학술논문
RADICAL SURGERY IN EARLY STAGE GASTRIC CANCER: SINGLE CENTER EXPERIENCE/ERKEN EVRE MIDE KANSERINDE RADIKAL CERRAHI: ISTANBUL UNIVERSITESI TIP FAKULTESI HASTANESI DENEYIMI
ARASTIRMA / RESEARCH
ARASTIRMA / RESEARCH
Document Type
Clinical report
Author
Source
Journal of Istanbul Faculty of Medicine. June 2020, Vol. 83 Issue 2, p86, 6 p.
Subject
Language
English
ISSN
1305-6433
Abstract
INTRODUCTION Early gastric cancer (adenocarcinoma) is defined as invasive gastric cancer that invades no more deeply than the submucosal layer, irrespective of lymph node metastasis (T1, any N) (1-3). Thanks [...]
Objective: This study was performed to determine the overall early stage gastric cancer (ESGC) prevalence and to evaluate the short and long-term postoperative outcomes of patients with ESGC who underwent radical surgery. Method: All 391 gastric cancer patients who underwent radical surgery between 2006 and 2013 were included in the study. Thirty nine patients who were diagnosed with ESGC were evaluated retrospectively in terms of demographics, pathological findings and clinical outcomes. Results: Thirteen (33%) patients had morbidity and mortality rates of zero. The depth of tumor invasion was submucosal in 26 (67%) patients, intramucosal in 13 (33%). Eleven (28%) patients had lymph node involvement. While lymph node involvement rate in intramucosal tumors was 14%, the rate rose up to 34.6% in submucosal tumors. The average follow-up period was 73.6 months. The long term outcomes in 4 (10%) patients had a recurrence and 3 (7.5%) patients died. Thirty-five (%89.7) patients are being monitored tumor-free at the time of publication. Conclusion: When compared to Asian countries, the prevalence of ESGC was lower in our study. However, lymph node involvement in ESGC was higher. Only 1.8% of patients were found appropriate for endoscopic resection according to the Japanese Endoscopic Treatment Guidelines. In line with these data, we find that radical surgery is an appropriate treatment choice for ESGC in our country. Keywords: Early stage of gastric cancer, metastatic lymph nodes, radical surgery Amac: Mide kanseri nedeniyle radikal cerrahi uygulanan olgular arasinda erken evre mide kanseri sikligi ve bu olgularda postoperatif erken ve gec donem sonuclarinin degerlendirilmesi amaclanmistir. Yontem: Bu calismada 2006-2013 yillari arasinda mide kanseri nedeniyle radikal cerrahi uygulanan 391 olgudan, histopatolojik degerlendirme sonucunda erken evre mide kanseri saptanan 39 olgunun demografik verileri, patolojik bulgulari ve klinik sonuclari retrospektif olarak incelenmistir. Bulgular: Morbidite 13 (%33) hastada izlenirken, mortalite gorulmedi. Invazyon derinligi olgularin 26'sinda (%67) submukozal, 13'unde (%33) intramukozal idi. Hastalarin 11'inde (%28) lenf nodu metastazi saptanmistir. Intramukozal yerlesimli tumorlerde lenf nodu metastazi orani %14'iken submukozal tumorlerde bu oran %34,6'ya cikmaktaydi. Ortalama takip sureleri 73,6 ay (48-111 ay) idi. Uzun donem takiplerinde 4 olguda (%10) hastalik nuksu saptanirken 3 olgu (%7,5) eks olmustur. Olgularin 35'i (%89,7) hastaliksiz olarak takip edilmektedir Sonuc: Uzak Dogu Ulkelerine kiyasla, calismamizda erken evre mide kanseri prevelansi daha dusuk olarak bulunmustur. Bununla birlikte, erken evre mide kanserinde lenf nodu tutulumunun daha yuksek oldugu saptanmistir. Japon Endoskopik Tedavi Kiavuzuna gore hastalarin sadece %1,8'i endoskopik rezeksiyona uygun bulunmustur. Bu veriler dogrultusunda, ulkemizde radika cerrahinin erken evre mide kanseri icin en uygun tedavi secenegi oldugunu dusunuyoruz. Anahtar Kelimeler: Erken evre mide tumoru, metastatik lenf nodu, radikal cerrahi
Objective: This study was performed to determine the overall early stage gastric cancer (ESGC) prevalence and to evaluate the short and long-term postoperative outcomes of patients with ESGC who underwent radical surgery. Method: All 391 gastric cancer patients who underwent radical surgery between 2006 and 2013 were included in the study. Thirty nine patients who were diagnosed with ESGC were evaluated retrospectively in terms of demographics, pathological findings and clinical outcomes. Results: Thirteen (33%) patients had morbidity and mortality rates of zero. The depth of tumor invasion was submucosal in 26 (67%) patients, intramucosal in 13 (33%). Eleven (28%) patients had lymph node involvement. While lymph node involvement rate in intramucosal tumors was 14%, the rate rose up to 34.6% in submucosal tumors. The average follow-up period was 73.6 months. The long term outcomes in 4 (10%) patients had a recurrence and 3 (7.5%) patients died. Thirty-five (%89.7) patients are being monitored tumor-free at the time of publication. Conclusion: When compared to Asian countries, the prevalence of ESGC was lower in our study. However, lymph node involvement in ESGC was higher. Only 1.8% of patients were found appropriate for endoscopic resection according to the Japanese Endoscopic Treatment Guidelines. In line with these data, we find that radical surgery is an appropriate treatment choice for ESGC in our country. Keywords: Early stage of gastric cancer, metastatic lymph nodes, radical surgery Amac: Mide kanseri nedeniyle radikal cerrahi uygulanan olgular arasinda erken evre mide kanseri sikligi ve bu olgularda postoperatif erken ve gec donem sonuclarinin degerlendirilmesi amaclanmistir. Yontem: Bu calismada 2006-2013 yillari arasinda mide kanseri nedeniyle radikal cerrahi uygulanan 391 olgudan, histopatolojik degerlendirme sonucunda erken evre mide kanseri saptanan 39 olgunun demografik verileri, patolojik bulgulari ve klinik sonuclari retrospektif olarak incelenmistir. Bulgular: Morbidite 13 (%33) hastada izlenirken, mortalite gorulmedi. Invazyon derinligi olgularin 26'sinda (%67) submukozal, 13'unde (%33) intramukozal idi. Hastalarin 11'inde (%28) lenf nodu metastazi saptanmistir. Intramukozal yerlesimli tumorlerde lenf nodu metastazi orani %14'iken submukozal tumorlerde bu oran %34,6'ya cikmaktaydi. Ortalama takip sureleri 73,6 ay (48-111 ay) idi. Uzun donem takiplerinde 4 olguda (%10) hastalik nuksu saptanirken 3 olgu (%7,5) eks olmustur. Olgularin 35'i (%89,7) hastaliksiz olarak takip edilmektedir Sonuc: Uzak Dogu Ulkelerine kiyasla, calismamizda erken evre mide kanseri prevelansi daha dusuk olarak bulunmustur. Bununla birlikte, erken evre mide kanserinde lenf nodu tutulumunun daha yuksek oldugu saptanmistir. Japon Endoskopik Tedavi Kiavuzuna gore hastalarin sadece %1,8'i endoskopik rezeksiyona uygun bulunmustur. Bu veriler dogrultusunda, ulkemizde radika cerrahinin erken evre mide kanseri icin en uygun tedavi secenegi oldugunu dusunuyoruz. Anahtar Kelimeler: Erken evre mide tumoru, metastatik lenf nodu, radikal cerrahi