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Ca gastrico

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By Peter Vorwald Surgeon
Brian Badgwell
Surgical resection is the primary method of obtaining a potential cure for patients with gastric adenocarcinoma. However, chemotherapy or chemoradiotherapy offer significant improvement in survival over surgery alone. Much of the difficulty in deciding the optimal treatment strategy is choosing between perioperative chemotherapy or adjuvant chemoradiotherapy. Adding to the complexity is the potential for incorporating treatment strategies based on clinical trials performed in Asia. There is likely a difference in tumor biology between Eastern and Western patients with gastric adenocarcinoma, in addition to the clear differences in screening, pathologic assessment, and surgical technique...
October 2016: Journal of the National Comprehensive Cancer Network: JNCCN
Noriyuki Inaki, Tsuyoshi Etoh, Tetsuji Ohyama, Kazuhisa Uchiyama, Natsuya Katada, Keisuke Koeda, Kazuhiro Yoshida, Akinori Takagane, Kazuyuki Kojima, Shinichi Sakuramoto, Norio Shiraishi, Seigo Kitano
BACKGROUND: The efficacy and safety outcomes of laparoscopy-assisted distal gastrectomy (LADG) with D2 lymph node dissection for locally advanced gastric cancer remain unclear. Therefore, we conducted a randomized, controlled phase II trial to confirm the feasibility of LADG in terms of technical safety, and short-term surgical outcomes were investigated. METHODS: Eligibility criteria included pre-operatively diagnosed advanced gastric cancer that could be treated by distal gastrectomy with D2 lymph node dissection; MP, SS, and SE without involvement of other organs; and N0-2 and M0...
November 2015: World Journal of Surgery
Naruhiko Ikoma, Mariela Blum, Yi-Ju Chiang, Jeannelyn S Estrella, Sinchita Roy-Chowdhuri, Keith Fournier, Paul Mansfield, Jaffer A Ajani, Brian D Badgwell
BACKGROUND: This study aimed to identify the yield of staging laparoscopy with peritoneal lavage cytology for gastric cancer patients and to track it over time. METHODS: The medical records of patients with gastric or gastroesophageal adenocarcinoma who underwent pretreatment staging laparoscopy at the authors' institution from 1995 to 2012 were reviewed. The yield of laparoscopy was defined as the proportion of patients who had positive findings on laparoscopy, including those with macroscopic carcinomatosis, positive cytology, or other clinically important findings...
December 2016: Annals of Surgical Oncology
Eric Van Cutsem, Xavier Sagaert, Baki Topal, Karin Haustermans, Hans Prenen
Gastric cancer is one of the leading causes of cancer-related death worldwide. Many patients have inoperable disease at diagnosis or have recurrent disease after resection with curative intent. Gastric cancer is separated anatomically into true gastric adenocarcinomas and gastro-oesophageal-junction adenocarcinomas, and histologically into diffuse and intestinal types. Gastric cancer should be treated by teams of experts from different disciplines. Surgery is the only curative treatment. For locally advanced disease, adjuvant or neoadjuvant therapy is usually implemented in combination with surgery...
November 26, 2016: Lancet
Jeung Hui Pyo, Cheol Min Shin, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Su Mi Kim, Min Gew Choi, Jun Ho Lee, Tae Sung Sohn, Jae Moon Bae, Kyung Mee Kim, Hye Seung Kim, Sin-Ho Jung, Jae J Kim, Sung Kim
OBJECTIVE: The aim of the study was to develop a reliable and easy-to-use risk-scoring system (RSS) to predict lymph-node metastasis (LNM) and determine the feasibility of endoscopic submucosal dissection for mucosa-confined signet ring cell carcinomas (SRCs). BACKGROUND: Fewer LNM and better survival rates have been reported for early gastric SRCs compared with other undifferentiated early gastric cancers (EGCs). METHODS: Data from 1544 patients with mucosa-confined SRCs were reviewed...
January 7, 2016: Annals of Surgery
Ming Fan, GuiChao Li, LiJun Shen, Hui Zhang, LiPing Liang, Zhen Zhang
OBJECTIVE: The role of adjuvant chemoradiotherapy (CRT) in locally advanced gastric cancer (LAGC) after D2 dissection is controversial. Subgroup analysis of the ARTIST trial indicated that patients with lymph node metastasis might benefit from additional radiation. The present study compared adjuvant CRT with adjuvant chemotherapy (CT) for the treatment of lymph node metastasis and suggested patient-selection guidelines. METHODS: Patients with LAGC and positive lymph nodes who underwent D2, R0 gastrectomy in our hospital were retrospectively investigated...
2016: British Journal of Radiology
Yoo Min Kim, Taeil Son, Hyoung-Il Kim, Sung Hoon Noh, Woo Jin Hyung
BACKGROUND: This study was undertaken to outline, in detail, the procedures for robotic D2 lymph node dissection during distal gastrectomy for middle- or lower-third gastric cancer, and to present data that may suggest the safety and feasibility of robotic D2 lymph node dissection.1 (-) 4 METHODS: From July 2005 to December 2009, a total of 316 robotic gastrectomies were performed at the Severance Hospital, Yonsei University Health System, Seoul, Korea. Of these, 95 distal subtotal gastrectomies with D2 lymph node dissection with partial omentectomy for gastric cancer were robotically performed...
August 2016: Annals of Surgical Oncology
Shibo Bian, Hongqing Xi, Xiaosong Wu, Jianxin Cui, Liangang Ma, Rong Chen, Bo Wei, Lin Chen
BACKGROUND: There is no consensus in the impact of No. 10 lymph node dissection (LND) for advanced proximal gastric cancer (APGC) and the status of negative No. 4sa and No. 4sb lymph nodes (No. 4s LNs) is reportedly associated with no metastasis to No. 10 LN. We aimed to evaluate the role of No. 10 LND in APGC patients with negative No. 4s LNs and the diagnostic accuracy of intraoperative pathologic examination. METHODS: We analyzed data on 727 patients with APGC who had undergone D2 lymphadenectomy with No...
July 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Yanfeng Hu, Changming Huang, Yihong Sun, Xiangqian Su, Hui Cao, Jiankun Hu, Yingwei Xue, Jian Suo, Kaixiong Tao, Xianli He, Hongbo Wei, Mingang Ying, Weiguo Hu, Xiaohui Du, Pingyan Chen, Hao Liu, Chaohui Zheng, Fenglin Liu, Jiang Yu, Ziyu Li, Gang Zhao, Xinzu Chen, Kuan Wang, Ping Li, Jiadi Xing, Guoxin Li
PURPOSE: The safety and efficacy of radical laparoscopic distal gastrectomy (LG) with D2 lymphadenectomy for the treatment of advanced gastric cancer (AGC) remain controversial. We conducted a randomized controlled trial to compare laparoscopic and conventional open distal gastrectomy with D2 lymph node dissections for AGC. PATIENTS AND METHODS: Between September 2012 and December 2014, 1,056 patients with clinical stage T2-4aN0-3M0 gastric cancer were eligible for inclusion...
April 20, 2016: Journal of Clinical Oncology
Kate F Willcutts, Mei C Chung, Cheryl L Erenberg, Kristen L Finn, Bruce D Schirmer, Laura D Byham-Gray
OBJECTIVE: To compare the effects of early oral feeding to traditional (or late) timing of oral feeding after upper gastrointestinal surgery on clinical outcomes. BACKGROUND: Early postoperative oral feeding is becoming more common, particularly as part of multimodal or fast-track protocols. However, concerns remain about the safety of early oral feeding after upper gastrointestinal surgery. METHODS: Comprehensive literature searches were conducted across 5 databases from January 1980 until June 2015 without language restriction...
July 2016: Annals of Surgery
Jian-Hui Chen, Shi-Rong Cai, Er-Tao Zhai, Si-Le Chen, Kai-Ming Wu, Wu Song, Yu-Long He
The Japanese Gastric Cancer Treatment Guidelines (third edition) have assigned No. 7 station left gastric artery lymph nodes (LNs) to the D1 range of lymphatic dissection. We investigated the clinicopathological characteristics, survival impact, and appropriateness of ascribing No. 7 station LNs to D1 lymphadenectomy in gastric cancer. Patients (n=608) undergoing radical resection with No. 7 station LN dissection were recruited between January 1997 and June 2008. They were subdivided into four groups: N0, no LN metastasis; D1, LN without No...
2015: International Journal of Clinical and Experimental Pathology
Wataru Okajima, Shuhei Komatsu, Daisuke Ichikawa, Toshiyuki Kosuga, Takeshi Kubota, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji
BACKGROUND: In gastric cancer, although at least 16 lymph nodes of retrieved lymph nodes (RLNs) are recommended for nodal staging in Japanese Classification of Gastric Carcinoma and TNM classifications, we wished to clarify their appropriateness. STUDY DESIGN: A total of 1289 consecutive gastric cancer patients, who underwent gastrectomy between 1997 and 2011, were analyzed retrospectively. RESULTS: (i) The patients were divided into two groups using a cut-off RLN number of 16 (RLN < 16 or RLN ≥ 16)...
September 2016: Journal of Gastroenterology and Hepatology
Zhixue Zheng, Yinan Zhang, Lianhai Zhang, Ziyu Li, Aiwen Wu, Xiaojiang Wu, Yiqiang Liu, Zhaode Bu, Jiafu Ji
BACKGROUND: To combine clinicopathological characteristics associated with lymph node metastasis for submucosal gastric cancer into a nomogram. METHODS: We retrospectively analyzed 262 patients with submucosal gastric cancer who underwent D2 gastrectomy between 1996 and 2012. The relationship between lymph node metastasis and clinicopathological features was statistically analyzed. With multivariate logistic regression analysis, we made a nomogram to predict the possibility of lymph node metastasis...
December 2015: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Leonie Haverkamp, Hylke J F Brenkman, Jelle P Ruurda, Fiebo J W Ten Kate, Richard van Hillegersberg
AIM: The aim of this study was to determine the oncologic value of omentectomy in patients undergoing gastrectomy for gastric cancer. METHODS: All consecutive patients with gastric cancer that underwent gastrectomy with curative intent between April 2012 and August 2015 were prospectively analyzed. The greater omentum was separately marked during operation and pathologically evaluated for the presence of omental lymph nodes and tumor deposits. RESULTS: In total, 50 patients were included...
May 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Haejin In, Olga Kantor, Susan M Sharpe, Marshall S Baker, Mark S Talamonti, Mitchell C Posner
BACKGROUND: The benefit of adjuvant therapy following resection of early stage, node-negative gastric adenocarcinoma following a margin negative (R0) resection is unclear. METHODS: The National Cancer Data Base was used to identify patients with a T2N0 gastric adenocarcinoma (tumor invasion into the muscularis propria) who underwent R0 resection. Patients treated with neoadjuvant therapy and those for whom lymph node count was unavailable were excluded from the analysis...
June 2016: Annals of Surgical Oncology
Lauren M Postlewait, Shishir K Maithel
Interpretation and management of the surgical margin is paramount to the treatment of gastric adenocarcinoma. Although in early-stage disease, a microscopically positive margin may be associated with poor outcomes, in later stages, it does not persist as an independent poor prognostic factor but rather is likely a marker of other adverse pathologic characteristics that ultimately determine outcomes. Thus, the decision to extend a resection to achieve a negative margin should be deliberate and individualized...
March 2016: Journal of Surgical Oncology
Britta Liersch-Löhn, Nadia Slavova, Heinz J Buhr, Idriss M Bennani-Baiti
Transmembrane tyrosine-kinase Ephrin receptors promote tumor progression and/or metastasis of several malignancies including leukemia, follicular lymphoma, glioma, malignant pleural mesothelioma, papillary thyroid carcinoma, sarcomas and ovarian, breast, bladder and non-small cell lung cancers. They also drive intestinal stem cell proliferation and positioning, control intestinal tissue boundaries and are involved in liver, pancreatic and colorectal cancers, indicating involvement in additional digestive system malignancies...
March 1, 2016: International Journal of Cancer. Journal International du Cancer
Yun-Suhk Suh, Seong-Ho Kong, Hyuk-Joon Lee, Han-Kwang Yang
No abstract text is available yet for this article.
August 2016: Annals of Surgery
Fan-Feng Chen, Dong-Dong Huang, Jin-Xiao Lu, Chong-Jun Zhou, Cheng-Le Zhuang, Su-Lin Wang, Xian Shen, Zhen Yu, Xiao-Lei Chen
BACKGROUND: The aim of this study was to evaluate the short- and long-term outcomes after total gastrectomy (TG) with D2 lymphadenectomy. METHODS: Patients undergoing TG with D2 lymphadenectomy for gastric cancer between December 2008 and December 2011 were enrolled. Univariate and multivariate analyses were performed to evaluate the risk factors for the short- and long-term outcomes. RESULTS: A total of 229 patients were analyzed, and 22...
March 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Shuanhu Wang, Zongbing Zhang, Mulin Liu, Shiqing Li, Congqiao Jiang
BACKGROUND: Endoscopic resection and gastrectomy are treatment modalities for early gastric cancer, but their relative benefits and risks are unclear. We conducted a systematic review and meta-analysis to compare endoscopic resection and gastrectomy for treating early gastric cancer. METHODS: We searched PubMed, Embase, and the Cochrane Library until April 2015 for studies comparing endoscopic resection with gastrectomy for treatment of early gastric cancer. Outcome measures were five-year overall survival (OS), length of hospital stay and postoperative morbidity...
2015: PloS One
2015-12-25 20:51:48
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