Multivisceral resection for locally advanced gastric cancer: A retrospective study
Multivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis. We retrospectively reviewed cT4b gastric cancer patients who underwent surgery...
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| Published in | The American journal of surgery Vol. 221; no. 5; pp. 1011 - 1017 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
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United States
Elsevier Inc
01.05.2021
Elsevier Limited |
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| Abstract | Multivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis.
We retrospectively reviewed cT4b gastric cancer patients who underwent surgery from January 1,1997 to December 31,2018. The primary endpoint was overall survival. Short-term results and prognostic values of clinical and pathologic factors were also analyzed.
Patients underwent multivisceral resection had an acceptable mortality and morbidity. The overall 5-year survival rate of multivisceral resection was higher than that of palliative surgery (P < 0.05). And independent prognostic factors of multivisceral resection were R+ resection, extensive lymph node involved (>15), vascular cancer emboli, and postoperative chemotherapy.
Conclusions: cT4b gastric cancer patients underwent multivisceral resection experience acceptable mortality and morbidity. The independent prognostic factors for multivisceral resection were completeness of resection, extensive lymph node involvement (>15), vascular cancer emboli, and postoperative chemotherapy.
•CT4b gastric cancer patients could benefit from multivisceral resection.•R0 resection is independent prognostic factor for multivisceral resection.•CT4bN3b gastric cancers should be excluded from multivisceral resection.•≥6 cycles chemotherapy should be performed after multivisceral resection. |
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| AbstractList | Multivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis.
We retrospectively reviewed cT4b gastric cancer patients who underwent surgery from January 1,1997 to December 31,2018. The primary endpoint was overall survival. Short-term results and prognostic values of clinical and pathologic factors were also analyzed.
Patients underwent multivisceral resection had an acceptable mortality and morbidity. The overall 5-year survival rate of multivisceral resection was higher than that of palliative surgery (P < 0.05). And independent prognostic factors of multivisceral resection were R+ resection, extensive lymph node involved (>15), vascular cancer emboli, and postoperative chemotherapy.
Conclusions: cT4b gastric cancer patients underwent multivisceral resection experience acceptable mortality and morbidity. The independent prognostic factors for multivisceral resection were completeness of resection, extensive lymph node involvement (>15), vascular cancer emboli, and postoperative chemotherapy.
•CT4b gastric cancer patients could benefit from multivisceral resection.•R0 resection is independent prognostic factor for multivisceral resection.•CT4bN3b gastric cancers should be excluded from multivisceral resection.•≥6 cycles chemotherapy should be performed after multivisceral resection. Multivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis.BACKGROUNDMultivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis.We retrospectively reviewed cT4b gastric cancer patients who underwent surgery from January 1,1997 to December 31,2018. The primary endpoint was overall survival. Short-term results and prognostic values of clinical and pathologic factors were also analyzed.METHODSWe retrospectively reviewed cT4b gastric cancer patients who underwent surgery from January 1,1997 to December 31,2018. The primary endpoint was overall survival. Short-term results and prognostic values of clinical and pathologic factors were also analyzed.Patients underwent multivisceral resection had an acceptable mortality and morbidity. The overall 5-year survival rate of multivisceral resection was higher than that of palliative surgery (P < 0.05). And independent prognostic factors of multivisceral resection were R+ resection, extensive lymph node involved (>15), vascular cancer emboli, and postoperative chemotherapy.RESULTSPatients underwent multivisceral resection had an acceptable mortality and morbidity. The overall 5-year survival rate of multivisceral resection was higher than that of palliative surgery (P < 0.05). And independent prognostic factors of multivisceral resection were R+ resection, extensive lymph node involved (>15), vascular cancer emboli, and postoperative chemotherapy.cT4b gastric cancer patients underwent multivisceral resection experience acceptable mortality and morbidity. The independent prognostic factors for multivisceral resection were completeness of resection, extensive lymph node involvement (>15), vascular cancer emboli, and postoperative chemotherapy.CONCLUSIONScT4b gastric cancer patients underwent multivisceral resection experience acceptable mortality and morbidity. The independent prognostic factors for multivisceral resection were completeness of resection, extensive lymph node involvement (>15), vascular cancer emboli, and postoperative chemotherapy. BackgroundMultivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis.MethodsWe retrospectively reviewed cT4b gastric cancer patients who underwent surgery from January 1,1997 to December 31,2018. The primary endpoint was overall survival. Short-term results and prognostic values of clinical and pathologic factors were also analyzed.ResultsPatients underwent multivisceral resection had an acceptable mortality and morbidity. The overall 5-year survival rate of multivisceral resection was higher than that of palliative surgery (P < 0.05). And independent prognostic factors of multivisceral resection were R+ resection, extensive lymph node involved (>15), vascular cancer emboli, and postoperative chemotherapy.Conclusions: cT4b gastric cancer patients underwent multivisceral resection experience acceptable mortality and morbidity. The independent prognostic factors for multivisceral resection were completeness of resection, extensive lymph node involvement (>15), vascular cancer emboli, and postoperative chemotherapy. Multivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis. We retrospectively reviewed cT4b gastric cancer patients who underwent surgery from January 1,1997 to December 31,2018. The primary endpoint was overall survival. Short-term results and prognostic values of clinical and pathologic factors were also analyzed. Patients underwent multivisceral resection had an acceptable mortality and morbidity. The overall 5-year survival rate of multivisceral resection was higher than that of palliative surgery (P < 0.05). And independent prognostic factors of multivisceral resection were R+ resection, extensive lymph node involved (>15), vascular cancer emboli, and postoperative chemotherapy. cT4b gastric cancer patients underwent multivisceral resection experience acceptable mortality and morbidity. The independent prognostic factors for multivisceral resection were completeness of resection, extensive lymph node involvement (>15), vascular cancer emboli, and postoperative chemotherapy. |
| Author | Ma, Yongchen Hu, Jianwen Chen, Guowei Yang, Yanpeng Liu, Yucun |
| Author_xml | – sequence: 1 givenname: Yanpeng surname: Yang fullname: Yang, Yanpeng – sequence: 2 givenname: Jianwen surname: Hu fullname: Hu, Jianwen – sequence: 3 givenname: Yongchen surname: Ma fullname: Ma, Yongchen – sequence: 4 givenname: Guowei surname: Chen fullname: Chen, Guowei email: doctor1993@163.com – sequence: 5 givenname: Yucun surname: Liu fullname: Liu, Yucun email: yucunliu@bjmu.edu.cn |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33036727$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3390_jcm12237360 crossref_primary_10_4251_wjgo_v16_i1_79 crossref_primary_10_1002_jso_26855 crossref_primary_10_3390_jcm13103010 crossref_primary_10_1007_s00423_023_03187_7 crossref_primary_10_17941_agd_1336914 crossref_primary_10_1186_s12957_024_03620_1 crossref_primary_10_1055_s_0043_1761278 crossref_primary_10_3919_jjsa_84_288 crossref_primary_10_1016_j_asjsur_2022_08_089 |
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| Keywords | T4b gastric Cancer Multivisceral resection Survival rate Prognostic factors |
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| SubjectTerms | Cancer Cancer therapies Chemotherapy Gastric cancer Gastrointestinal surgery Lymph nodes Lymphatic system Medical prognosis Medical records Morbidity Mortality Multivariate analysis Multivisceral resection Ostomy Pancreas Patients Prognostic factors Regression analysis Surgery Survival Survival analysis Survival rate T4b gastric Cancer |
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| Title | Multivisceral resection for locally advanced gastric cancer: A retrospective study |
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