Safety and feasibility of adjuvant chemotherapy with S-1 in Korean patients with curatively resected advanced gastric cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 121-121
Author(s):  
Jae Ho Jeong ◽  
Min-Hee Ryu ◽  
Sung Sook Lee ◽  
Baek-Yeol Ryoo ◽  
Sang Hong Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Female Gender ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Korean Patients ◽  
Independent Risk Factors ◽  
Grade 3

121 Background: Adjuvant chemotherapy with S-1 has been proven effective for patients with curatively resected advanced gastric cancer with D2 lymph node dissection in Japan. We assessed the safety and feasibility of adjuvant S-1 chemotherapy in Korean patients with stage II, III or IV(M0) gastric cancer. Methods: A total of 305 patients with stage II, III or IV(M0) gastric cancer received adjuvant S-1 chemotherapy following curative gastrectomy with D2 lymph node dissection in Asan Medical Center between October 2007 and December 2009. Adjuvant chemotherapy with S-1 was started 3-6 weeks after surgery and it was administered orally twice daily at the dose of 40 mg/m2 for 4 weeks followed by 2 weeks of rest, every 6 weeks 8 times for 1 year. We retrospectively reviewed the medical records of the patients and evaluated the safety and feasibility of adjuvant S-1 chemotherapy in Korean patients. Results: Among the 305 patients, 248 (81.3%) and 198 (64.9%) patients completed 4 and 8 cycles of adjuvant chemotherapy, respectively. The most common reasons for discontinuation of treatment were adverse event (43.9%) and recurrence (26.2%). Among the 305 patients, 75 (24.6%) patients required dose reduction because of toxicities. The most common grade 3/4 toxicities were neutropenia (12.8%), diarrhea (5.3%), abdominal pain (3.8%), and anemia (3.3%). Multivariate analysis showed that total gastrectomy (H.R. 2.50; 95% C.I. 1.32-4.72, p=0.005) and female gender (H.R. 1.95; 95% C.I. 1.03-3.66, p=0.039) were independent risk factors for grade 3/4 hematologic toxicities, and old age (>65 years) (H.R. 2.92; 95% C.I. 1.50-5.69, p=0.002) was an independent risk factor for grade 3 non-hematologic toxicities. Conclusions: Adjuvant chemotherapy with S-1 for 1 year was safe and feasible in Korean patients. Old age, female gender, and total gastrectomy were independent risk factors for severe toxicities of adjuvant S-1 chemotherapy.

scholarly journals Risk factors for esophagojejunal anastomotic leakage in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer: A retrospective cohort study

2020 ◽  
Author(s):  
Jiadi Xing ◽  
Maoxing Liu ◽  
Xinyu Qi ◽  
Jianhong Yu ◽  
Yingcong Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Alcohol Consumption ◽  
Anastomotic Leakage ◽  
Pulmonary Insufficiency ◽  
Intraoperative Blood Loss ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Independent Risk Factors ◽  
Esophagojejunal Anastomotic Leakage

Abstract Background: This study aimed to explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer.Methods: 390 consecutive patients receiving Roux-en-Y esophagojejunostomy reconstruction after surgery were reviewed. Multivariate analysis was performed using a logistic regression model to identify independent risk factors for EJAL.Results: Of the 390 patients enrolled in this study, EJAL occurred in 10 patients (2.6%). One patient (1/10) with EJAL died. Univariate analysis identified age (P = 0.025), alcohol consumption (P = 0.019), pulmonary insufficiency (P = 0.049), and intraoperative blood loss (P = 0.015) as risk factors for EJAL. Of these four risk factors, age (P = 0.043) and alcohol consumption (P = 0.043) were retained as independent risk factors by multivariate analysis.Conclusions: Surgeons should be very careful about anastomotic leakage during the perioperative period, especially in patients with advanced age and a history of alcohol consumption. Pulmonary insufficiency and intraoperative blood loss, although not being identified as independent risk factors, should also be considered.

scholarly journals Risk factors for esophagojejunal anastomotic leakage in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer: A retrospective cohort study

2020 ◽  
Author(s):  
Jiadi Xing ◽  
Maoxing Liu ◽  
Xinyu Qi ◽  
Jianhong Yu ◽  
Yingcong Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Alcohol Consumption ◽  
Anastomotic Leakage ◽  
Pulmonary Insufficiency ◽  
Intraoperative Blood Loss ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Independent Risk Factors ◽  
Esophagojejunal Anastomotic Leakage

Abstract Background This study aimed to explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer. Methods Consecutive patients receiving Roux-en-Y esophagojejunostomy reconstruction after surgery were reviewed. Multivariate analysis was performed using a logistic regression model to identify independent risk factors for EJAL. Results Of the 390 patients enrolled in this study, EJAL occurred in 10 patients (2.6%). One patient (1/10) with EJAL died. Univariate analysis identified age ( P = 0.025), alcohol consumption ( P = 0.019), pulmonary insufficiency ( P = 0.049), and intraoperative blood loss ( P = 0.015) as risk factors for EJAL. Of these four risk factors, age ( P = 0.043) and alcohol consumption ( P = 0.043) were retained as independent risk factors by multivariate analysis. Conclusions Surgeons should be very careful about anastomotic leakage during the perioperative period, especially in patients with advanced age and a history of alcohol consumption. Pulmonary insufficiency and intraoperative blood loss, although not being identified as independent risk factors, should also be considered.

Đánh giá kết quả phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư

2021 ◽  
Author(s):  
Van Huong Nguyen
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Total Gastrectomy ◽  
Lymph Node Dissection ◽  
Laparoscopic Total Gastrectomy ◽  
Node Dissection ◽  
Female Ratio ◽  
D2 Lymph Node Dissection ◽  
Totally Laparoscopic Total Gastrectomy ◽  
Totally Laparoscopic

TÓM TẮT Đặt vấn đề: Nghiên cứu nhằm đánh giá kết quả phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư tại Bệnh viện Hữu nghị Đa khoa Nghệ An. Phương pháp: Nghiên cứu mô tả hồi cứu, gồm 126 bệnh nhân ung thư dạ dày được phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày vét hạch D2, từ 2013 đến 2020 Kết quả: Tuổi trung bình 60,6 ± 11,1 tuổi. Tỷ lệ nam/nữ 2.8/1. Ung thư ở giai đoạn I, II, III là 19,0%, 49,2%, 31,7%. Ung thư biểu mô tuyến nhú và ống là 70,6% và tế bào nhẫn là 24,6%. Tỷ lệ tai biến trong mổ của nhóm PTNS hoàn toàn là 4,4% và PTNS hỗ trợ 20,6%. Số hạch nạo vét được trung bình của 2 nhóm PTNS hoàn toàn là 23,7 ± 7,1 hạch và PTNS hỗ trợ là 18,0 ± 7,2 hạch. Lượng máu mất trung bình của PTNS hoàn toàn 30,56 ± 10,2 ml và PTNS hỗ trợ 36,11 ± 9,9 ml. Thời gian phẫu thuật trung bình của nhóm PTNS hoàn toàn là 206,4 ± 30,6 phút và PTNS hỗ trợ 220 ± 40,9 phút. Tỷ lệ biến chứng sau mổ của nhóm PTNS hoàn toàn là 4,4% và PTNS hỗ trợ là 22,3%. Thời gian nằm viện trung bình của nhóm PTNS hoàn toàn là 7,5 ± 2,1 ngày và PTNS hỗ trợ là 10,2 ± 2,4 ngày. Kết luận: Phẫu thuật nội soi hoàn toàn và phẫu thuật nội soi hỗ trợ cắt toàn bộ dạ dày nạo vét hạch D2 do ung thư là kỹ thuật an toàn và hiệu quả trong điều trị ung thư dạ dày. ABSTRACT EVALUATION OF OUTCOMES TOTALLY LAPAROSCOPIC TOTAL GASTRECTOMY AND LAPAROSCOPIC - ASSISTED TOTAL GASTRECTOMY WITH D2 LYMPH NODE DISSECTION DUE TO CANCER Introduction: To evaluate the results of totally laparoscopic total gastrectomy (TLTG) and laparoscopicassisted total gastrectomy (LATG) with D2 lymph node dissection to treat gastric cancer in the Nghean General Friendship Hospital. Materials and Methods: In a retrospective cohort study, 126 patients with gastric cancer underwent TLTG and LATG with D2 lymph node dissection between 2013 and 2020. Results: There were 126 patients with an average age of 60.6 ± 11.1 years. The male/female ratio was 2.8/1. The percent of patients with tumors at stages I, II, III were 19.0%, 49.2%, 31.7%, 70.6% of patients had papillary adenocarcinoma and tubular adenocarcinoma. Patients with ring cell carcinoma wereaccounted for 24.6%. The total percent of incidents during the surgery of the group of TLTG was 4.4%, and the group of LATG was 20.6%. The average number of harvested lymph nodes in the group of TLTG was 23.7 ± 7.1, and the group of LATG was 18.0 ± 7.2. The average blood loss in the group of TLTG was 30.56 ± 10.2 ml, and the group of LATG was 36.11 ± 9.9 ml, and the average operation time in the group of TLTG was 206.4 ± 30.6 minutes, and the group of LATG was 220 ± 40.9 minutes. The total percent of postoperative complications in the group of TLTG was 4.4%, and the group of LATG was 22.3%. The hospital stays in the group of TLTG was 7.5 ± 2.1 days, and the group of LATG was 10.2 ± 2.4 days. Conclusions: TLTG and LATGwith D2 lymph node dissectionwere safe and effective in treating gastric cancer. Keywords: Laparoscopic gastrectomy, gastric cancer, total gastrectomy

Phase III Trial to Compare Adjuvant Chemotherapy With Capecitabine and Cisplatin Versus Concurrent Chemoradiotherapy in Gastric Cancer: Final Report of the Adjuvant Chemoradiotherapy in Stomach Tumors Trial, Including Survival and Subset Analyses

2015 ◽  
Vol 33 (28) ◽  
pp. 3130-3136 ◽  
Author(s):  
Se Hoon Park ◽  
Tae Sung Sohn ◽  
Jeeyun Lee ◽  
Do Hoon Lim ◽  
Min Eui Hong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Adjuvant Chemoradiotherapy ◽  
Final Report ◽  
D2 Lymph Node Dissection ◽  
Node Positive ◽  
Stomach Tumors

Purpose The Adjuvant Chemoradiotherapy in Stomach Tumors (ARTIST) trial tested whether the addition of radiotherapy to adjuvant chemotherapy improved disease-free survival (DFS) in patients with D2-resected gastric cancer (GC). Patients and Methods Between November 2004 and April 2008, 458 patients with GC who received gastrectomy with D2 lymph node dissection were randomly assigned to either six cycles of adjuvant chemotherapy with capecitabine and cisplatin (XP) or to two cycles of XP followed by chemoradiotherapy and then two additional cycles of XP (XPRT). This final update contains the first publication of overall survival (OS), together with updated DFS and subset analyses. Results With 7 years of follow-up, DFS remained similar between treatment arms (hazard ratio [HR], 0.740; 95% CI, 0.520 to 1.050; P = .0922). OS also was similar (HR, 1.130; 95% CI, 0.775 to 1.647; P = .5272). The effect of the addition of radiotherapy on DFS and OS differed by Lauren classification (interaction P = .04 for DFS; interaction P = .03 for OS) and lymph node ratio (interaction P < .01 for DFS; interaction P < .01 for OS). Subgroup analyses also showed that chemoradiotherapy significantly improved DFS in patients with node-positive disease and with intestinal-type GC. There was a similar trend for DFS and OS by stage of disease. Conclusion In D2-resected GC, both adjuvant chemotherapy and chemoradiotherapy are tolerated and equally beneficial in preventing relapse. Because results suggest a significant DFS effect of chemoradiotherapy in subsets of patients, the ARTIST 2 trial evaluating adjuvant chemotherapy and chemoradiotherapy in patients with node-positive, D2-resected GC is under way.

scholarly journals Comparison of laparoscopic versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer: A meta-analysis

2019 ◽  
Vol 1 (2) ◽  
pp. 110-121
Author(s):  
Sandrie Mariella Mac ◽  
Ashish Bahadur Malla
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Lymph Node Dissection ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Open Gastrectomy ◽  
Long Term Results ◽  
Node Dissection ◽  
D2 Lymph Node Dissection

For many decades, D2 procedure has been accepted in the far-east as the standard treatment for both early (EGC) and advanced gastric cancer (AGC). In case of AGC, the debate on the extent of nodal dissection has been open for many years in order to highlight the safety and efficacy of treatment, hence this study. A comprehensive literature research was performed in PubMed to identify studies that compared laparoscopic- assisted gastrectomy (LAG) and open gastrectomy (OG) with D2 lymph node dissection (D2-LND) for treatment of AGC for the last five years. Data of interest were checked and subjected to meta-analysis with RevMan 5.3 software. The pooled risk ratios (RR) and weighted mean difference (WMD) with 95% confidence intervals (CI) were calculated. Overall, 19 studies were included in this meta-analysis. LG had some advantages over OG, including shorter hospitalization (WMD -2.31; 95% CI -4.09 to -0.53; P = 0.01), less blood loss (WMD -120.49; 95% CI -174.27 to -66.71; P < 0.01), faster bowel recovery (WMD -0.55; 95% CI -0.86 to -0.24; P ˂ 0.01) and earlier ambulation (WMD -0.75; 95% CI -1.38 to -0.11; P = 0.02). In terms of surgical and oncological safety, LG could achieve similar lymph nodes (WMD, -0.94, 95% CI, -2.95 to 1.06; P=0.36), a lower complication rate [odds ratio (OR)=0.80; 95%CI, 0.68-0.97; P=0.02], and overall survival (OS) and disease-free survival (DFS) comparable to OG. In conclusion, for AGCs both techniques (LAG and OG) appeared comparable in short- and long-term results. More time was needed to perform LAG; nonetheless, it had some advantages in achieving faster postoperative recovery over OG. In order to clarify this controversial issue ongoing trials and future studies are needed.

Sign in / Sign up

Export Citation Format

Share Document