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Published online: 2022-04-25
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Influence of surgery treatment quality on longtime results gastric cancer combination therapy

Ireneusz Ryszard Pierzankowski1, Adam Dmitruk1, Sebastian Rybski1, Lucjan Wyrwicz1, Tomasz Olesiński1
DOI: 10.5603/NJO.a2022.0025
Affiliations
  1. Maria Sklodowska-Curie National Researche Institute of Oncology, Warsaw, Poland

open access

Ahead of print
Original article
Published online: 2022-04-25

Abstract

Introduction.The aim of this study was to analyze the influence of surgical center experience on long-term survival of patients with locoregionally advanced gastric adenocarcinoma undergoing primary surgery followed by complementary chemoradiotherapy according to MacDonald's regimen.

Material and methods. 154 patients treated surgically, including 75 (48.7%) at the Maria Sklodowska-Curie National Researche Institute of Oncology (NIO-PIB) in Warsaw, and 79 (51.3%) outside this center, were retrospectively analyzed. The compared groups were statistically homogeneous. The following parameters were analyzed: age, gender, tumor differentiation, TNM VII (2010) staging, nodal index, radicality of surgical treatment, tumor type according to Lauren classification, clinical stage, presence of prognostic factors, overall survival time.

Results. Among the patients operated at NIO-PIB, 71 (94.7%) patients underwent radical resection, 4 (5.3%) cases were microscopically non-radical resection. There were no macroscopically non-radical resections (0%). For patients operated outside NIO-PIB, 60 (75.9%) R0 resections, 15 (19%) R1 resections and 4 (5.1%) R2 resections were performed. The percentage of radical resections was significantly higher at NIO-PIB (p = 0.001). In 77% of patients operated on at NIO-PIB, disease progression in terms of feature n could be established. This percentage for patients operated on outside the NIO-PIB was 54% and was significantly lower (p = 0.001). The probability of 5-year survival was 41.6% in total, with 45.3% for the group of patients operated on in the NIO-PIB and 38.0 % for the group of patients operated on outside the CO-I, respectively (p = 0.628)

Conclusions. The quality of surgical treatment was significantly higher in NIO-PIB. The difference in 5-year overall survival (OS) between the compared groups is not statistically significant. Complementary treatment with chemoradiotheraphy (CRT) according to MacDonald's regimen reduces the shortcomings in the quality of surgical treatment in locoregionally advanced gastric adenocarcinoma.

Abstract

Introduction.The aim of this study was to analyze the influence of surgical center experience on long-term survival of patients with locoregionally advanced gastric adenocarcinoma undergoing primary surgery followed by complementary chemoradiotherapy according to MacDonald's regimen.

Material and methods. 154 patients treated surgically, including 75 (48.7%) at the Maria Sklodowska-Curie National Researche Institute of Oncology (NIO-PIB) in Warsaw, and 79 (51.3%) outside this center, were retrospectively analyzed. The compared groups were statistically homogeneous. The following parameters were analyzed: age, gender, tumor differentiation, TNM VII (2010) staging, nodal index, radicality of surgical treatment, tumor type according to Lauren classification, clinical stage, presence of prognostic factors, overall survival time.

Results. Among the patients operated at NIO-PIB, 71 (94.7%) patients underwent radical resection, 4 (5.3%) cases were microscopically non-radical resection. There were no macroscopically non-radical resections (0%). For patients operated outside NIO-PIB, 60 (75.9%) R0 resections, 15 (19%) R1 resections and 4 (5.1%) R2 resections were performed. The percentage of radical resections was significantly higher at NIO-PIB (p = 0.001). In 77% of patients operated on at NIO-PIB, disease progression in terms of feature n could be established. This percentage for patients operated on outside the NIO-PIB was 54% and was significantly lower (p = 0.001). The probability of 5-year survival was 41.6% in total, with 45.3% for the group of patients operated on in the NIO-PIB and 38.0 % for the group of patients operated on outside the CO-I, respectively (p = 0.628)

Conclusions. The quality of surgical treatment was significantly higher in NIO-PIB. The difference in 5-year overall survival (OS) between the compared groups is not statistically significant. Complementary treatment with chemoradiotheraphy (CRT) according to MacDonald's regimen reduces the shortcomings in the quality of surgical treatment in locoregionally advanced gastric adenocarcinoma.

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Keywords

gastric cancer; surgery; chemoradiotherapy

About this article
Title

Influence of surgery treatment quality on longtime results gastric cancer combination therapy

Journal

Nowotwory. Journal of Oncology

Issue

Ahead of print

Article type

Research paper (original)

Published online

2022-04-25

Page views

13

Article views/downloads

14

DOI

10.5603/NJO.a2022.0025

Keywords

gastric cancer
surgery
chemoradiotherapy

Authors

Ireneusz Ryszard Pierzankowski
Adam Dmitruk
Sebastian Rybski
Lucjan Wyrwicz
Tomasz Olesiński

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