ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Surgical Treatment Of Gastric Cancer: 11-year Experience
Dr. Nuri Aydın KAMA,a Dr. Mesut ATLI,a Dr. Gül DAĞLAR,a
Dr. Yunus Nadi YÜKSEK,a Dr. Tanju TÜTÜNCÜ,a Dr. Erhan REİSa
a4. Cerrahi Kliniği, Ankara Numune Eğitim ve Araştırma Hastanesi, ANKARA
Objective: To present our 11-year experience in the surgical treatment of gastric cancer.
Material and Methods: Between January 1992 and January 2003, 249 patients with the diagnosis of gastric cancer were admitted to our clinic. Of these patients, 117 underwent curative, and 73, palliative gastric resection, while 44 underwent other palliative surgical intervention. 15 received no surgical treatment. Overall survival with respect to treatment and stage was determined by the Kaplan-Meier method. Univariate and multivariate analyses were used to correlate factors affecting overall survival in a total of 190 patients who had palliative or curative gastric resection, and in 117 who had undergone curative resection.
Results: The mean overall survival periods was found to be 60 months [95%, confidence interval (CI): 48-72 months] in the 117 R0 resection patients, 29 months (95%, CI: 15-42 months) in 24 R1 resection patients, 9 months (95%, CI: 7-12 months) in 49 R2 resection patients, and 5 months (95%, CI: 3-6 months) in 59 non-resected patients (p< 0.001). When factors affecting overall survival were examined, in 190 gastric resection patients, the depth of tumor invasion (p= 0.001), metastatic lymph node ratio (p= 0.025), the Borrmann type (p= 0.024), vascular invasion (p= 0.028), and resectability (p= 0.035) were determined to be independent prognostic factors. In the 117 R0 resection patients, the depth of tumor invasion (p= 0.023), metastatic lymph node ratio (p= 0.002), tumor localisation (p= 0.008), the extent of lymphatic dissection (p= 0.016), and tumor diameter (p= 0.047) were significant factors.
Conclusion: The most effective treatment for gastric cancer remains curative surgery. Compared to standard gastrectomy, better results appear to be attainable through extended lymphadenectomyKeywords: Stomach neoplasms, surgery, lymph node excisionTurkiye Klinikleri J Med Sci 2005, 25:538-545
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