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Wang J, Tong J, Zhang Y, Cai H. Perioperative outcomes of da Vinci robot versus laparoscopic-assisted D2 radical resection of distal gastric cancer with Billroth II anastomosis. Asian J Surg 2024; 47:1510-1512. [PMID: 38184407 DOI: 10.1016/j.asjsur.2023.11.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/24/2023] [Indexed: 01/08/2024] Open
Affiliation(s)
- Jie Wang
- The 1st Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu Province, China; Department of General Surgery, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, 730000, Gansu Province, China; Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, Gansu Province, China; Gansu Research Center of Prevention and Control Project for Digestive Oncology, Gansu Provincial Hospital, Lanzhou, 730000, Gansu Province, China.
| | - Jiankang Tong
- The 1st Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu Province, China; Department of General Surgery, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, 730000, Gansu Province, China; Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, Gansu Province, China; Gansu Research Center of Prevention and Control Project for Digestive Oncology, Gansu Provincial Hospital, Lanzhou, 730000, Gansu Province, China
| | - Yipeng Zhang
- The 1st Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu Province, China; Department of General Surgery, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, 730000, Gansu Province, China; Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, Gansu Province, China; Gansu Research Center of Prevention and Control Project for Digestive Oncology, Gansu Provincial Hospital, Lanzhou, 730000, Gansu Province, China
| | - Hui Cai
- Department of General Surgery, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou, 730000, Gansu Province, China; Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, Gansu Province, China; Gansu Research Center of Prevention and Control Project for Digestive Oncology, Gansu Provincial Hospital, Lanzhou, 730000, Gansu Province, China.
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Yang Y, Dai D, Jin W, Huang Y, Zhang Y, Chen Y, Wang W, Lin W, Chen X, Zhang J, Wang H, Zhang H, Teng L. Microbiota and metabolites alterations in proximal and distal gastric cancer patients. J Transl Med 2022; 20:439. [PMID: 36180919 PMCID: PMC9524040 DOI: 10.1186/s12967-022-03650-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/18/2022] [Indexed: 12/24/2022] Open
Abstract
Background Globally, gastric cancer is the third most common cancer and the third leading cause of cancer death. Proximal and distal gastric cancers have distinct clinical and biological behaviors. The microbial composition and metabolic differences in proximal and distal gastric cancers have not been fully studied and discussed. Methods In this study, the gastric microbiome of 13 proximal gastric cancer tissues, 16 distal gastric cancer tissues, and their matched non-tumor tissues were characterized using 16S rRNA amplicon sequencing. Additionally, 10 proximal gastric cancer tissues, 11 distal gastric cancer tissues, and their matched non-tumor tissues were assessed by untargeted metabolomics. Results There was no significant difference in microbial diversity and richness between the proximal and distal gastric cancer tissues. At the genus level, the abundance of Rikenellaceae_RC9_gut_group, Porphyromonas, Catonella, Proteus, Oribacterium, and Moraxella were significantly increased in Proximal T, whereas that of Methylobacterium_Methylorubrum was significantly increased in Distal T. The untargeted metabolomics analysis revealed 30 discriminative metabolites between Distal T and Distal N. In contrast, there were only 4 discriminative metabolites between Proximal T and Proximal N. In distal gastric cancer, different metabolites were scattered through multiple pathway, including the sphingolipid signaling pathway, arginine biosynthesis, protein digestion and absorption, alanine, aspartate and, glutamate metabolism, etc.In proximal gastric cancer, differential microbial metabolites were mainly related to hormone metabolism. Conclusion Methylobacterium-Methylorubrum was significantly increased in Distal T, positively correlated with cancer-promoting metabolites, and negatively correlated with cancer-inhibiting metabolites. Rikenellaceae_RC_gut_group was significantly increased in Proximal T and positively correlated with cancer-promoting metabolites. Further studies regarding the functions of the above-mentioned microorganisms and metabolites were warranted as the results may reveal the different mechanisms underlying the occurrence and development of proximal and distal gastric cancers and provide a basis for future treatments. Importance First, the differences in microbial composition and metabolites between the proximal and distal gastric cancers were described; then, the correlation between microbiota and metabolites was preliminarily discussed. These microbes and metabolites deserve further investigations as they may reveal the different mechanisms involved in the occurrence and development of proximal and distal gastric cancers and provide a basis for future treatments. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03650-x.
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Affiliation(s)
- Yan Yang
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.,Clinical Research Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Daofeng Dai
- Jiangxi Otorhinolaryngology Head and Neck Surgery Institute, Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wen Jin
- The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Yingying Huang
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.,Clinical Research Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Yingzi Zhang
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.,Clinical Research Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Yiran Chen
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.,Clinical Research Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Wankun Wang
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.,Clinical Research Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Wu Lin
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.,Clinical Research Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Xiangliu Chen
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.,Clinical Research Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Jing Zhang
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Haohao Wang
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Haibin Zhang
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
| | - Lisong Teng
- Department of Surgical Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
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Ovalle-Hernández AF, Vargas-Rubio RD. Experience in the management of neoplastic gastric outlet obstruction in patients at the Hospital Universitario San Ignacio in Bogotá, Colombia. Rev Gastroenterol Mex (Engl Ed) 2021; 87:35-43. [PMID: 34656501 DOI: 10.1016/j.rgmxen.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/28/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Malignant gastric outlet obstruction is a condition that alters patient quality of life, conditioning progressive malnutrition. However, self-expanding metal stents (SEMSs) and surgical gastrojejunostomy (SGJ) are palliative options in patients with unresectable disease. AIM To characterize patients diagnosed with malignant gastric outlet obstruction requiring SEMS placement or SGJ. MATERIALS AND METHODS Sequential non-probability convenience sampling was conducted and included 68 patients, 40 of whom had SEMS placement and 28 of whom underwent SGJ. RESULTS Patients sought medical consultations for the symptoms of vomiting, abdominal pain, weight loss, and upper gastrointestinal bleeding. Ninety-five percent of the patients in the SEMS group and 64.3% in the SGJ group presented with metastasis. Technical and clinical success, patency duration, and number of patients with no complications were greater in the SGJ group. Mean survival in days was 88 (SD ± 21) in the SEMS group versus 501 (SD ± 122) in the SGJ group. The log-rank test detected a statistically significant difference between subgroups (p = 0.00). CONCLUSION SGJ has greater technical and clinical success rates but SEMS placement continues to be utilized in distal gastric cancer, especially in cases in which surgery is not an option.
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Affiliation(s)
- A F Ovalle-Hernández
- Unidad de Gastroenterología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.
| | - R D Vargas-Rubio
- Unidad de Gastroenterología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
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Zhang X, Zhang W, Yuan M, Shi X, Chen H, Feng Z, Chen Z, Liu D, Yan E, Ren S. Application of double layered end-to-end anastomosis with continuous manual suture for completing digestive tract reconstruction in totally laparoscopic distal gastrectomy. BMC Surg 2021; 21:213. [PMID: 33902547 PMCID: PMC8077891 DOI: 10.1186/s12893-021-01207-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 04/14/2021] [Indexed: 01/11/2023] Open
Abstract
Background We retrospectively reviewed and consecutively collected the clinical data of distal gastric cancer patients who received surgical treatment, and we discuss the safety and feasibility of double layered end-to-end anastomosis with continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy. Methods We reviewed the clinical data of 41 patients with distal gastric cancer from the gastroenterology department of the Second Affiliated Hospital of Dalian Medical University, from September 2018 to August 2019, who underwent totally laparoscopic distal gastrectomy. During the operation, the method of double layered end-to-end anastomosis with continuous manual suture was used for Billroth type I anastomosis to complete digestive tract reconstruction. All patients have been given a follow-up visit and gastroscopy three months after the operation. The peri-operative clinical information and postoperative follow-up information were collected for analysis, and the clinical application value was evaluated. Results General information: male(n = 27), female(n = 14), age = 65.02(SD 9.94) years, and BMI = 23.52(SD 2.56) kg/m2, Tumor location: antrum(32,78.0%), angle (6,14.6%), and body (3,7.3%). Clinical stage: I (27, 65.9%), II (7, 17.1%), and III (7, 17.1%). Operative information: operation time = 154.51(SD 33.37) min, anastomosis time = 26.88(SD 5.11) min; intraoperative bleeding = 66.34(SD 48.81) ml; first postoperative ambulation Median = 1(IQR 0) d, first postoperative flatus Median = 3(IQR 2) d, first postoperative diet Median = 3(IQR 1) d, postoperative hospital stay Median = 7(IQR 2) d, and total hospitalization cost = 10,935.00(SD 2205.72)USD. Differentiation degree: high and high-moderate (3,7.32%), moderate and poor-moderate (24, 58.54%), poor differentiation (14, 34.15%), dissected lymph nodes Median = 31(IQR 17), and positive lymph nodes Median = 0(IQR 1). Pathological stage: IA (20, 48.78%), IB (3, 7.32%), IIA (4, 9.76%), IIB (5, 12.20%), IIIA (1, 2.44%), IIIB (3, 7.32%), and IIIC (5, 12.20%). Complications (n = 4): lung infection (1, 2.44%), anastomotic leakage (1, 2.44%), and gastroparesis (2, 4.88%). Conclusion It is safe and feasible in clinical treatment to apply the method of double layered end-to-end anastomosis with continuous manual suture to complete digestive tract reconstruction in totally laparoscopic distal gastrectomy.
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Affiliation(s)
- XinSheng Zhang
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China
| | - WeiBin Zhang
- General Surgery Department of Jinzhou Central Hospital, No.51, Section 2, Shanghai Road, Guta District, Jinzhou, Liaoning, China
| | - MengLang Yuan
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China
| | - XiaoMeng Shi
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China
| | - HongYi Chen
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China
| | - Zhen Feng
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China
| | - ZiHao Chen
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China
| | - DunBo Liu
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China
| | - EnJun Yan
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China
| | - ShuangYi Ren
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Zhongshan Road 467, Shahekou District, Dalian, Liaoning, China.
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Xue J, Yang H, Huang S, Zhou T, Zhang X, Zu G. Comparison of the overall survival of proximal and distal gastric cancer after gastrectomy: a systematic review and meta-analysis. World J Surg Oncol 2021; 19:17. [PMID: 33468158 PMCID: PMC7816301 DOI: 10.1186/s12957-021-02126-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/11/2021] [Indexed: 12/26/2022] Open
Abstract
Background The aim of this study was to investigate the overall survival (OS) between proximal gastric cancer (PG) and distal gastric cancer (DG) patients after gastrectomy. Methods Articles on the prognostic study of PG and DG patients after gastrectomy were collected from the PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases from the date of establishment until December 2020. The data were statistically analyzed by Stata software (version 11.0, StataCorp). Results A total of 10 articles met the inclusion criteria. Meta-analysis showed that the 1-, 3- and 5-year OS rates of PG patients were significantly lower than those of DG patients (RR = 0.898, 95% CI: 0.825 to 0.977, P = 0.013; RR = 0.802, 95% CI: 0.708 to 0.909, P = 0.001; RR = 0.736, 95% CI: 0.642 to 0.844, P = 0.000). After subgroup analysis according to different countries, the combined RR values of were as follows: 1-year OS: eastern countries: RR = 0.966, 95% CI: 0.944 to 0.988, P = 0.003, western countries: RR = 0.687, 95% CI: 0.622 to 0.759, P = 0.000; 3-year OS: eastern countries: RR = 0.846, 95% CI: 0.771 to 0.929, P = 0.000, western countries: RR = 0.742, 95% CI: 0.399 to 1.382, P = 0.348; and 5-year OS: eastern countries: RR = 0.798, 95% CI: 0.716 to 0.889, P = 0.000, western countries: RR = 0.646, 95% CI: 0.414 to 1.008, P = 0.054. Conclusion In terms of 1-, 3-, and 5-year OS, PG patients had lower rates than DG patients and the eastern countries/western countries subgroup, but there were no significant differences in 3- and 5-year OS for the western countries. These results merit further clinical validation in future studies. (Registration ID: UMIN000040393; Date of registration: 2020/05/13)
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Affiliation(s)
- Jiaming Xue
- Department of Gastroenterology Surgery, The Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Southwest Road Shahekou District, Dalian, 116033, P.R. China.,Dalian Medical University, Dalian, 116011, P.R. China
| | - Huiliang Yang
- Department of Gastroenterology Surgery, The Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Southwest Road Shahekou District, Dalian, 116033, P.R. China.,Dalian Medical University, Dalian, 116011, P.R. China
| | - Shanshan Huang
- Dalian Medical University, Dalian, 116011, P.R. China.,Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, P.R. China
| | - Tingting Zhou
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, P.R. China
| | - Xiangwen Zhang
- Department of Gastroenterology Surgery, The Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Southwest Road Shahekou District, Dalian, 116033, P.R. China.
| | - Guo Zu
- Department of Gastroenterology Surgery, The Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Southwest Road Shahekou District, Dalian, 116033, P.R. China.
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Ovalle-Hernández AF, Vargas-Rubio RD. Experience in the management of neoplastic gastric outlet obstruction in patients at the Hospital Universitario San Ignacio in Bogotá, Colombia. Rev Gastroenterol Mex (Engl Ed) 2020; 87:S0375-0906(20)30136-1. [PMID: 33390275 DOI: 10.1016/j.rgmx.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/07/2020] [Accepted: 09/28/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Malignant gastric outlet obstruction is a condition that alters patient quality of life, conditioning progressive malnutrition. However, self-expanding metal stents (SEMSs) and surgical gastrojejunostomy (SGJ) are palliative options in patients with unresectable disease. AIMS To characterize patients diagnosed with malignant gastric outlet obstruction requiring SEMS placement or SGJ. MATERIALS AND METHODS Sequential non-probability convenience sampling was conducted and included 68 patients, 40 of whom had SEMS placement and 28 of whom underwent SGJ. RESULTS Patients sought medical consultations for the symptoms of vomiting, abdominal pain, weight loss, and upper gastrointestinal bleeding. Ninety-five percent of the patients in the SEMS group and 64.3% in the SGJ group presented with metastasis. Technical and clinical success, patency duration, and number of patients with no complications were greater in the SGJ group. Mean survival in days was 88 (SD ± 21) in the SEMS group versus 501 (SD ± 122) in the SGJ group. The log-rank test detected a statistically significant difference between subgroups (p = 0.00). CONCLUSION SGJ has greater technical and clinical success rates but SEMS placement continues to be utilized in distal gastric cancer, especially in cases in which surgery is not an option.
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Affiliation(s)
- A F Ovalle-Hernández
- Unidad de Gastroenterología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.
| | - R D Vargas-Rubio
- Unidad de Gastroenterología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
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Luo R, Liu D, Ye S, Tang H, Zhu W, He P, Tang C, Li T. Short- and long-term outcomes of totally robotic versus robotic-assisted radical distal gastrectomy for advanced gastric cancer: a mono-institution retrospective study. World J Surg Oncol 2019; 17:188. [PMID: 31711530 PMCID: PMC6849191 DOI: 10.1186/s12957-019-1722-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 10/09/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose By comparing short- and long-term outcomes following totally robotic radical distal gastrectomy (TRDG) and robotic-assisted radical distal gastrectomy (RADG), we aimed to assess in which modus operandi patients will benefit more. Methods From January 2015 to May 2019, we included 332 patients undergone RADG (237) and TRDG (95). Based on the propensity score matching (PSM), inclusion and exclusion criteria, 246 patients were finally included in the propensity score-matched cohort including RADG group (164) and TRDG group (82). We then compared the short- and long-term outcomes following both groups. Results Propensity score-matched cohort revealed no significant differences in both groups. Intra-abdominal bleeding, time to pass flatus, postoperative activity time, length of incision hospital stays, and stress response were significantly less in TRDG group than in RADG group. We observed 30 complications in RADG group while 13 complications in TRDG group. There were no significant differences in TRDG group and RADG group in terms of operation time, time for anastomosis, proximal resection, distal resection margin, number of lymph node resection, and total hospitalization cost. Both 3-year overall survival and 3-year disease-free survival were comparable in both groups. Conclusions TRDG is a safe and feasible modus operandi profiting from short- and long-term outcomes compared with RADG. As surgeons improving their professional skills, TRDG could serve as the standard procedure for distal locally advanced gastric cancer with D2 lymphadenectomy.
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Affiliation(s)
- Rui Luo
- Medical College of Nanchang University, Nanchang, 330000, China
| | - Dongning Liu
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Shanping Ye
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Hechun Tang
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Weiquan Zhu
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Penghui He
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Cheng Tang
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Taiyuan Li
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, China.
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Braga-Neto MB, Carneiro JG, de Castro Barbosa AM, Silva IS, Maia DC, Maciel FS, de Alcântara RJA, Vasconscelos PRL, Braga LLBC. Clinical characteristics of distal gastric cancer in young adults from Northeastern Brazil. BMC Cancer 2018; 18:131. [PMID: 29402219 PMCID: PMC5800037 DOI: 10.1186/s12885-018-3995-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/16/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It has been suggested that distal gastric carcinoma (GC) in younger patients has a more aggressive outcome than in older patients, however this is a controversial issue. The aim of this study was to compare clinicopathological features between younger and older patients with GC in Northeastern Brazil. METHODS A total of 207 patients with distal GC (41 patients ≤45 years, considered younger group, and 166 > 45 years, considered older group) were evaluated prospectively during a 6 year period. RESULTS The mean patient age in the young group was 37.41 years old and 64.43 years in the older group. No significant difference was found regarding gender, area of residence, history of alcohol consumption, chronic tobacco smoking. Prevalence of first-degree GC history was 12.5% (7.3% in younger group vs. 13.9% in older; p < 0.46). The most frequent symptom was gastric pain and weight loss. Diffuse infiltrative cancer was more frequently seen in younger patients (70.70% vs. 33.70%, respectively; p < 0.01), as was histologically less differentiated tumors (63.40% vs. 33.10%; p < 0.01) and stage IV of GC (48.80% vs. 30.70%; p < 0.015). Five-year survival, evaluated in 82 patients, was lower in younger patients (p = 0.045); however, after adjusting for stage of GC in the multivariate analysis, this association did not remain significant. Family history of GC and gender had no impact on survival. CONCLUSIONS Younger patients showed higher prevalence of diffuse type of Lauren and lower survival that was attributed to higher rate of advanced stage of GC. Gastric cancer screening strategies should also be considered in younger individuals, especially in areas of high prevalence. Further studies are warranted to determine risk factors associated with gastric cancer in young adults.
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Affiliation(s)
- Manuel B. Braga-Neto
- Department of Internal Medicine, Federal University of Ceará, Fortaleza, CE Brazil
- Clinical Research Unit, Federal University of Ceará, Fortaleza, CE Brazil
| | | | | | - Igor S. Silva
- Clinical Research Unit, Federal University of Ceará, Fortaleza, CE Brazil
| | - Danielle C. Maia
- Hospital Universitário Walter Cantídio, Federal University of Ceará, Fortaleza, CE Brazil
| | - Felipe S. Maciel
- Clinical Research Unit, Federal University of Ceará, Fortaleza, CE Brazil
| | | | | | - Lucia L. B. C. Braga
- Department of Internal Medicine, Federal University of Ceará, Fortaleza, CE Brazil
- Clinical Research Unit, Federal University of Ceará, Fortaleza, CE Brazil
- Hospital Universitário Walter Cantídio, Federal University of Ceará, Fortaleza, CE Brazil
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Lu SX, Zhang G, Hu SM. Clinical effects of FOLFOX4 regimen versus FLP regimen for patients with gastroesophageal junction cancer or distal gastric cancer. Shijie Huaren Xiaohua Zazhi 2014; 22:1446-1450. [DOI: 10.11569/wcjd.v22.i10.1446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the clinical effects of oxaliplatin (O) + fluorouracil (5-FU) + leucovorin (L) (FOLFOX4) regimen versus cisplatin (C) + 5-FU + L (FLP) regimen in the treatment of gastroesophageal junction cancer and distal gastric cancer.
METHODS: A retrospective analysis of 48 patients with gastroesophageal junction cancer and 52 patients with distal gastric cancer who were treated with the FOLFOX4 or FLP regimen at our hospital form January 2009 to December 2010 was performed. Overall survival, disease-free survival and adverse reactions were compared between different groups.
RESULTS: In patients with gastroesophageal junction cancer, the FOLFOX4 regimen was associated with significantly better overall survival and disease-free survival than the FLP regimen (42.1 mo vs 25.2 mo, 35.6 mo vs 16.6 mo, P < 0.05 for both). In contrast, there were no significantly differences in overall survival and disease-free survival in patients with distal gastric cancer treated with the FOLFOX4 regimen and those treated with the FLP regimen (P > 0.05 for both). In both patients with gastroesophageal junction cancer and those with distal gastric cancer, the incidence rates of leukopenia, thrombocytopenia, neutropenia, transaminase abnormalities and diarrhea (P > 0.05) showed no significant differences between the FOLFOX4 and FLP groups. In patients with gastroesophageal junction cancer, the incidence rate of nausea and vomiting was significantly lower in the FOLFOX4 group than in the FLP group (20.0% vs 47.8%, P < 0.05). In distal gastric cancer patients, the incidence rate of nausea and vomiting was significantly higher in the FOLFOX4 group than in the FLP group (30.0% vs 9.1%, P < 0.05).
CONCLUSION: In patients with gastroesophageal junction cancer, the FOLFOX4 regimen has better efficacy than the FLP regimen; however, in patients with distal gastric cancer, the two regimens have similar effects.
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