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Schizas D, Mylonas KS, Syllaios A, Kapetanakis EI, Hasemaki N, Ntomi V, Michalinos A, Theochari NA, Theochari CA, Krivan S, Mpoura M, Bakopoulos A, Karavokyros I, Liakakos T. Gastrectomy for Cancer: A 15-Year Analysis of Real-World Data from the University of Athens. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121792. [PMID: 36556994 PMCID: PMC9787625 DOI: 10.3390/medicina58121792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/19/2022] [Accepted: 11/30/2022] [Indexed: 12/09/2022]
Abstract
Background and Objectives: Encouraging data have been reported from referral centers following gastrointestinal cancer surgery. Our goal was to retrospectively review patient outcomes following gastrectomy for gastric or gastroesophageal junction (GEJ) cancer at a high-volume unit of the University of Athens. Methods: The enrollment period was from June 2003 to September 2018. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox proportional hazard models were constructed to identify variables independently associated with time-to-event outcomes. Results: A total of 205 patients were analyzed. R0 resection was achieved in 183 (89.3%) patients and was more likely to occur following neoadjuvant chemotherapy (p = 0.008). Recurrence developed in 46.6% of our cohort and the median disease-free survival was 31.2 months. On multivariate analysis, only staging (HR = 2.15; 95% CI: 1.06-4.36) was independently associated with increased risk of recurrence. All-cause mortality was 57.2% and the median time of death was 40.9 months. On multivariate regression, staging (HR: 1.35; 95% CI: 1.11-1.65) and recurrence (HR: 2.87; 95% CI: 1.32-6.22) predicted inferior prognosis. Conclusions: Gastrectomy at the University of Athens has yielded favorable outcomes for patients with GEJ cancer.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Konstantinos S. Mylonas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Athanasios Syllaios
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Emmanouil I. Kapetanakis
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, 12462 Athens, Greece
- Correspondence: ; Tel.: +30-6909200780
| | - Natasha Hasemaki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Vasileia Ntomi
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, 12462 Athens, Greece
| | | | - Nikoletta A. Theochari
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Christina A. Theochari
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Sylvia Krivan
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, 12462 Athens, Greece
| | - Maria Mpoura
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Anargyros Bakopoulos
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, 12462 Athens, Greece
| | - Ioannis Karavokyros
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Theodoros Liakakos
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
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Cui C, Wu X, Deng L, Wang W, Cui W, Wang Y. Modified Glasgow prognostic score predicts the prognosis of patients with advanced esophageal squamous cell carcinoma: A propensity score-matched analysis. Thorac Cancer 2022; 13:2041-2049. [PMID: 35624549 PMCID: PMC9284152 DOI: 10.1111/1759-7714.14486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 12/24/2022] Open
Abstract
Objective The aim of this study is to evaluate the prognostic value of the modified Glasgow prognostic score (mGPS) in advanced esophageal squamous cell carcinoma (SCC) patients. Methods The study enrolled 311 patients with advanced esophageal SCC from January 2012 to December 2018. Univariate and multivariate analyses were calculated by the Cox proportional hazards regression model in advanced esophageal SCC patients. The Kaplan–Meier method was used to evaluate the ability of the mGPS for survival rates. Propensity score‐matched (PSM) analysis was carried out to balance imbalanced variables. Results The Cox proportional hazards analysis showed that factors including M stage, ECOG, mGPS group, and sex were identified as independent predictors. The mGPS presented a good level of overall survival (OS) prediction with a risk‐adopted classification for advanced esophageal SCC patients. The survival rates in advanced esophageal SCC patients with mGPS 0, 1, and 2 were 18.8%, 8.4%, and 4.2%, respectively (p < 0.001). Moreover, before and after PSM, the mGPS was associated with 3‐year survival rates of advanced esophageal SCC patients in the Kaplan–Meier survival analysis. In addition, the mGPS for OS prediction demonstrated better performance than sex and ECOG score. The area under curve (AUC) of the mGPS combined with M stage for the prognosis of advanced esophageal SCC was 0.677 (0.592–0.763). Conclusion The mGPS is a cost‐effective, accessible tool capable of prognosticating in this cohort. It could be a useful surveillance system of prognosis in advanced esophageal SCC patients.
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Affiliation(s)
- Chanjuan Cui
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi Wu
- Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Deng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenqing Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Cui
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanfeng Wang
- Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Mylonas KS, Schizas D. Extranodal Extension in Esophageal Cancer: Does It Belong in the TNM System? J INVEST SURG 2022; 35:707-708. [PMID: 35164646 DOI: 10.1080/08941939.2021.1928342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Konstantinos S Mylonas
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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