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Feasibility of Total Gastrectomy with D2 Lymphadenectomy for Gastric Cancer and Predictive Factors for Its Short- and Long-Term Outcomes
- Source :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 20(3)
- Publication Year :
- 2015
-
Abstract
- The aim of this study was to evaluate the short- and long-term outcomes after total gastrectomy (TG) with D2 lymphadenectomy. Patients undergoing TG with D2 lymphadenectomy for gastric cancer between December 2008 and December 2011 were enrolled. Univariate and multivariate analyses were performed to evaluate the risk factors for the short- and long-term outcomes. A total of 229 patients were analyzed, and 22.3 % developed complications within 30 days of surgery. No patient died within 30 days, while 2.6 % died within 90 days of the operation. In the multivariate analysis, age ≥65 years and cardiopulmonary comorbidities were associated with morbidity, whereas hypoproteinemia and tumor–node–metastasis (TNM) stage III were associated with the disease-free survival (DFS) and overall survival (OS). The number of preoperative risk factors stratified the morbidity from 10.3 % in those without any risk factors to 40.5 % in patients with both risk factors. Similarly, 5-year survival rates decreased from 68.9 % (DFS) and 71.1 % (OS) in those without risk factors to 20.2 % (DFS) and 22.9 % (OS) in patients with both risk factors. TG with D2 lymphadenectomy has acceptable short- and long-term outcomes. Patient risk stratification may allow for more rational selection of patients and therapeutic strategies for gastric resection.
- Subjects :
- Male
medicine.medical_specialty
Multivariate analysis
Time Factors
medicine.medical_treatment
030230 surgery
Gastroenterology
Disease-Free Survival
Cohort Studies
03 medical and health sciences
Hypoproteinemia
0302 clinical medicine
Gastrectomy
Risk Factors
Stomach Neoplasms
Internal medicine
medicine
Humans
Stage (cooking)
Survival rate
Aged
Neoplasm Staging
D2 lymphadenectomy
business.industry
Cancer
Middle Aged
medicine.disease
Surgery
Survival Rate
Treatment Outcome
030220 oncology & carcinogenesis
Multivariate Analysis
Feasibility Studies
Lymph Node Excision
Female
business
Cohort study
Subjects
Details
- ISSN :
- 18734626
- Volume :
- 20
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
- Accession number :
- edsair.doi.dedup.....512aaac1dd5ccc7cf4bc8c039fd838fd