Abstract
Objectives: Comparison of clinicopathological and demographic features of early and late stage gastric cancer patients and determination of prognostic factors that specific for late stage patients.Patients and methods: Files of 145 patients diagnosed with adenocarcinoma, operated at Zonguldak Karaelmas University School of Medicine Training and Research Hospital were examined retrospectively.Results: There were 19 early-stage patient. Lymph node involvement of two patients was positive. Three patients had been died non-cancer related causes. Average follow-up time was 58.7 months for 16 patient. Average survey of late stage patients were 26.10 months. The factors that affect survey statistically significant were determined as age, T-N score and number of lymph node that removed. Prognostic factors that specific to the stages were examined: age and lymph node number that removed for stage 2, age, macroscopic image, taking chemotherapy, size and differentiation degree for stage 3, size for stage 4 was determined as a factors that effect to survey.Conclusion: In our study, depth of invasion was associated with lymph node positivity in early stage. The detection of number of lymph node resection as a prognostic factor in late stage might be due to insufficient lymph node dissection to 46 of 126 patients. Lack of statistical difference in terms of survey between stages 3-4 may be due to incorrect staging because of lower lymph node removal in stage 3 than stage 4 and extension of survey because of removal of more lymph nodes in stage 4
References
- Türkiye Sa¤lık ‹statistikleri. 1. Baskı. Ankara: Türk Tabipleri Birli¤i Yayınları; 2005. s. 60-1.
- Allgayer H, Heiss MM, Schildberg FW. Prognostic factors in gastric cancer. Br J Surg 1997;84:1651-64.
- Borie F, Millat B, Fingerhut A, Hay JM, Fagniez PL, De Saxce B. Lymphatic involvement in early gastric cancer: prevalence and prognosis in France. Arch Surg 2000;135:1218-23.
- Roviello F, Rossi S, Marrelli D, Pedrazzani C, Corso G, Vindigni C, et al. Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study. J Surg Oncol 2006;94:275-80.
- An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Kim S. Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg 2007;246:749-53.
- Siewert JR, Bottcher K, Stein HJ. Operative strategies. In: Wanebo HJ, editor. Surgery for gastrointestinal Cancer. Philadelphia: Lippincott- Raven; 1997. p. 310-1.
- Wu CW, Lo SS, Shen KH, Hsieh MC, Chen JH, Chiang JH, et al. Incidence and factors associated with recurrence patterns after intended curative surgery for gastric cancer. World J Surg 2003;27:153-8.
- Saito H, Osaki T, Murakami D, Sakamoto T, Kanaji S, Tatebe S, et al. Effect of age on prognosis in patients with gastric cancer. ANZ J Surg 2006;76:458-61.
- Yi SH, Kim HC, Lee SH, Park HC, Yoon C, Joo HZ, et al. Multivariate analysis of prognostic factors in gastric cancer. J Korean Surg Soc 1999;56:75-83.
- Msika S, Benhamiche AM, Jouve JL, Rat P, Faivre J. Prognostic factors after curative resection for gastric cancer. A population-based study. Eur J Cancer 2000;36:390-6.
- Liu KJ, Loewen M, Atten MJ, Millikan K, Tebbit C, Walter RJ. The survival of stage III gastric cancer patients is affected by the number of lymph nodes removed. Surgery 2003;134:639-44.
- Kikuchi Y, Tsuchiya A, Ando Y, Yoshida T, Takenosita S. Immunohistochemical detection of lymph node microinvolvement in node-negative gastric cancer. Gastric Cancer 1999;2:173-8.
- Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725-30.
- Sobin LH, Wittekind CH. UICC TNM classification of Malignant Tumors. 5th ed. New York: Wiley-Liss; 1997.
- Wang X, Wan F, Pan J, Yu GZ, Chen Y, Wang JJ. Tumor size: a non-neglectable independent prognostic factor for gastric cancer. J Surg Oncol 2008;97:236-40.
- Yook JH, Oh ST, Kim BS. Clinicopathological analysis of Borrmann type IV gastric cancer. Cancer Res Treat 2005;37:87-91.
Erken ve ileri evre mide kanserli hastaların klinikopatolojik ve demografik özelliklerinin karşılaştırılması
Abstract
Amaç: Erken ve geç evre mide kanserli hastaların klinikopatolojik, demografik özelliklerini karşılaştırmak ve ileri evre hastalarda evreye özel prognostoik
faktörleri belirlemek.
Hastalar ve yöntemler: Zonguldak Karaelmas Üniversitesi Tıp Fakültesi Uygulama ve Araştırma Hastanesinde mide adenokarsinomu tanısı konulmuş
ve ameliyat edilmiş 145 hastanın dosyaları retrospektif olarak incelendi.
Bulgular: Çalışmamızda 19 erken evre hasta vardı. İki hastada lenf nodu tutulumu pozitifti. Üç hasta kanser dışı nedenlerden dolayı kaybedildi. Diğer
16 hastada ortalama takip süresi 58.7 aydı. İleri evre mide kanserli hastaların ortalama sağkalımı 26.10 aydı. Regresyon analizinde sağkalıma istatistiksel
olarak anlamlı düzeyde etki eden faktörler; yaş, T-N skoru ve çıkarılan lenf nodu sayısı idi. Evrelere özel prognostik faktörler incelendiğinde ise evre 2’de
yaş, çıkarılan lenf nodu sayısı, evre 3’de yaş, makroskopik görünüm, kemoradyoterapi almak, boyut ve diferansiyasyon derecesi, evre 4’de tümör boyutu
sağkalıma etki eden faktörlerdi.
Sonuç: Çalışmamızda erken evrede lenf nodu pozitifliği ile invazyon derinliği ilişkiliydi. İleri evrede çıkarılan lenf nodu sayısının prognostik faktör
olarak saptanmasının nedeni 126 hastanın 46’sına yetersiz lenf nodu diseksiyonu yapılması olabilir. Evre 3-4 arasında sağkalım açısından istatistiksel
fark olmaması evre 3’de çıkarılan lenf nodu ortalamasının evre 4’e göre düşük kalmasından dolayı yanlış evrelemeden, evre 4’de daha fazla lenf nodu
çıkarılmasının sağkalımı uzatmasından kaynaklanabilir.
References
- Türkiye Sa¤lık ‹statistikleri. 1. Baskı. Ankara: Türk Tabipleri Birli¤i Yayınları; 2005. s. 60-1.
- Allgayer H, Heiss MM, Schildberg FW. Prognostic factors in gastric cancer. Br J Surg 1997;84:1651-64.
- Borie F, Millat B, Fingerhut A, Hay JM, Fagniez PL, De Saxce B. Lymphatic involvement in early gastric cancer: prevalence and prognosis in France. Arch Surg 2000;135:1218-23.
- Roviello F, Rossi S, Marrelli D, Pedrazzani C, Corso G, Vindigni C, et al. Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study. J Surg Oncol 2006;94:275-80.
- An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Kim S. Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg 2007;246:749-53.
- Siewert JR, Bottcher K, Stein HJ. Operative strategies. In: Wanebo HJ, editor. Surgery for gastrointestinal Cancer. Philadelphia: Lippincott- Raven; 1997. p. 310-1.
- Wu CW, Lo SS, Shen KH, Hsieh MC, Chen JH, Chiang JH, et al. Incidence and factors associated with recurrence patterns after intended curative surgery for gastric cancer. World J Surg 2003;27:153-8.
- Saito H, Osaki T, Murakami D, Sakamoto T, Kanaji S, Tatebe S, et al. Effect of age on prognosis in patients with gastric cancer. ANZ J Surg 2006;76:458-61.
- Yi SH, Kim HC, Lee SH, Park HC, Yoon C, Joo HZ, et al. Multivariate analysis of prognostic factors in gastric cancer. J Korean Surg Soc 1999;56:75-83.
- Msika S, Benhamiche AM, Jouve JL, Rat P, Faivre J. Prognostic factors after curative resection for gastric cancer. A population-based study. Eur J Cancer 2000;36:390-6.
- Liu KJ, Loewen M, Atten MJ, Millikan K, Tebbit C, Walter RJ. The survival of stage III gastric cancer patients is affected by the number of lymph nodes removed. Surgery 2003;134:639-44.
- Kikuchi Y, Tsuchiya A, Ando Y, Yoshida T, Takenosita S. Immunohistochemical detection of lymph node microinvolvement in node-negative gastric cancer. Gastric Cancer 1999;2:173-8.
- Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725-30.
- Sobin LH, Wittekind CH. UICC TNM classification of Malignant Tumors. 5th ed. New York: Wiley-Liss; 1997.
- Wang X, Wan F, Pan J, Yu GZ, Chen Y, Wang JJ. Tumor size: a non-neglectable independent prognostic factor for gastric cancer. J Surg Oncol 2008;97:236-40.
- Yook JH, Oh ST, Kim BS. Clinicopathological analysis of Borrmann type IV gastric cancer. Cancer Res Treat 2005;37:87-91.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | September 17, 2015 |
| Published in Issue | Year 2015 Volume: 1 Issue: 2 |
