Necessity of splenectomy for antral-type scirrhous gastric cancer.

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-10-06 DOI:10.1016/j.ejso.2024.108734

Yurina Yasui Fujisaki, Takaki Yoshikawa, Rei Ogawa, Masashi Nishino, Takeyuki Wada, Tsutomu Hayashi, Yukinori Yamagata, Masanori Tokunaga, Yusuke Kinugasa, Yasuyuki Seto

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引用次数: 0

Abstract

Background: Total gastrectomy with splenic hilar nodal dissection by splenectomy is frequently selected for resectable scirrhous gastric cancer (GC), irrespective of the whether it is of the antral or body type. However, whether splenectomy is necessary for antral-type scirrhous GC remains unclear.

Methods: We retrospectively reviewed the data of patients treated at National Cancer Center Hospital in Japan between 2000 and 2018. We selected patients with type IV GC in which the predominant location could be identified, who received D2 or more total gastrectomy with splenectomy, and in whom R0 or R1 resection was achieved. The therapeutic value index was evaluated by multiplying the metastatic rate of each nodal station by the five-year overall survival (OS) rate of patients with metastasis to each node.

Results: In total, 180 patients were included in this study (antral type, n = 19 [10.6 %]; body type, n = 161 [89.4 %]). Both types showed similar and frequent invasion of the greater curvature of the upper stomach. Metastasis to the splenic hilar nodes (#10) was not observed in the antral type (0/19) but was observed in the body type (35/161, 21.7 %); the difference was statistically significant (p = 0.027). The therapeutic value index of #10 was 0 in the antral type but was >7, the fourth highest, in the body type. The only nodes with an index >0 in the antral type were #4d, #3, #4sb, #6, #7, and #1.

Conclusions: Splenectomy may therefore be unnecessary for antral-type scirrhous GC.

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前胃鳞癌脾切除术的必要性

背景：对于可切除的鳞状胃癌（GC），无论其为前胃型还是体型，通常都会选择全胃切除加脾门结节切除术。然而，对前区型淤血性胃癌是否有必要进行脾切除术仍不清楚：我们回顾性分析了 2000 年至 2018 年期间在日本国立癌症中心医院接受治疗的患者数据。我们选择了可以确定主要位置的 IV 型 GC 患者，这些患者接受了 D2 或以上的全胃切除术，同时进行了脾切除，并实现了 R0 或 R1 切除。将各结节站的转移率乘以各结节转移患者的五年总生存率（OS）来评估治疗价值指数：本研究共纳入180例患者（前体型，n = 19 [10.6%]；体型，n = 161 [89.4%]）。这两种类型的癌细胞都经常侵犯上胃大弯。在前胃型（0/19）中未观察到向脾门结节（#10）的转移，但在体型（35/161，21.7%）中观察到；差异有统计学意义（p = 0.027）。10 号的治疗价值指数在前列腺类型中为 0，但在身体类型中大于 7，为第四高。只有 4d、3 号、4sb、6 号、7 号和 1 号结节的治疗价值指数大于 0：结论：因此，对前区型淤血性 GC 可能不需要进行脾切除术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.