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Enhanced Recovery After Surgery (ERAS) has been used to improve surgical outcomes in recent years. However, its safety and efficacy in elderly patients with gastric cancer remain unclear. The aim of this study was to reveal the safety and efficacy of the ERAS protocol in elderly patients with gastric cancer.Elderly gastric cancer patients (age≥70 years) who underwent gastrectomy were divided into the ERAS group and the conventional group. Postoperative complications, postoperative hospital stay, hospitalization expenses, and readmission rates were compared between the two groups.From December 2019 to January 2021, 100 eligible patients were enrolled in our study. All baseline data were balanced between the ERAS group and the conventional group. There was no significant difference in terms of complications (18% vs. 16%, P = 0.14) between the two groups. The most common complication was pneumonia. Four patients were observed in the conventional group and three patients in the ERAS group. The postoperative hospital stay was shorter in the ERAS group (8.2 vs. 10.4, P = 0.001).The ERAS protocol could be safely used in elderly gastric cancer patients undergoing gastrectomy and shorten postoperative hospital stay.

Background Proximal gastrectomy with double-tract reconstruction (DTR) has been used for upper third gastric cancer as a function-preserving procedure. However, the safety and feasibility of laparoscopic proximal gastrectomy (LPG) with DTR remain uncertain. This study compared open proximal gastrectomy (OPG) with DTR and LPG with DTR for proximal gastric cancer. Methods Sixty-four patients who had undergone OPG with DTR and forty-six patients who had undergone LPG with DTR were enrolled in this case–control study. The clinical characteristics, surgical outcomes and postoperative nutrition index were analysed retrospectively. Results The operation time was significantly longer in the LGP group than in the OPG group (258.3 min vs 205.8 min; p = 0.00). However, the time to first flatus and postoperative hospital stay were shorter in the LPG group [4.0 days vs 3.5 days (p = 0.00) and 10.6 days vs 9.2 days (p = 0.001), respectively]. No significant difference was found between the two groups in the number of retrieved lymph nodes, complications or reflux oesophagitis. The nutrition status was assessed using the haemoglobin, albumin, prealbumin and weight levels from pre-operation to six months after surgery. No significant difference was found between the groups. Conclusion LPG with DTR can be safely performed for proximal gastric cancer patients by experienced surgeons.

Gastric cancer is a common cancer of the gastrointestinal tract and the second most prevalent cause of cancer-associated mortality globally. Gastric cancer-associated mortality is increased in China compared with that in other countries. Key contributors to the poor prognosis of gastric cancer include late clinical presentation and genetic heterogeneity. Treatment based on the subtype of gastric cancer is important for effective therapy. The overexpression of the erb-b2 receptor tyrosine kinase 2 (ERBB2) gene and protein is associated with gastric cancer in humans. Chemotherapy and targeted therapy may control tumor growth and recurrence, which is an important function of conversion surgery. The present study reported a patient diagnosed with gastric cancer with multiple abdominal cavity and retroperitoneal lymph node metastases. ERBB2 amplification and overexpression were identified in both case reports presented. The patients were treated with four cycles of oxaliplatin, capecitabine and trastuzumab. Computed tomography revealed the lymph node metastases decreased in size following treatment, and surgical resection was performed. The four cycles of oxaliplatin, capecitabine and trastuzumab were continued subsequent to surgical resection at the administered dose. No recurrence was observed for >1 year after surgery. Trastuzumab combined with oxaliplatin and capecitabine as a conversion therapy regime for ERBB2-overexpressing advanced gastric adenocarcinoma increased the likelihood of successful surgical resection, and prolonged progression-free survival.

Objectives: To assess the safety and feasibility of total laparoscopy distal gastrectomy (TLDG). Methods: This meta-analysis was conducted between April and July 2013 in Sichuan Cancer Hospital, Chengdu, China. We searched PubMed, EMBASE and China Knowledge Resource Integrated Database updated until May 2013. Eight retrospective studies and one prospective study involving 2,046 total patients were included. Results: The results showed that TLDG was associated with lower blood loss (mean difference=-22.39, p=0.04). and a greater number of harvested lymph nodes (mean difference=2.74, p=0.02). There was no significant difference between the 2 groups in operation time, time to first flatus, length of postoperative hospital stay, and postoperative complications. Conclusion: Compared with laparoscopy-assisted distal gastrectomy, TLDG resulted in reduced blood loss, and a greater number of harvested lymph nodes. Total laparoscopy distal gastrectomy is safe and feasible for gastric cancer.

The association between gene polymorphisms of IFRD1 and gastric cancer is not clear. The aim of this study was to investigate the association between IFRD1 polymorphisms and gastric cancer in Chinese population. Fifty-three consecutive patients with the diagnosis of gastric cancer were defined as the case group, and another 50 healthy donors were denoted as the control group. About 4 ml of peripheral blood was collected from each donor for extracting DNA. Finally, IFRD1 rs7818, rs3807213, and rs6968084 SNPs were detected with polymerase chain reaction. C/C genotype distribution frequencies of rs6968084 and rs7817 in gastric cancer patients were similar with the controls (OR 0.192, 95 % CI 0.513-2.769, P = 0.683 and OR 2.075, 95 % CI 0.744-5.792, P = 0.16, respectively). Patients with gastric cancer had a significantly higher frequency of rs3807213 C allele and rs3807213 C/C genotype than controls. (OR 4.028, 95 % CI 1.513-10.72, P = 0.004) (OR 3.759, 95 % CI 1.521-9.294, P = 0.003). This study suggests that the SNPs of IFRD1 rs7818 and rs6968084 have nothing to do with the gastric cancer susceptibility. The allele gene C and genotype C/C of rs3807213 SNP are involved in susceptibility to gastric cancer, but there were no relations when subgroup stratified all the three SNPs according to pathological stages.

To investigate the association between rs3807213 gene polymorphism in interferon related developmental regulator 1 gene (IFRD1) and the risk of gastric cancer among Chinese.There were 53 gastric cancer patients and 50 healthy people included in this case-control study. The blood samples were collected from each observed object and genotype (AA, AC, CC) of IFRD1 rs3807213 SNP was detected after polymerase chain reaction (PCR). The relationships of rs3807213 gene polymorphism with gastric cancer risk, clinic and pathologic features were analyzed.Patients with stomach cancer had a significantly higher frequency of rs3807213 C allele distributions (OR = 3.759, 95% CI = 1.521-9.294; P = 0.003) than the controls. Compared with control group, patients with gastric cancer had a significantly higher frequency of rs3807213 CC genotype (OR = 4.028, 95% CI = 1.513-10.720; P = 0.004). When stratified by pathological stage of gastric cancer, there was no significant difference observed.IFRD1-rs3807213 polymorphism may be associated with the increased risk of gastric cancer.