PURPOSE: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a validated scoring system for auditing surgical outcomes. However, evaluation of this system has primarily been applied to open surgical techniques. The present study demonstrates the validity of P-POSSUM in predicting morbidity and mortality in the treatment of elderly patients with gastric cancer who underwent curative laparoscopic gastrectomy. METHODS: All patients aged 70 years or over, who underwent curative laparoscopic gastrectomy between January 2014 and January 2015, were collected from our hospital database. A case-note review was used to collate data in terms of clinical and operative factors as described in P-POSSUM. Observed/Estimated ratio of morbidity and 30-day mortality were calculated. RESULTS: Laparoscopic gastrectomy was performed in 101 patients. The mean age was 74.9 years (70~83 years). A significant postoperative morbidity was observed in 20 (19.8%) of 101 patients. There was no 30-day mortality. Using exponential analysis, P-POSSUM predicted morbidity in 22 patients. Thus, O/E ratios for morbidity and mortality were 0.9 and 0, respectively. CONCLUSION: P-POSSUM scoring slightly overestimated predictions of morbidity and mortality. An assessment of its application to laparoscopic gastrectomy of elderly patients with gastric cancer merits further evaluation. Also, laparoscopic gastrectomy was a feasible and safe treatment for elderly patients in terms of P-POSSUM.
Aged* ; Gastrectomy* ; Humans ; Mortality ; Stomach ; Stomach Neoplasms*

No abstract available.
Early Detection of Cancer* ; Mortality* ; Stomach Neoplasms*

No abstract available.
Female ; Humans ; Male ; Stomach Neoplasms/*mortality

It is very important to select the appropriate operative method in cancer surgery. For proximal gastric cancer, a total gastrectomy (TG) has usually had less morbidity and mortality than an extended total gastrectomy (ETG). To compare and evaluate the results of a TG with those of an ETG, the authors analyzed 50 cases treated by a TG and 50 cases treated by an ETG during the last 12 years. The results were as follows: The post operative complication rates were 34% for a TG and 54% for an ETG, the average operation time was 3 hours 53 minutes for a TG and 3 hours 42 minutes for an ETG, the postoperative fasting period was 7.1 days for a TG and 6.5 days for an ETG, and the mean length of hospital stay was 21.4 days for a TG and 22.6 days for an ETG. the ETG had a higher complication rate than the TG, but there was no statistical difference between the operation times, the postoperative fasting periods, and the length of stay in the hospital. from our experience, it is suggested that the ETG is easier, or almost the same, to carry out than the TG procedure. Therefore, we recommend an ETG for proximal gastric cancer to achieve better curative results.
Fasting ; Gastrectomy* ; Length of Stay ; Mortality ; Stomach Neoplasms*

OBJECTIVES: This study was performed to evaluate the effect of stage shift according to screening of stomach cancer. METHODS: Total 840 cases of stomach cancer patients, undergone a surgical operation at Department of Surgery, Kangnam St. Mary's Hospital, The Catholic University of Korea from Jan. 1989 to Dec. 1995, were reviewed by stomach cancer working sheet, and classified as asymptomatic and symptomatic group based on the presence of subjective symptoms on their hospital visit. Their histopathologic stages were analysed. We compared the histopathologic stages of asymptomatic stomach cancer patients with those of symptomatic patients. RESULTS: From the total of 840 patients, asymptomatic patients group comprised 28 cases (3.3%). Proportion of asymptomatic patients tended to increase from 1.9% in 1990, 0.9% in 1991 to 8.6% in 1995. Proportions of asymptomatic patients by stages were 78.6% (stage I), 3.6% (stage III), 17.9% (stage IV) and that of symptomatic patients by stages were 38.2% (stage I), 16.5% (stage II), 24.8% (stage III), 19.1% (stage IV). In less than 40 years old, 50.5% of symptomatic patients were diagnosed as stage I. With increment of ages, proportions of stage I were markedly decreased. It was significantly different between proportion of early gastric cancer in asymptomatic patients (60.1%) and that in symptomatic patients (25.0%). CONCLUSIONS: We confirmed stage shift according to screening of stomach cancer. And proportion of early gastric cancer in asymptomatic patients was higher than that in symptomatic patients. This results suggest that screening of gastric cancer be important to reduce mortality and it be indirectly started from 40 years old.
Adult ; Humans ; Korea ; Mass Screening* ; Mortality ; Stomach Neoplasms* ; Stomach*

OBJECTIVEUsing the data on death for esophagus and stomach cancers in Linzhou cancer registration system, the mortality was described as well as the changing trend was analyzed.

METHODS18 240 death recorders for the both cancers during 1988 to 2003 were drawn from Linzhou cancer registration system. Of which, 10138 cases were esophageal cancer and 8102 cases were gastric cancer. Then data were stratified by sex, age, year and then linked to demographic classifications. The mortalities of two topographic site cancers were calculated and the age-adjusted rates were calculated by direct standardization to the world population. The Joinpoint model was used to get the estimated annual percent change (EAPC) of the age-adjusted rates, so to estimate the death rate change trends of both cancers in population of Linzhou city.

RESULTSIn 2003, the age-adjusted mortalities of esophageal cancer and gastric cancer were 68.47 per 100,000 and 57.01 per 100,000 respectively of Linzhou city. From 1988 to 2003 the death rates for both of cancers had showed the decline trends. The EAPC of the mortality for esophageal cancer was -3.82 (-4.81 - -2.82, P < 0.001) and that for gastric cancer was -2.95 (-4.16 - -1.73, P < 0.001) respectively.

CONCLUSIONThe declining trend in was observed the mortality of esophageal and gastric cancer in Linzhou by this study.

China ; epidemiology ; Esophageal Neoplasms ; mortality ; Female ; Humans ; Male ; Mortality ; trends ; Stomach Neoplasms ; mortality

Since the cancer has been the leading cause of deaths in Korea, estimation of the cancer deaths for the upcoming years in the population using the vital statistics is considered to be necessary. The aim of this study was to estimate the number and trends of cancer deaths in Korea. The expected numbers of cancer deaths were calculated by a time series model fitting the actual numbers of cancer deaths for each of the years 1983 through 2000 reported by Korea National Statistical Office. The options selected for the time series model included a quadratic time trend, which incorporated long-term information into the model and an autoregressive component which incorporated information about short-term fluctuations. The forecasting numbers of cancer deaths and their 95% confidence intervals were estimated for both genders and primary sites. The forecasting number of deaths from all cancers is increasing so that the cumulative number of expected cancer deaths between 2001 and 2005 would be about 309 thousand persons. Cancers of the lung, stomach, liver, and colorectum continue to be the most common causes of cancer deaths. While the numbers of expected cancer deaths in the stomach and liver show a decreasing trend, the cancer in the lung, colorectum, pancreas, breast, and oral cavity have an increasing trend. These observations indicate that cancer deaths in the near future would be increasing through the early 2000s, and there should be some urgent government's policy on the cancer management.
Colorectal Neoplasms/mortality ; Female ; Forecasting ; Humans ; Korea/epidemiology ; Liver Neoplasms/mortality ; Lung Neoplasms/mortality ; Male ; Models, Statistical ; Neoplasms/*mortality ; Stomach Neoplasms/mortality ; Time Factors

Cancer of the stomach is responsible for approximately 650,000 deaths globally each year and is probably second only to lung cancer worldwide as an overall cause of cancer-related mortality. Similar to the situation with most adenocarcinomas of the gastointestinal tract, carcinomas of the stomach can spread by local extension to adjacent normal structures and can develop lymphatic, peritoneal, and distant metastases. The tumor cells, can also permeate diffusely into the lymphatic plexus of the bowel, more often at the level of the upper duodenum hut sometimes down into the distal ileum and the large bowel. We report a case of lymphatic metastasis of gastric adenocarcinoma to the ampulla of Vater with review of the literature.
Adenocarcinoma* ; Ampulla of Vater* ; Duodenum ; Ileum ; Lung Neoplasms ; Lymphatic Metastasis* ; Mortality ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms

OBJECTIVECancer is one of the leading causes of death in China. The study aimed to examine the temporal trend of cancer mortality rate during 1989-2008 in urban and rural areas of China.

METHODSThe mortality data of all cancers from 1989 to 2008 from National Cancer Registry database were sorted and checked. Age standardized mortality rates were calculated by the direct methods using the China population of 1982 and World Segi's population. Joinpoint regression was performed to obtain the annual percentage changes (APC) in mortality rates. The top ten cancer sites were calculated and analyzed. The mortality rates were compared with statistics of the United States.

RESULTSFrom 1989 to 2008, the trend of crude cancer mortality increased with an annual percentage change (APC) of 1.0%. After age standardization, the mortality rate was significantly decreased, with an APC of -1.2%. In urban areas, lung cancer was the most common cancer of death, whereas in rural areas, stomach cancer and esophageal cancer remained top cancers of death. Especially, in both urban and rural areas, the mortality of lung cancer was on increase. The mortality rates of stomach and esophageal cancers showed a decrease in urban areas. Compared with the cancer mortality rates of the United States, the Chinese cancer mortality rate in males remained highest. The decreasing trend of cancer mortality in females of China was less obvious than that of the United States.

CONCLUSIONSThe crude mortality rates of cancer in China show an increase whereas the age standardized mortality raters has declined between 1989 and 2008. Cancer is still a major public health issue threatening people's life in China. Effective intervention for cancer control and prevention is needed in the future.

China ; epidemiology ; Esophageal Neoplasms ; mortality ; Female ; Humans ; Lung Neoplasms ; mortality ; Male ; Mortality ; trends ; Neoplasms ; mortality ; Registries ; Rural Population ; Sex Factors ; Stomach Neoplasms ; mortality ; United States ; epidemiology ; Urban Population

Gastric cancer is the most prevalent cancer in Korea and comprises the second cause of cancer death. Surgery only can provide chance of cure, but most locally advanced cancers recur after a curative resection, even though important advances in the surgical and nonsurgical treatments of gastric cancer have taken place. Preoperative chemotherapy theoretically can provide the advantages of reducing the bulk of tumor, which might improve the R0 resection rate, and of treating micrometastases early. Also, preoperative chemotherapy is expected to render unresectable tumors resectable without increasing postoperative morbidity and mortality. There are many new chemotherapeutic agents available for the treatment of advanced gastric cancer, but still the most effective agent, the optimal time and number of cycle for administration are still not known. The addition of postoperative chemotherapy through an intraperitoneal route and/or radiotherapy might affect the outcome of surgery favorably, but that hasn't been proved yet. A multicenter prospective randomized phase III trial should be performed to answer for those questions and to improve the curability of gastric cancer treatment.
Drug Therapy* ; Korea ; Mortality ; Neoplasm Micrometastasis ; Radiotherapy ; Stomach Neoplasms*