Pancreaticoduodenectomy in Advanced Distal Gastric Cancer.
- Author:
Sung Jin OH
1
;
Jae Ho CHEONG
;
Jae Hoon LEE
;
Woo Jin HYUNG
;
Seung Ho CHOI
;
Sung Hoon NOH
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Korea. choish@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Gastric cancer;
Pancreaticoduodenectomy;
Palliative subtotal gastrectomy
- MeSH:
Disease Progression;
Duodenum;
Gastrectomy;
Head;
Humans;
Incidence;
Length of Stay;
Lung;
Lymph Nodes;
Mortality;
Neoplasm Metastasis;
Pancreas;
Pancreaticoduodenectomy*;
Prognosis;
Recurrence;
Retrospective Studies;
Stomach Neoplasms*
- From:Journal of the Korean Surgical Society
2003;65(6):528-533
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: In spite of a very poor prognosis for primary gastric cancer invading neighboring organs, combined resection of the involved adjacent organ may improve. Whether pancreaticoduodenectomy in advanced distal gastric cancer improves the survival is controversial. We conducted this study to evaluate the results of pancreaticoduodenectomy in advanced distal gastric cancer. METHODS: We retrospectively analysed 29 patients who underwent surgery at the Department of Surgery, Yonsei University College of Medicine, between January 1994 and December 2001. Patients included in this study had locally advanced distal gastric cancer, without evidence of distant metastases, which had invaded to the duodenum and/or pancreas head, or conglomerated infrapyloric lymph nodes. Patients were divided into two groups: pancreaticoduodenectomy (PD) (n=12), or palliative subtotal gastrectomy (PSTG) (n=17). We compared the clinicopathologic features, operative outcomes, recurrence and survival between these two groups. RESULTS: There were no differences in clinicopathologic features between the two groups. Operation time, incidence and amount of perioperative transfusion, postoperative hospital stay and morbidity were greater in the PD group than in the PSTG group. However, there was no postoperative mortality in either group. Five patients had systemic recurrence (liver, lung, and paraaortic LN metastases) in the PD group, while most patients experienced regional disease progression in the PSTG group. The survival of the PD group was significantly better than that of the PSTG group (P=0.0006). CONCLUSION: Pancreaticoduodenectomy can be safely performed and improves the prognosis for patients with locally far advanced distal gastric cancer that is associated with invasion into the duodenum and/or pancreas head, or conglomerated infrapyloric lymph nodes.
