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. 2018 Dec 10;73(suppl 1):e543s.
doi: 10.6061/clinics/2018/e543s.

Surgical treatment of gastric cancer: a 10-year experience in a high-volume university hospital

Marcus Fernando Kodama Pertille Ramos  1 , Marina Alessandra Pereira  1 , Osmar Kenji Yagi  1 , Andre Roncon Dias  1 , Amir Zeide Charruf  1 , Rodrigo Jose de Oliveira  1 , Evelise Pelegrinelli Zaidan  1 , Bruno Zilberstein  1 , Ulysses Ribeiro-Júnior  1 , Ivan Cecconello  1
Affiliations

Surgical treatment of gastric cancer: a 10-year experience in a high-volume university hospital

Marcus Fernando Kodama Pertille Ramos et al. Clinics (Sao Paulo). .

Abstract

Objectives: Surgery remains the cornerstone treatment modality for gastric cancer, the fifth most common type of tumor in Brazil. The aim of this study was to analyze the surgical treatment outcomes of patients with gastric cancer who were referred to a high-volume university hospital.

Methods: We reviewed all consecutive patients who underwent any surgical procedure due to gastric cancer from a prospectively collected database. Clinicopathological characteristics, surgical and survival outcomes were evaluated, with emphasis on patients treated with curative intent.

Results: From 2008 to 2017, 934 patients with gastric tumors underwent surgical procedures in our center. Gastric adenocarcinoma accounted for the majority of cases. Of the 875 patients with gastric adenocarcinoma, resection with curative intent was performed in 63.5%, and palliative treatment was performed in 22.4%. The postoperative surgical mortality rate for resected cases was 5.3% and was related to D1 lymphadenectomy and the presence of comorbidities. Analysis of patients treated with curative intent showed that resection extent, pT category, pN category and final pTNM stage were related to disease-free survival (DFS) and overall survival (OS). The DFS rates for D1 and D2 lymphadenectomy were similar, but D2 lymphadenectomy significantly improved the OS rate. Additionally, clinical factors and the presence of comorbidities had influence on the OS.

Conclusions: TNM stage and the type of lymphadenectomy were independent factors related to prognosis. Early diagnosis should be sought to offer the optimal surgical approach in patients with less-advanced disease.

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Figures

Figure 1
Figure 1
Survival curves for gastric adenocarcinoma patients according to cTNM stage and surgical intent.
Figure 2
Figure 2
Survival curves according to the type of surgery and lymphadenectomy for patients who underwent curative resection.
Figure 3
Figure 3
Survival curves according to depth of invasion and lymph node status for patients who underwent curative resection.
Figure 4
Figure 4
Survival curves according to pTNM stage for patients who underwent curative resection.
See this image and copyright information in PMC

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