[GASTRIC CANCER: DIAGNOSIS AND ROLE OFLYMPHADENECTOMY IN SURGICAL TREATMENT]

Rev Gastroenterol Peru. 1997 Jan-Apr;17(1):44-55.
[Article in Spanish]

Abstract

This prospective, non-controlled study assessed clinico pathologic features and 5 year survival of 62 patients with gastric cancer seen at Belen Hospital, between 1990 and 1994. Mean age was 59,3 years. There were 38 men and 24 women. Mean length of disease was 16 months. The most frequent symptoms were abdominal pain and pallor. The overall endoscopic and biopsy accuracy was 100% as compared to 94% for endoscopy alone. We found improvement in endoscopy biopsy after obtaining more than 6 biopsies, in Borrmann's types I and II, located in the body or histologically diffuse. Most patients with inoperable and nonresectable disease were women (P = 0,006), had tumors greater than 10cm (p = 0,0001), stages III and IV (p = 0,0001) or diffuse tumors (p = 0,007) as compared with resectable cases. Most nodes were found in the perigastric region. The survival rate was different among patients with inoperable (n=10), non-resectable (n = 1 8), and resectable (n = 34) disease, with the 5-year survival rate being 0%, 0%, and 15%, respectively (p < 0,001). The survival rates of patients were significantly different among DO(n = 8), D1 (n = 9), and D2-D3(n = 17) dissections, with the 5-year survival rate being 0%, 23%, and 41%, respectively (p < 0,0001). The 5 year survival rates for patients who underwent curative and palliative operation were 60% and 7%, respectively (p < 0,0001). The 5-year survival rate for the total series was 10%. We concluded that only the patients that could be submitted to gastric resection had a survival perspective of more than 5 years, mainly those underwent extended lymphadenectomy.