., Bencivenga, M., Donini, A., Rosati, R., Sansonetti, A., Ansaloni, L., Zanoni, A., Galli, F., Dionigi, G. |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Settore MED/18 - CHIRURGIA GENERALE medicine.medical_treatment Elderly Gastric cancer High morbidity Lymphadenectomy Tailored treatment Adenocarcinoma Adult Age Factors Aged Aged 80 and over Cardiovascular Diseases Comorbidity Dementia Diabetes Mellitus Disease-Free Survival Female Gastrectomy Humans Liver Diseases Lymph Node Excision Middle Aged Postoperative Complications Pulmonary Disease Chronic Obstructive Retrospective Studies Stomach Neoplasms Survival Rate 030230 surgery 0302 clinical medicine 80 and over Pulmonary Disease Chronic Obstructive Surgery Oncology Retrospective Studie Cardiovascular Disease Age Factor Liver Disease Diabetes Mellitu General Medicine Dissection 030220 oncology & carcinogenesis Human medicine.medical_specialty 03 medical and health sciences Stomach Neoplasm medicine Survival rate business.industry Cancer Postoperative complication Retrospective cohort study medicine.disease Postoperative Complication business |
| Popis: | 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. Postoperative complications, overall survival (OS), and disease-specific survival (DSS) according to age and the Charlson Comorbidity Score were analyzed in relation to the extent of lymphadenectomy. Results Postoperative morbidity was 30.4%. Complications were more frequent in highly co-morbid elderly patients, and, although general morbidity rates after D2 and D1 lymphadenectomy were similar (29.9% and 33.2%, respectively), they increased following D2 in highly co-morbid elderly patients (39.6%). D2-lymphadenectomy significantly improved 5-year OS and DSS (48.0% vs. 37.6% in D1, p |
| Databáze: | OpenAIRE |
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