Total Gastrectomy with Distal Pancreatico-splenectomy for Treating Locally Advanced Gastric Cancer
Journal of the Korean Gastric Cancer Association
; : 74-81, 2007.
Article
em Ko
| WPRIM
| ID: wpr-121562
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE:
Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material andMethods:
We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed.RESULTS:
The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 6.8%.CONCLUSION:
Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.Palavras-chave
Texto completo:
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Base de dados:
WPRIM
Assunto principal:
Pâncreas
/
Baço
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Neoplasias Gástricas
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Análise Multivariada
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Taxa de Sobrevida
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Estudos Retrospectivos
/
Mortalidade
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Fístula Pancreática
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Abscesso Abdominal
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Gastrectomia
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
Ko
Revista:
Journal of the Korean Gastric Cancer Association
Ano de publicação:
2007
Tipo de documento:
Article