Extended local resection for advanced gastric cancer: increased survival versus increased morbidity.

Abstract:

OBJECTIVE:To characterize factors predictive of improved survival following gastrectomy with additional organ resection for the treatment of gastric cancer. SUMMARY BACKGROUND DATA:Recent large series have reported significant survival disadvantages to patients who have undergone gastrectomy with splenectomy or pancreaticosplenectomy, and yet gastrectomy with additional organ resection is needed to accomplish an R0 resection in some cases. Gastrectomy with splenectomy and other organ resections has been associated with advanced T-stage, positive resection margins, and higher postoperative morbidity and mortality rather than an absolute predictor of survival. METHODS:The authors reviewed the Department of Surgery prospective gastric database at Memorial Sloan-Kettering Cancer Center from July 1985 to July 2000. During this period, of the 2,112 patients with primary gastric cancer, 1,133 underwent an R0 resection. The R0 resection group included 865 patients who underwent gastrectomy alone and 268 patients who underwent gastrectomy with another organ resection. Clinicopathologic, operative, complication, and survival data were compared between these two groups. Chi-square analysis and the Kaplan-Meier method were used to compare and estimate median survival. RESULTS:The most common organs resected were the spleen and pancreas, with an even distribution of other organs. Pathologic factors revealed that the gastrectomy with organ resection group had significantly larger lesions, greater T-stage, and a higher incidence of advanced nodal disease than the group who did not undergo additional organ resection. The incidence of pathologically confirmed T4 cancers in the additional organ resection group was only 14%. The overall 5-year survival rate for patients with T3/T4 disease was 27% with additional organ resection. The overall 5-year survival rate for the gastrectomy with organ resection group (32%, median 32 months) was significantly less than the group that did not undergo additional resection (50%, median 63 months) on univariate analysis. However, additional organ resection was not a predictor of survival on multivariate analysis. Multivariate analysis identified advanced T-stage (T3 or greater) and nodal stage (N1 or greater) as adverse predictors of survival in this group. CONCLUSIONS:Long-term survival following gastrectomy with additional organ resection is possible. Depth of invasion and the extent of lymph node metastasis are the most important predictors of survival following gastrectomy with additional organ resection, and a R0 resection has been achieved. Judicious use of additional organ resection for the treatment of advanced gastric cancer must be emphasized, given the increased overall morbidity and infrequent finding of actual T4 disease. Additional organ resection can be performed with minimal morbidity and can improve the chance of overall survival in patients with advanced T-stage disease.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Martin RC 2nd,Jaques DP,Brennan MF,Karpeh M

doi

10.1097/00000658-200208000-00003

subject

Has Abstract

pub_date

2002-08-01 00:00:00

pages

159-65

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

236

pub_type

杂志文章
  • Variation in Bariatric Surgery Episode Costs in the Commercially Insured: Implications for Bundled Payments in the Private Sector.

    abstract:OBJECTIVE:To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. BACKGROUND:Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002462

    authors: Kelsall AC,Cassidy R,Ghaferi AA

    更新日期:2018-12-01 00:00:00

  • A personal experience with 100 consecutive total colectomies and straight ileoanal endorectal pull-throughs for benign disease of the colon and rectum in children and adults.

    abstract::In 1974 total colectomy and ileoanal straight endorectal pull-through (ERPT) were first used at our institution for the definitive management of total colonic Hirschsprung's disease in infants and children. Early success with this operation encouraged us to use this procedure in children and adults with ulcerative col...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199009000-00002

    authors: Coran AG

    更新日期:1990-09-01 00:00:00

  • Interleukin-6 in the injured patient. Marker of injury or mediator of inflammation?

    abstract:OBJECTIVE:The effects of interleukin (IL)-6 in the injured patient are examined in an attempt to clarify the potential pathophysiologic role of IL-6 in the response to injury. SUMMARY BACKGROUND DATA:Interleukin-6 is an integral cytokine mediator of the acute phase response to injury and infection. However, prolonged ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199611000-00009

    authors: Biffl WL,Moore EE,Moore FA,Peterson VM

    更新日期:1996-11-01 00:00:00

  • Repeat hepatic surgery for colorectal cancer metastasis to the liver.

    abstract:OBJECTIVE:The authors addressed whether a repeat hepatic operation is warranted in patients with recurrent isolated hepatic metastases. Are the results as good after second operation as after first hepatic operation? SUMMARY BACKGROUND DATA:Five-year survival after initial hepatic operation for colorectal metastases i...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199606000-00015

    authors: Pinson CW,Wright JK,Chapman WC,Garrard CL,Blair TK,Sawyers JL

    更新日期:1996-06-01 00:00:00

  • Tissue- and time-dependent upregulation of cytokine mRNA in a murine model for the multiple organ dysfunction syndrome.

    abstract:OBJECTIVE:We sought to quantitate the course of specific cytokine mRNA expression in tissues that exhibit increasing histopathological changes in time in an animal model for the multiple organ dysfunction syndrome (MODS). SUMMARY BACKGROUND DATA:The development of treatment protocols for MODS requires elucidation of t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000130725.52373.e7

    authors: Volman TJ,Goris RJ,van der Meer JW,Hendriks T

    更新日期:2004-07-01 00:00:00

  • Vein cuff interposition prevents juxta-anastomotic neointimal hyperplasia.

    abstract::This study sought to minimize juxta-anastomotic neointimal hyperplasia (JNIH) following the use of polytetrafluorethylene (PTFE) conduits. PTFE anastomoses to canine carotid arteries (noncuff grafts) were compared with grafts with vein cuffs interposed proximally and distally between the graft and native artery. This ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198806000-00011

    authors: Suggs WD,Henriques HF,DePalma RG

    更新日期:1988-06-01 00:00:00

  • Chemotherapy or liver transplantation for nonresectable liver metastases from colorectal cancer?

    abstract:OBJECTIVE:The primary objective was to compare overall survival (OS) in patients with colorectal cancer (CRC) with nonresectable liver-only metastases treated by liver transplantation or chemotherapy. BACKGROUND:CRC is the third most common cancer worldwide. About 50% of patients will develop metastatic disease primar...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000000786

    authors: Dueland S,Guren TK,Hagness M,Glimelius B,Line PD,Pfeiffer P,Foss A,Tveit KM

    更新日期:2015-05-01 00:00:00

  • Improving the AJCC/TNM staging for adenocarcinomas of the appendix: the prognostic impact of histological grade.

    abstract:PURPOSE:Though histological grade is known to have a major prognostic impact in metastatic mucinous appendiceal adenocarcinomas, the prognostic impact of grade in localized disease, and the validity of the American Joint Committee on Cancer AJCC Staging Manual 7th edition's decision to combine moderately and poorly dif...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318269d680

    authors: Overman MJ,Fournier K,Hu CY,Eng C,Taggart M,Royal R,Mansfield P,Chang GJ

    更新日期:2013-06-01 00:00:00

  • Comparison of amputation with limb-sparing operations for adult soft tissue sarcoma of the extremity.

    abstract::The use of amputation in extremity soft tissue sarcoma has been decreasing at Memorial Sloan-Kettering Cancer Center (MSKCC) over the last 15 years. In an attempt to define the efficacy and future role of amputation in extremity soft tissue sarcoma, a prospective sarcoma database compiled at MSKCC from July 1982 to Ja...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199203000-00012

    authors: Williard WC,Hajdu SI,Casper ES,Brennan MF

    更新日期:1992-03-01 00:00:00

  • Metabolic consequences of (regional) total pancreatectomy.

    abstract::Little information has been reported on the metabolic characteristics of the totally pancreatectomized patient or the efficacy of medical management after radical pancreatic surgery. The prospective evaluation of 49 such patients, with 31% followed for 48 or more months, forms the basis of this report. The major immed...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199108000-00007

    authors: Dresler CM,Fortner JG,McDermott K,Bajorunas DR

    更新日期:1991-08-01 00:00:00

  • Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

    abstract:OBJECTIVE:The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. BACKGROUND:Training on VR simulators has been shown to improve technical performance in the operating room (OR). Current...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000000254

    authors: Palter VN,Grantcharov TP

    更新日期:2014-03-01 00:00:00

  • Influence of the postoperative state on the intracellular free amino acids in human muscle tissue.

    abstract::Five patients were studied before and two to three days after major, uncomplicated abdominal operation. Muscle tissue was obtained by needle biopsy from m. quadriceps femoris after eight hours overnight fast. Plasma free amino acids were analyzed in simultaneously obtained samples. In the homogenized muscle samples th...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197512000-00001

    authors: Vinnars E,Bergstöm J,Fürst P

    更新日期:1975-12-01 00:00:00

  • The LeVeen shunt in the elective treatment of intractable ascites in cirrhosis. A prospective study on 140 patients.

    abstract::One hundred and forty patients with an intractable ascites complicating a chronic liver disease received a peritoneovenous shunt (PVS) using the LeVeen valve. Operative mortality was ten per cent but was 25% in patients with severe liver failure. Intraoperative drainage of ascites sharply decreased postoperative compl...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198504000-00014

    authors: Smadja C,Franco D

    更新日期:1985-04-01 00:00:00

  • Multiple subcritical arterial stenoses: effect on poststenotic pressure and flow.

    abstract::Diminished poststenotic pressure and flow accompanied experimental application of multiple subcritical arterial stenoses in series. Effects of additional stenoses, causing equivalent constrictions, were cumulative in a nonlinear fashion. Seven-hundred-twenty measurements were performed using 10 cm ileofemoral canine a...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197711000-00020

    authors: Flanigan DP,Tullis JP,Streeter VL,Whitehouse WM Jr,Fry WJ,Stanley JC

    更新日期:1977-11-01 00:00:00

  • Surgical management of papillary and follicular carcinoma of the thyroid.

    abstract::The clinical outcome in 155 patients with papillary or follicular carcinoma of the thyroid gland operated on over a 25-year period demonstrated no difference in survival rates or incidence of recurrent tumor between those treated by total thyroidectomy and those undergoing less than total thyroidectomy. However, the c...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198012000-00001

    authors: Farrar WB,Cooperman M,James AG

    更新日期:1980-12-01 00:00:00

  • Fifty years' experience with esophageal atresia and tracheoesophageal fistula. Beginning with Cameron Haight's first operation in 1935.

    abstract::Four hundred twenty-six patients with esophageal atresia with or without tracheoesophageal fistula have been primarily cared for at the University of Michigan Medical Center since Cameron Haight's initial experience with this entity. Over the period of observation, the incidence of new cases as well as the number of a...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198610000-00013

    authors: Manning PB,Morgan RA,Coran AG,Wesley JR,Polley TZ Jr,Behrendt DM,Kirsh MM,Sloan HE

    更新日期:1986-10-01 00:00:00

  • Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan Clinical Oncology Group Study JCOG 0404.

    abstract:OBJECTIVE:A randomized controlled trial to confirm the non-inferiority of laparoscopic surgery to open surgery in terms of overall survival was conducted, and short-term surgical outcomes are demonstrated. BACKGROUND:The efficacy and safety outcome of laparoscopic surgery for clinical stages II/III colon cancer underg...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000000499

    authors: Yamamoto S,Inomata M,Katayama H,Mizusawa J,Etoh T,Konishi F,Sugihara K,Watanabe M,Moriya Y,Kitano S,Japan Clinical Oncology Group Colorectal Cancer Study Group.

    更新日期:2014-07-01 00:00:00

  • Surgical management of acute cholecystitis in patients 65 years of age and older.

    abstract::The proportion of the population of the U.S. 65 years of age and over is increasing. Biliary tract disease is estimated to involve 15% of the adult population. A review of 12,200 patients treated surgically at one medical center reveals that 2401 (20%) had acute cholecystitis. There were 93 deaths, for a mortality rat...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198101000-00009

    authors: Glenn F

    更新日期:1981-01-01 00:00:00

  • Pulmonary microembolism associated with massive transfusion: II. The basic pathophysiology of its pulmonary effects.

    abstract::In animals pulmonary hypertension, a decrease in total body O2 consumption and metabolic acidosis occur after transfusion of blood with an elevated screen filtration pressure (SFP) through standard blood transfusion filters. The purpose of this study was to define in detail the pulmonary abnormalities that develop fol...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197507000-00011

    authors: Barrett J,Dawidson I,Dhurandhar HN,Miller E,Litwin MS

    更新日期:1975-07-01 00:00:00

  • Partial versus total portacaval shunt in alcoholic cirrhosis. Results of a prospective, randomized clinical trial.

    abstract:OBJECTIVE:Results of the first prospective randomized clinical trial comparing partial and total portacaval shunt for variceal hemorrhage are reported. SUMMARY BACKGROUND DATA:Total portacaval shunts produce subnormal portal pressures, completely diverting hepatic portal flow. Partial shunts maintain higher pressures ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-199404000-00005

    authors: Sarfeh IJ,Rypins EB

    更新日期:1994-04-01 00:00:00

  • Surgery for post-myocardial infarct ventricular septal defect.

    abstract::Forty-three patients (mean age 62 +/- 1 years) were treated for ventricular septal defect (VSD) secondary to myocardial infarction. Whenever possible, operation was postponed until six weeks post-onset chest pain. However, hemodynamic instability, evidenced by cardiogenic shock, refractory pulmonary edema, or a rising...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197709000-00004

    authors: Daggett WM,Guyton RA,Mundth ED,Buckley MJ,McEnany MT,Gold HK,Leinbach RC,Austen WG

    更新日期:1977-09-01 00:00:00

  • Proficiency of surgeons in inguinal hernia repair: effect of experience and age.

    abstract:OBJECTIVES:We examined the influence of surgeon age and other factors on proficiency in laparoscopic or open hernia repair. SUMMARY BACKGROUND DATA:In a multicenter, randomized trial comparing open and laparoscopic herniorrhaphies, conducted in Veterans Administration hospitals (CSP 456), we reported significant diffe...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/01.sla.0000179644.02187.ea

    authors: Neumayer LA,Gawande AA,Wang J,Giobbie-Hurder A,Itani KM,Fitzgibbons RJ Jr,Reda D,Jonasson O,CSP #456 Investigators.

    更新日期:2005-09-01 00:00:00

  • Addition of glutamine to total parenteral nutrition after elective abdominal surgery spares free glutamine in muscle, counteracts the fall in muscle protein synthesis, and improves nitrogen balance.

    abstract::Twenty-two patients undergoing elective abdominal surgery were given total parenteral nutrition (TPN) after the operation. The TPN contained either a conventional amino acid solution supplemented with glutamine or a conventional amino acid solution without supplementation. To study amino acid and protein metabolism, m...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198904000-00011

    authors: Hammarqvist F,Wernerman J,Ali R,von der Decken A,Vinnars E

    更新日期:1989-04-01 00:00:00

  • Variability in length of stay after colorectal surgery: assessment of 182 hospitals in the national surgical quality improvement program.

    abstract:BACKGROUND:Length of postoperative stay (LOS) has gained increasing attention as a potential indicator of surgical efficiency. Our objective was to examine the feasibility of assessing LOS at 182 hospitals to identify institutions with outlying performance. METHODS:Patients were identified who underwent colorectal sur...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/sla.0b013e3181b2a948

    authors: Cohen ME,Bilimoria KY,Ko CY,Richards K,Hall BL

    更新日期:2009-12-01 00:00:00

  • Twenty-five-year follow-up for liver resection: the personal series of Dr. Joseph G. Fortner.

    abstract:BACKGROUND:Liver resection is performed for many types of malignancies. Few reports document actual long-term survival. METHODS:Long-term follow-up of a series of 548 liver resections performed between 1970 and 1992 was performed and is presented. RESULTS:All patients were followed for at least 15 years after surgery...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181b59491

    authors: Fortner JG,Fong Y

    更新日期:2009-12-01 00:00:00

  • Effects of superoxide dismutase and allopurinol on the survival of acute island skin flaps.

    abstract::We have demonstrated previously that oxygen-derived free radicals are important mediators of tissue injury following ischemia (total venous occlusion) and reperfusion in small (3 cm X 6 cm) island skin flaps in rats. In this study, we evaluated extension of this concept to regional ischemia in large (8 cm X 8 cm) acut...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198503000-00018

    authors: Im MJ,Manson PN,Bulkley GB,Hoopes JE

    更新日期:1985-03-01 00:00:00

  • Defining "the elderly" undergoing major gastrointestinal resections: receiver operating characteristic analysis of a large ACS-NSQIP cohort.

    abstract:OBJECTIVE:"The elderly" is an often used but poorly defined descriptor of surgical patients. Investigators have used varying subjectively determined age cutoffs to report outcomes in the elderly. We set out to use objective outcomes data to determine the "at-risk" elderly population. METHODS: PATIENTS:129,331 patient...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182a196d8

    authors: Kurian AA,Wang L,Grunkemeier G,Bhayani NH,Swanström LL

    更新日期:2013-09-01 00:00:00

  • The Carbon Footprint of Surgical Operations: A Systematic Review.

    abstract:OF BACKGROUND DATA AND OBJECTIVES:Operating theatres are typically the most resource-intensive area of a hospital, 3-6 times more energy-intensive than the rest of the hospital and a major contributor of waste. The primary objective of this systematic review was to evaluate existing literature calculating the carbon fo...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003951

    authors: Rizan C,Steinbach I,Nicholson R,Lillywhite R,Reed M,Bhutta MF

    更新日期:2020-12-01 00:00:00

  • Multicenter Stratified Comparison of Hospital Costs Between Laparoscopic and Open Colorectal Cancer Resections: Influence of Tumor Location and Operative Risk.

    abstract:OBJECTIVE:To compare actual 90-day hospital costs between elective open and laparoscopic colon and rectal cancer resection in a daily practice multicenter setting stratified for operative risk. BACKGROUND:Laparoscopic resection has developed as a commonly accepted surgical procedure for colorectal cancer. There are co...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000002000

    authors: Govaert JA,Fiocco M,van Dijk WA,Kolfschoten NE,Prins HA,Dekker JWT,Tollenaar RAEM,Tanis PJ,Wouters MWJM,Dutch Value Based Healthcare Study Group.

    更新日期:2017-12-01 00:00:00

  • Comparative study of portal vein embolization versus portal vein ligation for induction of hypertrophy of the future liver remnant using a mini-pig model.

    abstract:SUMMARY BACKGROUND DATA:The extent of hepatectomies is limited by the functional reserve of the remnant liver. The introduction of preoperative portal vein occlusion techniques to induce a preoperative hyperplasia of the future liver remnant has reduced the risk of postoperative liver failure. However, it has remained ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31816a9d7c

    authors: Wilms C,Mueller L,Lenk C,Wittkugel O,Helmke K,Krupski-Berdien G,Rogiers X,Broering DC

    更新日期:2008-05-01 00:00:00