Document Detail


Focus on the conditions of resection and reconstruction in gastric cancer. What extent of resection and what kind of reconstruction provide the best outcomes for gastric cancer patients?
MedLine Citation:
PMID:  16024924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess the roles of the extent of gastric resection and duodenal food passage reconstruction in gastric cancer, we examined a consecutive series of 1,061 patients who underwent total or partial (proximal and distal) gastrectomies with or without duodenal food passage reconstruction between August of 1974 and January of 2002, and received gastrectomies with D2-3 lymph node dissection. Patients who underwent distal or proximal gastrectomy were found to have significantly better survival rates than those who underwent total gastrectomy in stages 1A (10-year survival: 86.6 and 78.9 vs. 61.6%), 2 (56.5 and 65.6 vs. 34.4%), 3A (45.9 and 33.3 vs. 15.2%), and 4 (5-year survival rates: 23.7 and 50.0 vs. 7.1%). Additionally, patients with duodenal food passage reconstruction or double tract reconstruction also showed significantly better survival rates than those without duodenal food reconstruction in stages 1A (10-year survival: 86.4 and 82.5 vs. 61.7%), 1B (69.9 and 90.6 vs. 54.1%), 2 (60.5 and 63.3 vs. 16.5%), and 3A (39.9 and 47.4 vs. 23.1%). In multivariate analysis, the independent prognostic factors were age at operation, depth of tumor, duodenal food passage reconstruction, and lymph node metastasis. Our results indicate that both the extent of gastric resection and duodenal food passage reconstruction were important factors in the outcome of gastric cancer patients, and that surgeons should perform minimal gastric resection with preservation of the duodenal food passage when the gastric stump is tumor-free.
Authors:
Kyoji Ogoshi; Yuichi Okamoto; Kazuhito Nabeshima; Mari Morita; Kenji Nakamura; Kunihiro Iwata; Jinichi Soeda; Yasumasa Kondoh; Hiroyasu Makuuchi
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Publication Detail:
Type:  Journal Article     Date:  2004-09-06
Journal Detail:
Title:  Digestion     Volume:  71     ISSN:  0012-2823     ISO Abbreviation:  Digestion     Publication Date:  2005  
Date Detail:
Created Date:  2005-08-16     Completed Date:  2005-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150472     Medline TA:  Digestion     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  213-24     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2005 S. Karger AG, Basel.
Affiliation:
Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan. ogoshi@is.icc.u-tokai.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / surgery*
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Duodenum / surgery*
Female
Gastrectomy / methods*
Humans
Lymph Node Excision
Male
Middle Aged
Prognosis
Proportional Hazards Models
Reconstructive Surgical Procedures / methods*
Stomach Neoplasms / surgery*
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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