ABSTRACT
BACKGROUND/AIMS: The objective of our paper is to report on the remote results of patients with gastric cancer treated by mini-invasive surgery as a surgical tool with the "intention to treat with laparoscopy". METHODOLOGY: Between June 1993 and January 2004, 101 patients comprising 72 men and 29 women with gastric adenocarcinoma were prospectively selected by two hospitals based on prior agreement (the CHU Charleroi, Belgium, and Zumárraga Hospital, the Basque Country, Spain). Patients with adenocarcinoma of the cardia were excluded. Average age of the patients was 67 (37-83). RESULTS: Postoperative mortality within 60 days of operation was of 5 patients; 87 patients were therefore properly followed-up for an average of 41 months (7-129). Average survival time for 10 non-resected patients was 4.5 months. Average survival rate of the 10 palliatively resected patients was 7.1 months. Actuarial 5-year survival rate RO-type surgery was 34%. The global actuarial 5-year survival rate after resective surgery was 29%. CONCLUSIONS: Laparoscopic gastrectomy with any kind of lymphadenectomy is a heavy but safe operation, and produces acceptable mortality and morbidity rates in patients with advanced gastric cancer in a general poor condition. Laparoscopic gastrectomies for locally advanced cancers are equivalent to those reported by laparotomy as far as long-term oncological results are concerned.
Subject(s)
Adenocarcinoma/pathology , Adenocarcinoma/surgery , Gastrectomy , Laparoscopy , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Adenocarcinoma/mortality , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Gastrectomy/adverse effects , Humans , Male , Middle Aged , Prospective Studies , Stomach Neoplasms/mortality , Survival Rate , Treatment OutcomeABSTRACT
A study was made of 125 gastrectomy pieces with gastric carcinoma in which metaplastic and dysplastic changes on the intact gastric mucosa adjacent to the tumor were analyzed. Both incomplete intestinal metaplasia and different types of dysplasia were more frequently and significantly associated with carcinomas of intestinal pattern than with diffuse ones (p less than 0.001). Jass type I dysplasia was more frequent in well-differentiated carcinomas, while Jass type II was more common in relatively undifferentiated tumors, the difference being highly significant (p less than 0.001). Our results and those of other studies in the literature suggest a pathogenic relationship only between preneoplastic lesions and gastric carcinoma of intestinal pattern, which probably includes entities that can be differentiated by pathogenesis to judge from the variations in the dysplastic changes observed.
