Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era-A Single Institute Experience over a Decade.

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2018-01-14 eCollection Date: 2018-01-01 DOI:10.1155/2018/9371492
Harsh Kanhere, Raghav Goel, Ben Finlay, Markus Trochsler, Guy Maddern
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引用次数: 6

Abstract

Background and objectives: Most gastric cancer patients now undergo perioperative chemotherapy (POCT) based on the MAGIC trial results. POCT consists of neoadjuvant chemotherapy (NACT) as well as postoperative adjuvant chemotherapy. This study assessed the applicability of perioperative chemotherapy and the impact of radical gastrectomy encompassing a detailed lymph-node resection on outcomes of gastric cancer.

Methods: Medical and pathology records of all gastric carcinoma resections were reviewed from 2006 onwards. Pathological details, number of lymph-nodes resected, and proportion of involved nodes, reasons for nonadministration of NACT, complications, recurrence, and survival data were analysed.

Results: Only twenty-eight (37.8%) out of 74 patients underwent NACT and only nine completed POCT. NACT was declined due to comorbidities/patient refusal n = 24, early stage n = 14, and emergency presentation n = 8. Patients receiving NACT were much younger. Anastomotic leaks, hospital-mortality, lymph-node yield, and proportion of involved lymph-nodes were similar in both groups. Thirty-two patients died due to recurrence with lymph-node involvement heralding higher recurrence risk and much poorer survival (HR 2.66; p = 0.013).

Conclusion: More than 60% patients with resectable gastric carcinoma did not undergo NACT. Radical gastrectomy with lymphadenectomy remained the cornerstone of treatment in this period.

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胃癌根治术:围手术期化疗时代胃癌根治性治疗的基石——十多年来单院经验
背景和目的:基于MAGIC试验结果,大多数胃癌患者现在接受围手术期化疗(POCT)。POCT包括新辅助化疗(NACT)和术后辅助化疗。本研究评估围手术期化疗的适用性和胃癌根治性切除术包括详细淋巴结切除术对胃癌预后的影响。方法:回顾2006年以来所有胃癌切除术的医学和病理记录。分析病理细节、切除淋巴结数量、受累性淋巴结比例、未给予NACT的原因、并发症、复发和生存数据。结果:74例患者中只有28例(37.8%)接受了NACT,只有9例完成了POCT。NACT因合并症/患者拒绝24例,早期14例,急诊8例而被拒绝。接受NACT治疗的患者更年轻。吻合口漏、住院死亡率、淋巴结产量和受累淋巴结比例在两组中相似。32例患者因复发并累及淋巴结而死亡,预示着更高的复发风险和更差的生存率(HR 2.66;P = 0.013)。结论:60%以上的可切除胃癌患者未行NACT手术。根治性胃切除术加淋巴结切除术仍然是这一时期治疗的基石。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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