Mide kanseri hastalarında tümör lokalizasyonu ve lenf nodu tutulumunun prognoz ve sağkalıma etkisi

Yıl 2020, Cilt: 6 Sayı: 2, 248 - 257, 30.08.2020

Cihan Gökler , Oktay İrkorucu , Enver Reyhan , Hilmi Bozkurt , Mustafa Görür

https://doi.org/10.30569/adiyamansaglik.717688

Öz

Amaç: Mide kanseri nedeniyle ameliyat edilen hastalarda tümör yerleşimi ve lenf nodu tutulumunun prognoz ve sağkalım üzerine etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Prognostik faktörleri belirlemek için kliniğimizde ameliyat edilen hastaların klinik ve histopatolojik özelliklerini araştırdık.
Bulgular: Tümör lokalizasyon grupları arasında ve metastatik lenf noduna göre sağkalım farkı gözlenmedi (Log Rank p=0,255 ve 0,188). Evreye ve 60 yaş üstü olma durumuna göre anlamlı sürvi farkı vardı (p=0,001, p=0,003). Üst 1/3 yerleşimli gastrik kanserde diseke edilen metastatik lenf nodu sayısı fazlaydı (p=0,026, 0,036)
Sonuç: Mide kanseri hastalarında tümör lokalizasyonu ve lenf nodu tutulumunun sürviye etkisi saptanmamışken, 60 yaş üzeri olma ve Evre-III kötü prognostik faktörler olarak saptandı.

Anahtar Kelimeler

Mide Kanseri, Gastrektomi, Metastatik Lenf Nodu, İleri yaş, Prognoz

Destekleyen Kurum

Herhangi bir kurum desteği yoktur

Teşekkür

Adana Şehir Hastanesi Genel Cerrahi kliniğine teşekkür ederiz.

Effect of tumor location and lymph node involvement on prognosis and survival in gastric cancer patients

Öz

Aim: The present study evaluates the effect of tumor localization and lymph node involvement on prognosis and survival in patients undergoing surgery for gastric cancer.
Materials and Methods: The clinical and histopathological characteristics of patients who underwent surgery in our clinic were evaluated to determine the prognostic factors.
Results: No difference was observed in the survival rates of the groups in terms of tumor locations and metastatic lymph nodes (Log Rank p=0.255 and 0.188). A significant difference was found in the survival rates of the groups based on stage and age over 60 years (p=0.001, p=0.003). The number of metastatic lymph nodes dissected was high in gastric cancers located in the upper-third of the stomach (p=0.026, 0.036).
Conclusion: No effect of tumor localization or lymph node involvement was determined on survival in patients with gastric cancer; however, age over 60 years and stage III were found to be poor prognostic factors.

Anahtar Kelimeler

Gastric Cancer, Gastrectomy, Metastatic Lymph Nodes, Advanced Age, Prognosis

Kaynakça

• 1.Torre LA, Bray F, Siegel RL, Ferlay J, Lortet‐Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer journal for clinicians 2015; 65(2): 87-108.
• 2.Sencan I, Ince GN ed. Turkish Ministry of Health Public Health Agency Cancer Statistics. 2016; 1-60.
• 3.Siewert JR, Böttcher K, Stein HJ, Roder JD. Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study. Ann Surg. 1998;228(4):449-61.
• 4.Sert OZ, Bozkurt H, Bulut IC, et al.C-Reactive Protein to Albumin Ratio:A Reliable Marker in Gastric Surgery. Indian J Surg. (2020) https://doi.org/10.1007/s12262-020-02310-y.
• 5.Park JC, Lee YC, Kim JH, et al. Clinicopathological aspects and prognostic value with respect to age: an analysis of 3,362 consecutive gastric cancer patients. J Surg Oncol. 2009;99(7):395‐401.
• 6.Kim JP, Lee JH, Kim SJ, Yu HJ, Yang HK. Clinicopathologic characteristics and prognostic factors in 10 783 patients with gastric cancer. Gastric Cancer. 1998 ;1(2):125-133.
• 7.Jemal A, Siegel R, Xu J, Ward E. Cancer statistics. 2010. CA Cancer J Clin. 2010;60:277–300.
• 8.Schwarz RE, Smith DD. Clinical impact of lymphadenectomy extent in resectable gastric cancer of advanced stage. Ann Surg Oncol. 2007;14(2):317-28.
• 9.Sert OZ, Bozkurt H, Ozlem T, et al. Clinical research Clinicopathologic and immunohistochemical features of gastrointestinal stromal tumors: a single-center experience. Arch Med Sci Civil Dis. 2020; 5: 8–13.
• 10.Seevaratnam R, Bocicariu A, Cardoso R, et al. How many lymph nodes should be assessed in patients with gastric cancer? A systematic review. Gastric Cancer. 2012 ; 15(1): 70-88.
• 11.Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol. 2010 May;11(5):439-49.
• 12.Sasako M, Sano T, Yamamoto S, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med. 2008;359(5):453‐462.
• 13.Seevaratnam R, Bocicariu A, Cardoso R, et al. A meta-analysis of D1 versus D2 lymph node dissection. Gastric Cancer. 2012 ;15(1):60-9.
• 14.Liu X, Cai H, Wang Y. Prognostic significance of tumor markers in T4a gastric cancer. World J Surg Oncol. 2012;10:68.
• 15.Shim JH, Song KY, Jeon HM, et al. Is gastric cancer different in Korea and the United States? Impact of tumor location on prognosis. Ann Surg Oncol. 2014;21(7):2332‐2339.
• 16.Qiu MZ, Wang ZQ, Zhang DS, et al. Clinicopathological characteristics and prognostic analysis of gastric cancer in the young adult in China. Tumour Biol. 2011;32(3):509‐514.
• 17.Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol. 2010;11(5):439‐449.
• 18.Cuschieri A, Weeden S, Fielding J, et al. Patient survival after D1 and D2 resections for gastric cancer: long-term results of the MRC randomized surgical trial. Surgical Co-operative Group. Br J Cancer. 1999;79(9-10):1522‐1530.
• 19.Sano T, Sasako M, Yamamoto S, et al. Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy--Japan Clinical Oncology Group study 9501. J Clin Oncol. 2004;22(14):2767‐2773.
• 20.Sano T, Aiko T. New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric Cancer. 2011;14(2):97‐100.
• 21.Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14(2):113‐123.
• 22.Ozer I, Bostanci EB, Koc U, et al. Surgical treatment for gastric cancer in Turkish patients over age 70: early postoperative results and risk factors for mortality. Langenbecks Arch Surg. 2010;395(8):1101‐1106.
• 23.Zhou CJ, Chen FF, Zhuang CL, et al. Feasibility of radical gastrectomy for elderly patients with gastric cancer. Eur J Surg Oncol. 2016;42(2):303‐311.
• 24.Oñate-Ocaña LF, Aiello-Crocifoglio V, Gallardo-Rincón D, et al. Serum albumin as a significant prognostic factor for patients with gastric carcinoma. Ann Surg Oncol. 2007;14(2):381‐389.
• 25.Tegels JJ, De Maat MF, Hulsewé KW, Hoofwijk AG, Stoot JH. Improving the outcomes in gastric cancer surgery. World J Gastroenterol. 2014;20(38):13692‐13704.
• 26.Shim H, Cheong JH, Lee KY, Lee H, Lee JG, Noh SH. Perioperative nutritional status changes in gastrointestinal cancer patients. Yonsei Med J. 2013;54(6):1370‐1376.
• 27.Rey-Ferro M, Castaño R, Orozco O, Serna A, Moreno A. Nutritional and immunologic evaluation of patients with gastric cancer before and after surgery. Nutrition. 1997;13(10):878‐881.
• 28.Weimann A, Braga M, Harsanyi L, et al. ESPEN Guidelines on Enteral Nutrition: Surgery including organ transplantation. Clin Nutr. 2006;25(2):224‐244.
• 29.Sano T, Coit DG, Kim HH, et al. Proposal of a new stage grouping of gastric cancer for TNM classification: International Gastric Cancer Association staging project. Gastric Cancer. 2017;20(2):217‐225.