Long-term results after radical resection for gastric adenocarcinoma

Czech version

Authors: F. Pazdírek ¹; J. Leffler ¹; L. Štěpánek ²; D. Kostrouch ¹; J. Votava ¹; M. Šimša ³
Authors‘ workplace: Chirurgická klinika 2. LF UK a FN v Motole, Praha ¹; Fakulta biomedicínského inženýrství ČVUT v Praze ²; Chirurgická klinika 1. LF UK a Thomayerova nemocnice, Praha ³
Published in: Gastroent Hepatol 2016; 70(5): 402-407
Category: Gastrointestinal Oncology: Original Article
doi: https://doi.org/10.14735/amgh2016402

Overview

Background:
Gastric cancer is a serious disease with a generally poor prognosis. Because systemic anticancer treatment is not sufficiently effective, only complete removal of the tumor gives patients a chance of a cure.

Aim:
The study evaluated the long-term treatment outcomes of patients after radical resections for gastric adenocarcinoma.

Methods:
The study group included 48 patients who had undergone radical gastrectomy for adenocarcinoma. The results of statistical analyses of prospectively collected data were evaluated for 30-day overall patient survival (OS) and disease free survival (DFS), and 90-day postoperative mortality and morbidity. Further, the study evaluated the relationship between survival of patients in different clinical stages and the extent of lymphadenectomy, adjuvant effect of cancer treatment on survival and DFS, and the potential impact of early postoperative complications on OS.

Results:
Twenty-one patients (43.8%) survived five years. Postoperative surgical complications occurred in 12.5% of patients and non-surgical complications occurred in 12.5% of patients. The extent of lymphadenectomy D1 vs. D2 did not affect survival of patients neither overall nor in individual stages of the disease (p = 0.189). Conversely, a significant difference in long-term survival was found in cases where the number of histologically negative nodes among the total number of examined lymph nodes was greater than 60% (p < 0.0001). The extent of gastric resection or postoperative complications in our cohort had no impact on OS (p = 0.625; p = 0.268). Adjuvant therapy did not extend the OS of patients but prolonged DFS (FUFA combination with radiotherapy; p < 0.033).

Conclusion:
Gastric adenocarcinoma remains a serious disease with a prognosis that depends mainly on the stage of disease at the time of diagnosis. In our group, we did not find a positive effect of D2 lymphadenectomy on OS. A statistically significant difference in long-term survival was found in cases where the number of histologically negative nodes among the total number of examined lymph nodes was greater than 60%. Adjuvant cancer treatment had no effect on OS but prolonged DFS.

Key words:
carcinoma – stomach – treatment – prognosis – survival

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
4. 8. 2016

Accepted:
18. 9. 2016

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