Document Detail

Trends in characteristics of surgically treated early gastric cancer patients after the introduction of gastric cancer treatment guidelines in Japan.
MedLine Citation:
PMID:  20602192     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The gastric cancer treatment guidelines (Guidelines) of the Japanese Gastric Cancer Association allow endoscopic treatment and a modified gastrectomy for the treatment of early gastric cancer (EGC). Endoscopic treatment is indicated for EGC with a minimal chance of nodal metastasis. Consequently, surgeons will likely treat an increasing number of EGC patients with greater chance of nodal metastasis using a reduced extent of lymphadenectomy. The aim of this study was to investigate the trends in characteristics and long-term oncological outcomes of surgically treated EGC patients after the introduction of the Guidelines. METHODS: Between 2001 and 2003, 696 patients underwent a gastrectomy according to the Guidelines. These 696 patients (the Guidelines group) were retrospectively compared with 635 patients (the control group) who had undergone a gastrectomy between 1991 and 1995 (before the introduction of the Guidelines). RESULTS: The incidence of nodal metastasis in mucosal cancers was higher in the Guidelines group than in the control group (6.5% vs 2.6%). The proportion of D2 or greater extended lymphadenectomy in the Guidelines group was lower than that in the control group (29.7% vs 62.5%). Nevertheless, the 5-year survival rate in the Guidelines group was similar to that in the control group (94.2% vs 92.3%). CONCLUSION: Surgeons treated more cases of mucosal cancer with nodal metastasis after the introduction of the Guidelines. The long-term oncological outcomes for patients with EGC remained excellent. So far, the Guidelines for the treatment of EGC appear acceptable.
Norimitsu Tanaka; Hitoshi Katai; Hirokazu Taniguchi; Makoto Saka; Shinji Morita; Takeo Fukagawa; Takuji Gotoda
Publication Detail:
Type:  Journal Article     Date:  2010-07-03
Journal Detail:
Title:  Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association     Volume:  13     ISSN:  1436-3291     ISO Abbreviation:  Gastric Cancer     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886238     Medline TA:  Gastric Cancer     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  74-7     Citation Subset:  IM    
Gastric Surgery Division, National Cancer Center Hospital, Chuo-ku, Tokyo, 104-0045, Japan.
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MeSH Terms
Aged, 80 and over
Follow-Up Studies
Gastrectomy / methods*
Gastric Mucosa / pathology
Gastroscopy / methods*
Lymphatic Metastasis
Middle Aged
Practice Guidelines as Topic*
Retrospective Studies
Stomach Neoplasms / pathology,  surgery*
Survival Rate
Time Factors
Treatment Outcome
Young Adult

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

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