ABSTRACT
BACKGROUND: Gastroesophageal reflux (GR) after radical resection of proximal gastric cancer (PGC) may influence survival; however, few studies have investigated survival in PGC patients who develop GR following radical resection. This study aimed to correlate the occurrence of GR after proximal gastrectomy (PG) and total gastrectomy (TG) with clinicopathological factors and long-term survival. METHODS: The PGC patient cohort was retrospectively grouped as follows: postoperative patients with and without GR (NGR). Clinicopathological characteristics and survival data were compared between the two groups. RESULTS: A total of 88 patients who underwent PG (53%) experienced postoperative GR; however, only 30 patients who underwent TG (14%) experienced GR (P = 0.000). The incidence of GR was significantly associated with surgical procedure (P < 0.01), tumor size (P < 0.01), infiltration depth (P < 0.01), lymph node metastasis (P = 0.018), postoperative distant metastasis (P < 0.01) and recurrence (P = 0.001). The 5-year overall survival of the GR group was significantly worse than that of the NGR group (39.3 vs. 46.5%, respectively; P = 0.046). The PG and TG groups had significantly different 5-year overall survival (45.2 vs. 50.9%, respectively; P = 0.047), and multivariate analysis revealed GR as an independent risk factor associated with poor overall survival. CONCLUSIONS: Patients who experienced GR after radical resection for PGC were more likely to develop recurrence and metastasis, leading to shorter survival. TG for PGC was associated with a more favorable 5-year overall survival than was PG. Thus, TG should be performed for PGC patients with tumors larger than 5 cm, T3/T4 disease or lymph node metastasis to improve their long-term survival.
Subject(s)
Gastrectomy/adverse effects , Gastroesophageal Reflux/etiology , Neoplasm Recurrence, Local/epidemiology , Postoperative Complications/etiology , Stomach Neoplasms/mortality , Stomach Neoplasms/pathology , Aged , Female , Gastroesophageal Reflux/mortality , Gastroesophageal Reflux/pathology , Humans , Male , Middle Aged , Postoperative Complications/mortality , Postoperative Complications/pathology , Retrospective Studies , Stomach Neoplasms/surgery , Survival RateABSTRACT
Primary sarcomas of the vulva constitute an unusual groups of neoplasm. Peripheral nerve sheath tumor (Schwannoma) is arising from schwann cell of the neuroectodermal origin. This tumor arises on the cranial and spinal nerve roots, as well as on the course of the peripheral nerves rarely. In most cases this tumor is solitary but be multiple in Von Recklinghausen's disease. This initial treatment of this unusual tumor should be radical excision of the primary. Regional lymphadenectomy probably is not useful, since metastases are generally hematogenous rather than lymphatics. Radiation is ineffective as primary therapy
Subject(s)
Lymph Node Excision , Neoplasm Metastasis , Neural Plate , Neurofibromatosis 1 , Peripheral Nerves , Sarcoma , Spinal Nerve Roots , VulvaABSTRACT
Meigs' syndrome is characterized by the pleural effusion and ascites in patients with solid benign ovarian tumors and the resolution of the effusions after resection of the tumor. The tumor secretes a large amount fluid, possibly aggravated by lymphatics and venous obstruction of its pedicle by the relatively large tumor. Meigs' syndrome can resemble a metastatic pelvic carcinoma on its presentation, but the progression is more favorable when the syndrome is associated with a benign ovarian tumor. A case of ovarian fibroma associated with ascites and pleural effusion is presented with the brief review of literatures.
