Zdravniški Vestnik (Apr 2004)

WHAT DID WE LEARN IN SURGICAL TREATMENT OF GASTRIC ADENOCARCINOMA: COMPARISON OF TWO PERIODS

  • Stojan Potrč,
  • Rajko Kavalar,
  • Tine Hajdinjak,
  • Matjaž Horvat,
  • Damjan Vidovič,
  • Maja Šturm,
  • Arpad Ivanecz,
  • Eldar Gadžijev

Journal volume & issue
Vol. 73, no. 4

Abstract

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Background. In January 1992 a standardized and more radical surgical approach in gastric cancer treatment as well as standardized pathohistological workup of specimens was started in our institution. The aim of our retrospectively designed study was to evaluate results of this work for the 10 year period.Methods. We compared the results of two chronologically subsequent groups of altogether 402 patients who underwent a total or subtotal gastrectomy for gastric cancer (period A: 166 patients operated in a period between 1992 and 1996; period B: 236 patients operated in a period between 1997 and 2001).Results. The two groups of patients were comparable with regard to age, gender, general condition of the patient and proportion of potentially curable (R0) resections. There was significant difference between the groups with regard to type of operation (more total gastrectomies in period B), extend of lymphadenectomy (more D2 and D3 in period B), average number of examined nodes (higher in period B) and to the UICC stage (less stage II in period B). Incidence of surgical complications (15.6% vs. 18.7%) and average hospital stay were not significantly different between the two groups (14.72 days vs. 14.70 days). The 5-year survival calculated according to Kaplan-Meier for all patients with R0 and R2 resections together was 30.3% and was 39.1% for the group of R0 resected patients. In patients with UICC stage I–IIIa and R0 resection the 5-year survival was significantly higher in period B (59.9%) than in period A (40.6%) (p = 0.0197).Conclusions. Comparison of two chronologically subsequent groups of patients shows that after a definite period of systematical surgical work improvements of results set in, and are reflecting in the present study in higher number of extracted lymph nodes, in higher number of total gastrectomies and in higher 5-year survival for stages Ia, Ib, II and IIIa in the period B.

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