Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and the esophagogastric junction: a retrospective analysis from an experienced single center
Introduction Gastric cancer remains the fourth leading cause of cancer-related death in Europe, while the proportion of adenocarcinomas of the esophagogastric junction has risen by more than one third over recent years. In 2018, 14,700 new cases of gastric cancer were estimated in Germany, while the...
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| Format: | Article |
| Language: | English |
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Termedia Publishing House
2021-12-01
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| Series: | Archives of Medical Science |
| Subjects: | |
| Online Access: | https://www.archivesofmedicalscience.com/Surgical-and-oncological-outcome-after-extended-lymph-node-dissection-for-carcinoma,141165,0,2.html |
| _version_ | 1797214540945948672 |
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| author | Dimitrios Raptis Matthias Maak Christian Krautz Susanne Merkel Maximilian Brunner Abbas Agaimy Arndt Hartmann Sabine Semrau Oliver Ott Rainer Fietkau Jürgen Siebler Robert Grützmann Werner Hohenberger Claus-Wilhelm Schildberg |
| author_facet | Dimitrios Raptis Matthias Maak Christian Krautz Susanne Merkel Maximilian Brunner Abbas Agaimy Arndt Hartmann Sabine Semrau Oliver Ott Rainer Fietkau Jürgen Siebler Robert Grützmann Werner Hohenberger Claus-Wilhelm Schildberg |
| author_sort | Dimitrios Raptis |
| collection | DOAJ |
| description | Introduction
Gastric cancer remains the fourth leading cause of cancer-related death in Europe, while the proportion of adenocarcinomas of the esophagogastric junction has risen by more than one third over recent years. In 2018, 14,700 new cases of gastric cancer were estimated in Germany, while the 5-year relative survival rate is reported to be 33% for women and 30% for men; in the USA almost the same rate was reported, with 31% 5-year survival.
Material and methods
Between 2001 and 2014, 590 patients with a diagnosis of gastric cancer underwent surgery in our institution, including 120 Siewert type II/III carcinomas of the esophagogastric junction. All patients underwent distal resection of the stomach, gastrectomy or total gastrectomy combined with transhiatal distal esophageal resection. All operations included D2-D3 lymph node dissection (LND). Data were recorded by the cancer registry of the department of surgery and analyzed retrospectively.
Results
The patients were classified according to the TNM (UICC 2010) and Lauren classification. 29% of the patients underwent primary surgery and 31% received neoadjuvant therapy. The median number of harvested lymph nodes was 33 for patients diagnosed with gastric cancer, and 29 for esophagogastric adenocarcinomas, respectively. The anastomotic leak rate was 3%. In this study, the 5-year overall survival rate was 51% concerning gastric carcinomas, 44% for Siewert type II and 47% for Siewert III cancers of the esophagogastric junction.
Conclusions
Increased survival with low complication rates were achieved after individualized and multimodal treatment concepts combined with consistently applied extended lymphadenectomy. |
| first_indexed | 2024-04-24T11:15:48Z |
| format | Article |
| id | doaj.art-2e0a58b0820f40bc8e66ed5ca2b45af3 |
| institution | Directory Open Access Journal |
| issn | 1734-1922 1896-9151 |
| language | English |
| last_indexed | 2024-04-24T11:15:48Z |
| publishDate | 2021-12-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Archives of Medical Science |
| spelling | doaj.art-2e0a58b0820f40bc8e66ed5ca2b45af32024-04-11T08:11:15ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512021-12-0120112413210.5114/aoms/141165141165Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and the esophagogastric junction: a retrospective analysis from an experienced single centerDimitrios Raptis0Matthias Maak1Christian Krautz2Susanne Merkel3Maximilian Brunner4Abbas Agaimy5Arndt Hartmann6Sabine Semrau7Oliver Ott8Rainer Fietkau9Jürgen Siebler10Robert Grützmann11Werner Hohenberger12Claus-Wilhelm Schildberg13Surgical Department, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, GermanySurgical Department, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, GermanySurgical Department, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, GermanySurgical Department, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, GermanySurgical Department, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, GermanyInstitute of Pathology, Friedrich-Alexander University of Erlangen-Nuremberg, GermanyInstitute of Pathology, Friedrich-Alexander University of Erlangen-Nuremberg, GermanyDepartment of Radiation Oncology, Universitätsklinikum Erlangen, GermanyDepartment of Radiation Oncology, Universitätsklinikum Erlangen, GermanyDepartment of Radiation Oncology, Universitätsklinikum Erlangen, GermanyDepartment of Internal Medicine 1 – Gastroenterology, Pulmonology and Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, GermanySurgical Department, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, GermanySurgical Department, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, GermanyDepartment of Surgery, Brandenburg Medical School, University Hospital, Brandenburg/Havel, GermanyIntroduction Gastric cancer remains the fourth leading cause of cancer-related death in Europe, while the proportion of adenocarcinomas of the esophagogastric junction has risen by more than one third over recent years. In 2018, 14,700 new cases of gastric cancer were estimated in Germany, while the 5-year relative survival rate is reported to be 33% for women and 30% for men; in the USA almost the same rate was reported, with 31% 5-year survival. Material and methods Between 2001 and 2014, 590 patients with a diagnosis of gastric cancer underwent surgery in our institution, including 120 Siewert type II/III carcinomas of the esophagogastric junction. All patients underwent distal resection of the stomach, gastrectomy or total gastrectomy combined with transhiatal distal esophageal resection. All operations included D2-D3 lymph node dissection (LND). Data were recorded by the cancer registry of the department of surgery and analyzed retrospectively. Results The patients were classified according to the TNM (UICC 2010) and Lauren classification. 29% of the patients underwent primary surgery and 31% received neoadjuvant therapy. The median number of harvested lymph nodes was 33 for patients diagnosed with gastric cancer, and 29 for esophagogastric adenocarcinomas, respectively. The anastomotic leak rate was 3%. In this study, the 5-year overall survival rate was 51% concerning gastric carcinomas, 44% for Siewert type II and 47% for Siewert III cancers of the esophagogastric junction. Conclusions Increased survival with low complication rates were achieved after individualized and multimodal treatment concepts combined with consistently applied extended lymphadenectomy.https://www.archivesofmedicalscience.com/Surgical-and-oncological-outcome-after-extended-lymph-node-dissection-for-carcinoma,141165,0,2.htmlgastric cancerd3 dissectionsiewert ii/iii |
| spellingShingle | Dimitrios Raptis Matthias Maak Christian Krautz Susanne Merkel Maximilian Brunner Abbas Agaimy Arndt Hartmann Sabine Semrau Oliver Ott Rainer Fietkau Jürgen Siebler Robert Grützmann Werner Hohenberger Claus-Wilhelm Schildberg Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and the esophagogastric junction: a retrospective analysis from an experienced single center Archives of Medical Science gastric cancer d3 dissection siewert ii/iii |
| title | Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and
the esophagogastric junction: a retrospective analysis from an experienced single center |
| title_full | Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and
the esophagogastric junction: a retrospective analysis from an experienced single center |
| title_fullStr | Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and
the esophagogastric junction: a retrospective analysis from an experienced single center |
| title_full_unstemmed | Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and
the esophagogastric junction: a retrospective analysis from an experienced single center |
| title_short | Surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and
the esophagogastric junction: a retrospective analysis from an experienced single center |
| title_sort | surgical and oncological outcome after extended lymph node dissection for carcinoma of the stomach and the esophagogastric junction a retrospective analysis from an experienced single center |
| topic | gastric cancer d3 dissection siewert ii/iii |
| url | https://www.archivesofmedicalscience.com/Surgical-and-oncological-outcome-after-extended-lymph-node-dissection-for-carcinoma,141165,0,2.html |
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