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Our stomach cancer experiences: is there any retardation in diagnosis or treatment?

Year 2017, Volume: 16 Issue: 1, 6 - 11, 24.04.2017
https://doi.org/10.17941/agd.315558

Abstract

Background and Aims: Early diagnosis of gastric cancer allows for limited resection and improved survival. Our aim is to evaluate the symptoms, endoscopic findings and surgical procedures of our patients with stomach cancer and to determine at which stage they are applying. Materials and Methods: The data of 77 patients who were operated for gastric cancer were evaluated retrospectively. Patients’ demographic data, co-morbidities, tumor localization, presence or absence of passage, symptoms, and duration, endoscopic pathology results, American Society of Anesthesiologist, type and method of resection applied, pathologic stage, tumor size, the number of lymph nodes removed, the number of metastatic lymph nodes and stages were evaluated. Results: In our study, 55 (71.4%) male and 22 (28.6%) women were included. Total gastrectomy was performed in 46 patients (59.8%), subtotal gastrectomy in 16 patients (20.8%) and explorative laparotomy in 15 patients (19.4%). Two patients (2.6%) underwent total gastrectomy with the laparoscopic approach and subtotal gastrectomy in two patients (2.6%). In nine (11.68%) cases, additional organ resection was performed. Morbidity was seen in nine patients (11.6%) and mortality was seen in 3 cases(3.9%). The most frequent pathologic stages were pT3 and pT4 (18.2% and 55.8%, respectively). It was seen that the majority of our cases were in Stage 3 (61%). Conclusion: Our patients who are operated due to gastric cancer are usually in an advanced stage during diagnosis and they have extensive gastric resections and lymph node dissections. In order to be able to perform less invasive surgical procedures or endoscopic procedures, it is necessary to detect the cases at an earlier stage with screening programs.

References

  • 1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86. 2. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011;61:69-90. 3. Yalçın B, Zengin N, Aydın F, et al. The clinical and pathological features of patients with gastric cancer in Turkey: A Turkish Oncology Group Study. Turk J Cancer 2006;36:108-15. 4. Karimi P, Islami F, Anandasabapathy S, et al. Gastric cancer: descriptive epidemiology, risk factors, screening, and prevention. Cancer Epidemiol Biomarkers Prev 2014;23:700-13. 5. D’Elia L, Rossi G, Ippolito R, et al. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31:489-98. 6. Crew KD, Neugut AI. Epidemiology of gastric cancer. World J Gastroenterol 2006;12:354-62. 7. Oliveira C, Pinheiro H, Figueiredo J, et al. Familial gastric cancer: genetic susceptibility, pathology, and implications for management. Lancet Oncol 2015;16:e60-70. 8. Park JY, von Karsa L, Herrero R. Prevention strategies for gastric cancer: a global perspective. Clin Endosc 2014;47:478-89. 9. Yüksel BC, Uçar NS, Yıldız Y, et al. Mide kanserinde standart D2 diseksiyona karşı D1 diseksiyonun mortalite ve morbidite çalışması. Ulus Cerrahi Derg 2009;25:87-91. 10. Wanebo HJ, Kennedy BJ, Chmiel J, et al. Cancer of stomach. A patient care study by the American College of Surgeon. Ann Surg 1993;218:583-92. 11. Bretthauer M, Kalager M, Adami HO. Do's and don'ts in evaluation of endoscopic screening for gastrointestinal cancers. Endoscopy 2016;48:75-80. 12. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101-12.
  • 13. Vural V, Saylam B, Çomçalı B, et al. D1 versus D2 dissection in gastric carcinoma: Evaluation of postoperative mortality and complications. Ulus Cerrahi Derg 2013;29:1-6. 14. Kodera Y, Yamamura Y, Torii A, et al. Postoperative staging of gastric carcinoma. A comparison between the UICC Stage Classification and the 12. edition of the Japanese General Rules for Gastric Cancer Study. Scand J Gastroenterol 1996;31:476-80. 15. Youn HG, An JY, Choi MG, et al. Recurrence after curative resection of early gastric cancer. Ann Surg Oncol 2010;17:448-54. 16. Camargo MC, Anderson WF, King JB, et al. Divergent trends for gastric cancer incidence by anatomical subsite in US adults. Gut 2011;60:1644-9. 17. Song H, Held M, Sandin S, et al. Increase in the prevalence of atrophic gastritis among adults age 35 to 44 years old in Northern Sweden between 1990 and 2009. Clin Gastroenterol Hepatol 2015;13:1592-600. 18. Göçmen E, Kocaoğlu H. Mide kanseri epidemiyolojisi. T Klin J Surg 2000;5:161-2. 19. Traynor OJ, Lennon J, Dervan P, et al. Diagnostic and prognostic problems in early gastric cancer. Am J Surg 1987;154:516-9. 20. Songun I, Putter H, Kranenbarg EM, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 2010;11:439-49. 21. Bonenkamp JJ, Songun I, Hermans J, et al. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 1995;345:745-8. 22. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma. 2nd English ed. Gastric Cancer 1998;1:10-24. 23. Derici H, Yaman İ, İşgüder AS, et al. Lokal ileri evre mide kanserinde kombine rezeksiyonlar. Türkiye Klinikleri J Med Sci 2006;26:514-21. 24. Hartgrink HH, van de Velde CJ, Putter H, et al. Extended lymph node dissection for gastric cancer: who may beneit? Final results of the randomized Dutch gastric cancer group trial. J Clin Oncol 2004;22:2069-77. 25. Furukawa H, Hiratsuka M, Ishikawa O, et al. Total gastrectomy with dissection of lymph nodes along the splenic artery: a pancreas-preserving method. Ann Surg Oncol 2000;7:669-73. 26. Csendes A, Burdiles P, Rojas J, et al. A prospective randomized study comparing D2 total gastrectomy versus D2 total gastrectomy plus splenectomy in 187 patients with gastric carcinoma. Surgery 2002;131:401-7. 27. National Oesophago-Gastric Cancer Audit 2015. Healthcare Quality Improvement Partnership Ltd, 2015. http://www.hqip.org.uk/resources/national-oesophagogastric-cancer-audit-report-2015/ (8 August 2016, date last accessed). 28. Deng Y, Zhang Y, Guo TK. Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: A meta-analysis based on seven randomized controlled trials. Surg Oncol 2015;24:71-7. 29. Haverkamp L, Ruurda JP, Offerhaus GJ, et al. Laparoscopic gastrectomy in Western European patients with advanced gastric cancer. Eur J Surg Oncol 2016;42:110-5. 30. Waddell T, Verheij M, Allum W, et al. Gastric cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24:vi57-63. 31. Degiuli M, Sasako M, Ponti A, et al. Randomized clinical trial comparing survival after D1 or D2 gastrectomy for gastric cancer. Br J Surg 2014;101:23-31. 32. Kısaoğlu A, Özoğul B, Yıldırgan Mİ, et al. Mide kanserinde cerrahi: 504 Olgu. Abant Med J 2014;3:220-5. 33. Goh KL, Chan WK, Shiota S, et al. Epidemiology of Helicobacter pylori infection and public health implications. Helicobacter 2011;16:1-9. 34. Cayci HM, Erdogdu UE, Karaman K, et al. Should endoscopy be routinely performed for bariatric surgery candidates? Eur Res J 2016;2:93-8. 35. Ishaq S, Nunn L. Helicobacter pylori and gastric cancer: a state of the art review. Gastroenterol Hepatol Bed Bench 2015;8:6-14. 36. Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet 1975;2:58-60. 37. Li WQ, Ma JL, Zhang L, et al. Effects of Helicobacter pylori treatment on gastric cancer incidence and mortality in subgroups. J Natl Cancer Inst 2014;106.pii:dju116.

Mide kanseri deneyimlerimiz: Tanı ve tedavide geç mi kalıyoruz?

Year 2017, Volume: 16 Issue: 1, 6 - 11, 24.04.2017
https://doi.org/10.17941/agd.315558

Abstract

Giriş ve Amaç: Mide kanserinin erken tanınması tedavide daha sınırlı rezeksiyonların yapılmasına ve sağ kalımın iyileşmesine olanak sağlar. Amacımız mide kanserli hastalarımızın semptomları, endoskopik bulguları ve ameliyat piyeslerini değerlendirerek hangi evrelerde başvurduklarını saptamaktır. Gereç ve Yöntem: Mide kanseri nedeniyle elektif opere edilen 77 hastanın verileri retrospektif olarak değerlendirildi. Hastaların demografik verileri, ko-morbiditeleri, tümör lokalizasyonları, pasaj geçişinin olup olmadığı, semptomlar ve süreleri, endoskopik patoloji sonuçları, Amerikan Anesteziyoloji Derneği sınıflaması, uygulanan rezeksiyon tipleri, patolojik evreler, tümör büyüklüğü, çıkarılan ortalama lenf nodu ve metastatik lenf nodu sayısı ve evreleri değerlendirildi. Bulgular: Çalışmamızda, olguların 55’i (%71,4) erkek, 22’si (%28,6) kadın idi. Olguların 46’sına (%59,8) total gastrektomi,16’sına (%20.8) subtotal gastrektomi ve 15’ine de (%19,4) eksploratif laparotomi uygulandı. Laparoskopik yaklaşımla 2 (%2,6) olguya total gastrektomi, 2 (%2,6) olguya subtotal gastrektomi yapıldı. Olguların 9’unda (%11,68) ek organ rezeksiyonu yapıldı. Morbidite 9 (%11,6) olguda görüldü. Mortalite 3 (%3,9) olguda görüldü. En sık saptanan T patolojik evresi pT3 ve pT4 idi (sırasıyla %18,2 ve %55,8). Olgularımızın büyük çoğunluğunun Evre 3 (%61) oldukları görüldü. Sonuç: Mide kanseri nedeniyle ile ameliyat edilen hastalarımız tanı sırasında genellikle ileri evrede olup, bu hastalara geniş çaplı mide rezeksiyonları ve lenf nodu diseksiyonları yapılmaktadır. Minimal cerrahi girişimlerin veya endoskopik girişimlerin uygulanabilmesi için tarama programları ile olguların erken evrede saptanması gereklidir.

References

  • 1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86. 2. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011;61:69-90. 3. Yalçın B, Zengin N, Aydın F, et al. The clinical and pathological features of patients with gastric cancer in Turkey: A Turkish Oncology Group Study. Turk J Cancer 2006;36:108-15. 4. Karimi P, Islami F, Anandasabapathy S, et al. Gastric cancer: descriptive epidemiology, risk factors, screening, and prevention. Cancer Epidemiol Biomarkers Prev 2014;23:700-13. 5. D’Elia L, Rossi G, Ippolito R, et al. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31:489-98. 6. Crew KD, Neugut AI. Epidemiology of gastric cancer. World J Gastroenterol 2006;12:354-62. 7. Oliveira C, Pinheiro H, Figueiredo J, et al. Familial gastric cancer: genetic susceptibility, pathology, and implications for management. Lancet Oncol 2015;16:e60-70. 8. Park JY, von Karsa L, Herrero R. Prevention strategies for gastric cancer: a global perspective. Clin Endosc 2014;47:478-89. 9. Yüksel BC, Uçar NS, Yıldız Y, et al. Mide kanserinde standart D2 diseksiyona karşı D1 diseksiyonun mortalite ve morbidite çalışması. Ulus Cerrahi Derg 2009;25:87-91. 10. Wanebo HJ, Kennedy BJ, Chmiel J, et al. Cancer of stomach. A patient care study by the American College of Surgeon. Ann Surg 1993;218:583-92. 11. Bretthauer M, Kalager M, Adami HO. Do's and don'ts in evaluation of endoscopic screening for gastrointestinal cancers. Endoscopy 2016;48:75-80. 12. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101-12.
  • 13. Vural V, Saylam B, Çomçalı B, et al. D1 versus D2 dissection in gastric carcinoma: Evaluation of postoperative mortality and complications. Ulus Cerrahi Derg 2013;29:1-6. 14. Kodera Y, Yamamura Y, Torii A, et al. Postoperative staging of gastric carcinoma. A comparison between the UICC Stage Classification and the 12. edition of the Japanese General Rules for Gastric Cancer Study. Scand J Gastroenterol 1996;31:476-80. 15. Youn HG, An JY, Choi MG, et al. Recurrence after curative resection of early gastric cancer. Ann Surg Oncol 2010;17:448-54. 16. Camargo MC, Anderson WF, King JB, et al. Divergent trends for gastric cancer incidence by anatomical subsite in US adults. Gut 2011;60:1644-9. 17. Song H, Held M, Sandin S, et al. Increase in the prevalence of atrophic gastritis among adults age 35 to 44 years old in Northern Sweden between 1990 and 2009. Clin Gastroenterol Hepatol 2015;13:1592-600. 18. Göçmen E, Kocaoğlu H. Mide kanseri epidemiyolojisi. T Klin J Surg 2000;5:161-2. 19. Traynor OJ, Lennon J, Dervan P, et al. Diagnostic and prognostic problems in early gastric cancer. Am J Surg 1987;154:516-9. 20. Songun I, Putter H, Kranenbarg EM, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 2010;11:439-49. 21. Bonenkamp JJ, Songun I, Hermans J, et al. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 1995;345:745-8. 22. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma. 2nd English ed. Gastric Cancer 1998;1:10-24. 23. Derici H, Yaman İ, İşgüder AS, et al. Lokal ileri evre mide kanserinde kombine rezeksiyonlar. Türkiye Klinikleri J Med Sci 2006;26:514-21. 24. Hartgrink HH, van de Velde CJ, Putter H, et al. Extended lymph node dissection for gastric cancer: who may beneit? Final results of the randomized Dutch gastric cancer group trial. J Clin Oncol 2004;22:2069-77. 25. Furukawa H, Hiratsuka M, Ishikawa O, et al. Total gastrectomy with dissection of lymph nodes along the splenic artery: a pancreas-preserving method. Ann Surg Oncol 2000;7:669-73. 26. Csendes A, Burdiles P, Rojas J, et al. A prospective randomized study comparing D2 total gastrectomy versus D2 total gastrectomy plus splenectomy in 187 patients with gastric carcinoma. Surgery 2002;131:401-7. 27. National Oesophago-Gastric Cancer Audit 2015. Healthcare Quality Improvement Partnership Ltd, 2015. http://www.hqip.org.uk/resources/national-oesophagogastric-cancer-audit-report-2015/ (8 August 2016, date last accessed). 28. Deng Y, Zhang Y, Guo TK. Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: A meta-analysis based on seven randomized controlled trials. Surg Oncol 2015;24:71-7. 29. Haverkamp L, Ruurda JP, Offerhaus GJ, et al. Laparoscopic gastrectomy in Western European patients with advanced gastric cancer. Eur J Surg Oncol 2016;42:110-5. 30. Waddell T, Verheij M, Allum W, et al. Gastric cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24:vi57-63. 31. Degiuli M, Sasako M, Ponti A, et al. Randomized clinical trial comparing survival after D1 or D2 gastrectomy for gastric cancer. Br J Surg 2014;101:23-31. 32. Kısaoğlu A, Özoğul B, Yıldırgan Mİ, et al. Mide kanserinde cerrahi: 504 Olgu. Abant Med J 2014;3:220-5. 33. Goh KL, Chan WK, Shiota S, et al. Epidemiology of Helicobacter pylori infection and public health implications. Helicobacter 2011;16:1-9. 34. Cayci HM, Erdogdu UE, Karaman K, et al. Should endoscopy be routinely performed for bariatric surgery candidates? Eur Res J 2016;2:93-8. 35. Ishaq S, Nunn L. Helicobacter pylori and gastric cancer: a state of the art review. Gastroenterol Hepatol Bed Bench 2015;8:6-14. 36. Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet 1975;2:58-60. 37. Li WQ, Ma JL, Zhang L, et al. Effects of Helicobacter pylori treatment on gastric cancer incidence and mortality in subgroups. J Natl Cancer Inst 2014;106.pii:dju116.
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Details

Subjects Health Care Administration
Journal Section Articles
Authors

Hacı Murat Çaycı

Umut Eren Erdoğdu This is me

Hasan Çantay This is me

Süleyman Orman This is me

Mustafa Akar This is me

Hakan Demirci This is me

Publication Date April 24, 2017
Published in Issue Year 2017 Volume: 16 Issue: 1

Cite

APA Çaycı, H. M., Erdoğdu, U. E., Çantay, H., Orman, S., et al. (2017). Mide kanseri deneyimlerimiz: Tanı ve tedavide geç mi kalıyoruz?. Akademik Gastroenteroloji Dergisi, 16(1), 6-11. https://doi.org/10.17941/agd.315558

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