Total Versus Subtotal Gastrectomy for Distal Gastric Poorly Cohesive Carcinoma.
Details
Serval ID
serval:BIB_85A83CD8BB90
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Total Versus Subtotal Gastrectomy for Distal Gastric Poorly Cohesive Carcinoma.
Journal
Annals of surgical oncology
Working group(s)
French Association of Surgery
Contributor(s)
Regimbeau J.M., Brac B., Lermite E., Barbieux J., Cloche E., Gueroult P., Puia-Negulsecu S., Degrandi O., Joumaa C., Seel M., Bouriez D., Celarier S., Gronnier C., Collet D., Théréaux J., Roche C., Pezet D., Veziant J., Gagnière J., Bacœur-Ouzillou O., Lecomte C., Badon-Murgue F., Al Mustafa S., Sarkis A., Lescure G., Gandon A., Eveno C., Dubreuilh G., Piessen G., Arnalsteen L., Pasquer A., Breton A., Robert M., Poncet G., Mège D., Sielezneff I., Guiramand J., Turrini O., Chaussende C., Ewassadja V., Chevalier R., Souche F.R., Fabre J.M., Ferrandis C., Bardol T., Ferre L., Manceau G., Karoui M., Pocard M., Djelil D., Voron T., Lefevre J.H., Parc Y., Paye F., Balladur P., Fuks D., de Carbonnières A., Bonnet S., Cattan P., Demma J., Corte H., Margot N., Rault A., Courvoisier-Clément T., Faure J.P., Bergeat D., Wasielewski E., Meunier B., Le Roy B., Vincentelli D.A., Epin A., Sole T., Deheppe J., Denneval A., Pella C., Melnikov S., Péré G., Carrere N., Genty F., Mantziari S., Abboretti F., Schäfer M., Demartines N., Gualtierotti M., Sanou A., Doamba R.N., Somé R.O., Souadka A., Houmada A., Souadka A., Atiq S.E., Benkabbou A., Anas Majbar M., Mohsine R., Berkane S., Mesli S.N.
ISSN
1534-4681 (Electronic)
ISSN-L
1068-9265
Publication state
Published
Issued date
11/2023
Peer-reviewed
Oui
Volume
31
Number
2
Pages
744-752
Language
english
Notes
Publication types: Multicenter Study ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Gastric poorly cohesive carcinoma (PCC) in advanced stages has a poor prognosis. Total gastrectomy (TG) remains the common treatment for distal gastric PCC, but subtotal gastrectomy (SG) may improve quality of life without compromising outcomes. Currently, no clear recommendation on the best surgical strategy for distal PCC is available. This study aimed to compare overall survival (OS) and disease-free survival (DFS) at 5 years for patients with antropyloric PCC treated by total versus subtotal gastrectomy.
A large retrospective European multicenter cohort study analyzed 2131 patients treated for gastric cancer between 2007 and 2017 by members of the French Association of Surgery (AFC). The study compared a group of patients who underwent TG with a group who underwent SG for antropyloric PCC. The primary outcomes were 5 year OS and DFS.
The study enrolled 269 patients: 140 (52.0%) in the TG group and 129 (48.0%) in the SG group. The baseline characteristics and pTNM stage were similar between the two groups. According to Dindo-Claven classification, the patients treated with TG had more postoperative complications than the patients treated with SG (p < 0.001): grades I to IIIa (77.1% vs 59.5%) and grades IIIb to IVb (14.4% vs 9.0%). No difference in 5-year OS was observed between TG (53.8%; 95 % confidence interval [CI], 43.2-63.3%) and SG (53.0%; 95% CI, 41.4-63.3%) (hazard ratio [HR], 0.94; 95% CI, 0.68-1.29). The same was observed for 5-year DFS: TG (46.0%; 95% CI, 35.9-55.5%) versus SG (45.3%; 95% CI, 34.3-55.6%) (HR, 0.97; 95% CI, 0.70-1.34).
At 5 years, SG was not associated with worse OS and DFS than TG for distal PCC. Surgical morbidity was higher after TG. Subtotal gastrectomy is a valuable option for distal PCC gastric cancer.
A large retrospective European multicenter cohort study analyzed 2131 patients treated for gastric cancer between 2007 and 2017 by members of the French Association of Surgery (AFC). The study compared a group of patients who underwent TG with a group who underwent SG for antropyloric PCC. The primary outcomes were 5 year OS and DFS.
The study enrolled 269 patients: 140 (52.0%) in the TG group and 129 (48.0%) in the SG group. The baseline characteristics and pTNM stage were similar between the two groups. According to Dindo-Claven classification, the patients treated with TG had more postoperative complications than the patients treated with SG (p < 0.001): grades I to IIIa (77.1% vs 59.5%) and grades IIIb to IVb (14.4% vs 9.0%). No difference in 5-year OS was observed between TG (53.8%; 95 % confidence interval [CI], 43.2-63.3%) and SG (53.0%; 95% CI, 41.4-63.3%) (hazard ratio [HR], 0.94; 95% CI, 0.68-1.29). The same was observed for 5-year DFS: TG (46.0%; 95% CI, 35.9-55.5%) versus SG (45.3%; 95% CI, 34.3-55.6%) (HR, 0.97; 95% CI, 0.70-1.34).
At 5 years, SG was not associated with worse OS and DFS than TG for distal PCC. Surgical morbidity was higher after TG. Subtotal gastrectomy is a valuable option for distal PCC gastric cancer.
Keywords
Humans, Stomach Neoplasms/pathology, Retrospective Studies, Quality of Life, Cohort Studies, Survival Rate, Adenocarcinoma/surgery, Gastrectomy/adverse effects, Gastric poorly cohesive carcinoma (PCC), Signet ring cells (SRC), Subtotal gastrectomy, Total gastrectomy
Pubmed
Web of science
Create date
18/01/2024 11:44
Last modification date
19/01/2024 8:13
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