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What are the important prognostic factors in gastric cancer with positive duodenal margins? A multi-institutional analysis.
Fujita, Shohei; Oshima, Yoko; Yajima, Satoshi; Kikuchi, Yoshinori; Nagaoka, Sakae; Yamashita, Hiroharu; Seto, Yasuyuki; Fujisaki, Muneharu; Mitsumori, Norio; Otsuka, Koji; Murakami, Masahiko; Urakami, Hidejiro; Isobe, Yoh; Yoshimoto, Yutaro; Satodate, Hitoshi; Saida, Yoshihisa; Shimada, Hideaki.
Afiliación
  • Fujita S; Department of Surgery, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
  • Oshima Y; Division of General and Gastroenterological Surgery, Department of Surgery (Omori), Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan.
  • Yajima S; Division of General and Gastroenterological Surgery, Department of Surgery (Omori), Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan.
  • Kikuchi Y; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan.
  • Nagaoka S; Department of Gastroesophageal Surgery, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-Ku, Tokyo, 150-8935, Japan.
  • Yamashita H; Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
  • Seto Y; Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
  • Fujisaki M; Department of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
  • Mitsumori N; Department of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
  • Otsuka K; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
  • Murakami M; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
  • Urakami H; National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
  • Isobe Y; National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
  • Yoshimoto Y; NTT Medical Center Tokyo, 5-9-22, Higashi-gotanda, Shinagawa-ku, Tokyo, 141-0022, Japan.
  • Satodate H; NTT Medical Center Tokyo, 5-9-22, Higashi-gotanda, Shinagawa-ku, Tokyo, 141-0022, Japan.
  • Saida Y; Department of Surgery, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
  • Shimada H; Division of General and Gastroenterological Surgery, Department of Surgery (Omori), Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan. hideaki.shimada@med.toho-u.ac.jp.
Surg Today ; 51(4): 561-567, 2021 Apr.
Article en En | MEDLINE | ID: mdl-32797287
ABSTRACT

PURPOSE:

Positive margins are reported in from 4.8 to 9.5% of all gastric cancer surgeries and they have a negative impact on the overall survival. Few cases with positive duodenal margins have been included in previous studies regarding the prognosis.

METHODS:

This multi-institutional retrospective study included 115 gastric cancer patients with positive duodenal margins following gastrectomy between January 2002 and December 2017. The association between clinicopathological factors and the overall survival was evaluated by univariate and multivariate analyses.

RESULTS:

The three-year overall survival was 22% and the median survival was 13 months. A multivariate analysis found that distant metastasis, no postoperative chemotherapy, and non-Type 4 disease were significantly associated with a poor survival. Patients without distant metastasis who received postoperative chemotherapy had a 3-year overall survival of 56% and a median survival of 44 months.

CONCLUSION:

The patients who underwent post-operative chemotherapy showed a significantly better OS compared with those who did not undergo post-operative chemotherapy, regardless of the existence of distant metastasis. Postoperative chemotherapy may, therefore, improve the prognosis of surgically treated gastric cancer patients with positive duodenal margins.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Duodeno / Márgenes de Escisión / Metástasis de la Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Surg Today Año: 2021 Tipo del documento: Article País de afiliación: Japón
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Duodeno / Márgenes de Escisión / Metástasis de la Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Surg Today Año: 2021 Tipo del documento: Article País de afiliación: Japón