Author/Editor     Potrč, Stojan; Kavalar, Rajko; Hajdinjak, Tine; Horvat, Matjaž; Vidovič, Damjan; Gadžijev, Eldar
Title     What have we learned from surgical treatment of gastric adenocarcinoma? A comparison of two periods
Type     članek
Source     Wien Klin Wochenschr
Vol. and No.     Letnik 116, št. Suppl 2
Publication year     2004
Volume     str. 56-9
Language     eng
Abstract     In January 1992, a standardized and more radical surgical approach in gastric cancer treatment and a standardized pathohistological workup of specimens was introduced at our institution. The aim of our retrospectively designed study was to compare the results of two consecutive groups of altogether 348 patients who underwent a total or subtotal gastrectomy for gastric cancer (period A: 162 patients operated between 1992 and 1996; period B: 186 patients operated between 1997 and 2000). The two groups of patients were comparable in age, sex, their general condition, and the proportion of potentially curable (RO) resections. There was a significant difference between the groups with regard to tumor site (fewer distal and more proximal stomach tumors in period B), type of operation (more total gastrectomies in period B), extent of lymphadenectomy (more D2 and D3 in period B), average number of affected lymph nodes (higher in period B), average number of examined nodes (higher in period B), and in UICC stage (less stage II in period B). UICC classification was impossible in 19 patients overall, but there were fewer non-classified patients in period B. The incidence of surgical complications (15.6% vs. 18.7%) and average hospital stay (14.72 days vs. 14.70 days) was not significantly different in the two groups. The drop in overall mortality rate (potentially curable and non-curable resections) in period B almost reached statistical significance (period A: 8%, period B: 6.5%; p=0.57). The 5-year survival for all RO resected patients (279) in 9 years was 31 %. The median survival was significantly longer in period B (941 days) than in period A (570 days) for RO and non-curable (R2) resections together (p=0.0132) as well as for RO resections alone (period A: 844 days, period B: 1176 days; p=0.0127). (Abstract truncated at 2000 characters).
Descriptors     STOMACH NEOPLASMS
ADENOCARCINOMA
GASTRECTOMY
LYMPH NODE EXCISION
NEOPLASM STAGING
POSTOPERATIVE COMPLICATIONS
SURVIVAL ANALYSIS