Long-Term Outcomes of the Treatment for Gastric Tube Cancer After Esophagectomy for Esophageal Cancer.

IF 1.1 4区 医学 Q3 SURGERY
Junya Kitadani, Keiji Hayata, Taro Goda, Akihiro Takeuchi, Shinta Tominaga, Naoki Fukuda, Tomoki Nakai, Shotaro Nagano, Toshiyasu Ojima, Manabu Kawai
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引用次数: 0

Abstract

Background: The long-term outcomes of gastric tube cancer (GTC) are unclear. This study therefore aimed to clarify clinicopathologic features and the long-term outcomes of patients with GTC.

Methods: The 25 patients who were diagnosed with GTC between April 2003 and December 2022 at our hospital were eligible for inclusion in this retrospective study, and this included 27 lesions. We retrospectively evaluated clinicopathologic factors based on hospital records.

Results: In our cohort, 88% of incidences of GTC were located in the middle or lower gastric tube. As the treatment of GTC, we used endoscopic submucosal dissection, gastrectomy, chemoradiotherapy, chemotherapy, and best supportive care for 16 (59%), 6 (22%), 1 (4%), 1 (4%), and 3 (11%) lesions, respectively. Perforation after endoscopic submucosal dissection was observed in 6 of the 16 lesions. Partial gastric tube resection was performed for 3 patients and total gastric tube resection was performed for 3 patients. One patient who underwent total gastric tube resection died due to acute respiratory distress syndrome. In survival analysis, the 3-year overall survival rate was 52% and the 3-year disease-specific survival rate was 74%. Five patients (20%) died of aspiration pneumonia, 2 patients (8%) of another disease, and 1 patient (4%) of another type of cancer. According to multivariate analysis, independent prognostic factors for overall survival were cN status (HR, 18.021; P =0.004) and complication of aspiration pneumonia (HR, 8.373; P =0.004).

Conclusions: The occurrence of aspiration pneumonia and cN status were prognostic factors after the treatment for GTC. Assessment of dysphagia and surveillance after treatment for GTC are important to improve the prognosis.

食管癌食管切除术后胃管癌变的长期治疗效果。
背景:胃管癌(GTC)的长期预后尚不明确。因此,本研究旨在明确胃管癌患者的临床病理特征和长期预后:方法:2003 年 4 月至 2022 年 12 月期间在我院确诊为 GTC 的 25 例患者符合纳入本回顾性研究的条件,其中包括 27 例病变。我们根据医院病历对临床病理因素进行了回顾性评估:在我们的队列中,88%的 GTC 病例位于胃中管或胃下管。作为 GTC 的治疗方法,我们分别对 16 例(59%)、6 例(22%)、1 例(4%)、1 例(4%)和 3 例(11%)病变采用了内镜粘膜下剥离术、胃切除术、化放疗、化疗和最佳支持治疗。16 例病变中有 6 例在内镜粘膜下剥离术后出现穿孔。3 名患者接受了部分胃管切除术,3 名患者接受了全胃管切除术。一名接受全胃管切除术的患者因急性呼吸窘迫综合征而死亡。在生存率分析中,3 年总生存率为 52%,3 年疾病特异性生存率为 74%。5名患者(20%)死于吸入性肺炎,2名患者(8%)死于其他疾病,1名患者(4%)死于其他类型的癌症。根据多变量分析,总生存率的独立预后因素为 cN 状态(HR,18.021;P=0.004)和吸入性肺炎并发症(HR,8.373;P=0.004):结论:吸入性肺炎的发生和 cN 状态是 GTC 治疗后的预后因素。结论:发生吸入性肺炎和 cN 状态是 GTC 治疗后的预后因素,GTC 治疗后的吞咽困难评估和监测对改善预后非常重要。
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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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