D2 dissection improves disease-specific survival in advanced gastric cancer patients: 15-year follow-up results of the Italian Gastric Cancer Study Group D1 versus D2 randomised controlled trial

2021 ◽  
Vol 150 ◽  
pp. 10-22
Author(s):  
M. Degiuli ◽  
R. Reddavid ◽  
M. Tomatis ◽  
A. Ponti ◽  
M. Morino ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Controlled Trial ◽  
Study Group ◽  
Disease Specific Survival ◽  
Cancer Study Group ◽  
Gastric Cancer Study ◽  
Gastric Cancer Patients ◽  
Randomised Controlled ◽  
Disease Specific

Effectiveness of D2 gastrectomy for lymph node positive and advanced gastric cancer: Survival results of the Italian Gastric Cancer Study Group (IGCSG) randomized surgical trial on D1 versus D2 dissection for gastric carcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4027-4027
Author(s):  
Maurizio Degiuli ◽  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Survival Benefit ◽  
Cancer Survival ◽  
D2 Lymphadenectomy ◽  
Disease Specific Survival ◽  
Intention To Treat ◽  
Surgical Trial ◽  
Gastric Cancer Study ◽  
Disease Specific

4027 Background: It is still unclear whether D2 lymphadenectomy can significantly improve survival of gastric cancer and therefore should be applied routinely or performed in selected cases. We conducted a multicenter randomized trial to compare the efficacy of D2 and D1 lymphadenectomy for gastric cancer. Primary outcome was overall survival; secondary endpoints were disease specific survival, morbidity and in-hospital mortality. Methods: Between June 1998 and December 2006 patients with gastric adenocarcinoma were randomly assigned to either D1 or D2 lymphadenectomy. Intraoperative randomization was implemented centrally by telephone. Results: A total of 267 eligible patients were allocated to either D1 (133) or D2 group (134). Morbidity (12·0% vs 17·9%, p=0·18) and mortality (3·0% vs 2·3%; p=0·72) were similar. There was no difference in the overall 5-year survival (66·5% vs 64·2%, p = 0.70). Subgroups analyses showed a 5-years disease specific survival benefit for pT1 cases treated with D1 dissection (98.0% vs 82.9%, p = 0.01) and of pT>1 LN+ patients treated with D2 resection (38·4% vs 59·5%, p = 0.05 at five years). Conclusions: In intention to treat analysis we observed no overall 5-year survival benefit from D2 resection. The trial showed a survival benefit of D1 procedure in early stages. On the opposite, despite evidence of contamination in the D1 arm, a survival advantage was documented in patients with advanced disease and lymph node metastases submitted to D2 procedure. Clinical trial information: ISRCTN11154654. [Table: see text]

scholarly journals Appraisal of Long-time Outcomes After Curative Surgery in Elderly Patients with Gastric Cancer: A Propensity Score Matching Analysis

2020 ◽  
Author(s):  
Tomoyuki Matunaga ◽  
Ryo Ishiguro ◽  
Wataru Miyauchi ◽  
Yuji Shishido ◽  
Kozo Miyatani ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Stage Iii ◽  
Disease Specific Survival ◽  
Gastric Cancer Patients ◽  
Disease Specific

Abstract Background: This study was conducted to assess the long-term outcomes of elderly patients among propensity-score-matched gastric cancer patients after curative gastrectomy and to propose the proper management of elderly gastric cancer patients.Methods: We enrolled 626 patients with gastric cancer who underwent curative gastrectomy at our institution between January 2004 and December 2015. To minimize selection bias among 2 groups, propensity score matching was performed.Results: Patients were divided into an elderly group over 75 years old (EP group; n=186) and a non-elderly group (NEP group; n=440). After propensity score matching, patients were divided into EP group (n=186) and NEP group (n=186). Five-year overall survival was significantly lower in the EP group than in the NEP group, consistent with a subgroup analysis of each stage. However, the 5-year disease-specific survival among all enrolled patients and those with stage I and II disease did not differ significantly. Moreover, in the subgroup of stage III patients, 5-year disease-specific survival was significantly lower in the EP group (23.0%) than in the NEP group (59.4%; P=0.004). Because elderly patients with stage III disease had an extremely poor prognosis, we decided to compare the two groups with stage III. The EP group contained significantly fewer patients with D2 lymphadectomy (P=0.002) and adjuvant chemotherapy (P<0.001) than the NEP group. Multivariate analysis revealed that older age and lymphatic invasion were independent prognostic factors. C-reactive protein to albumin ratio was significantly higher in patients in the EP group than in the NEP group (P=0.046), and the prognostic nutritional index was significantly lower in EP group patients than NEP group patients (P=0.045). Conclusions: Elderly gastric cancer patients with stage III disease showed poorer disease-specific survival compared with non-elderly patients, which may be due to fewer D2 lymphadenectomies, a lack of adjuvant chemotherapy, and a poorer nutritional and inflammatory background. The safe induction of standard lymphadenectomy and adjuvant chemotherapy with perioperative aggressive nutritional support may improve the prognosis of elderly gastric cancer patients with stage III disease.

scholarly journals A 40 Month Double-Blind, Randomized, Placebo-Controlled Trial on the Effect of BCc1 Nanomedicine on Survival of Metastatic and Non-Metastatic Gastric Cancer Patients

2021 ◽  
Author(s):  
Maryam Hafizi ◽  
Somayeh Kalanaky ◽  
Hassan Moaiery ◽  
Sajad Noorian ◽  
Maryam Khayamzadeh ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Events ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Metastatic Gastric Cancer ◽  
P Value ◽  
Double Blind ◽  
Gastric Cancer Patients

Abstract Background: Complementary experiments on nanomedicines as proper candidates for the control and treatment of cancer are widely being conducted nowadays. In the previous study, the effect of BCc1 nanomedicine, which is synthetized based on nanochelating technology, on overall survival (OS) and quality of life of gastric cancer patients was evaluated after 18 months of consumption. The OS of the same patients is reported in this study after 40 months. Methods: A double-blind, randomized, placebo-controlled, parallel, multicenter design was used in this study. 123 metastatic and non-metastatic gastric cancer patients of both genders (between 25 and 85 years old) participated in this experiment to evaluate their OS after consuming BCc1 for 40 months and to identify the adverse events of this nanomedicine. Results: The median OS of metastatic patients was 257 days in the BCc1 group [95% confidence interval (CI): 144. 142-369.858], while it was 161 days in the placebo [95% CI: 118.462-203.538]; hazard ratio (HR): 0.802 [95% CI: 0.483-1.333] (P-Value = 0.395). Similarly, the median OS of non-metastatic patients was 718 days in the BCc1 group [95% CI; 577.706-860.213], while it was 520 days in the placebo [95% CI: 460.280- 580.690]; HR: 0.807 [95% CI: 0.343,1.902] (P-Value = 0.624). There was no evidence of adverse events after 40 months.Conclusion: The OS improvement of metastatic and non-metastatic gastric cancer patients in the previous (18 months of follow-up) and current (40 months of follow-up) studies showed that BCc1 can be used along with base treatments to improve cancer patients’ OS. Trial registration: IRCTID, IRCT2017101935423N1.Registered on 19 October 2017, http://www.irct.ir/ IRCT2017101935423N1.

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