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rdf:type |
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lifeskim:mentions |
umls-concept:C0008902,
umls-concept:C0016441,
umls-concept:C0023981,
umls-concept:C0024623,
umls-concept:C0030705,
umls-concept:C0034378,
umls-concept:C0035647,
umls-concept:C0036760,
umls-concept:C0205231,
umls-concept:C0332306,
umls-concept:C0449295,
umls-concept:C0543467,
umls-concept:C0681842,
umls-concept:C0920420,
umls-concept:C1274040,
umls-concept:C1521733,
umls-concept:C1705493
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pubmed:issue |
12
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pubmed:dateCreated |
2001-6-12
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pubmed:abstractText |
UICC classification accurately predicts overall survival but not recurrence-risk. We report here data of overall and first site-specific recurrence following curative surgery useful for the development of recurrence-oriented preventive target therapies. Patients who underwent resection for gastric cancer were stratified according to curability of surgery [curative (R0) vs non-curative resection], extent of surgery [limited (D1) vs extended (D2) node dissection] and pathological nodal/serosal status. The intent-to-treat principle, log-rank test and Cox regression analysis were used for statistical analysis of time-to-event (recurrence, death) endpoints. Curative resection only produced a chance of cure whereas survival was very poor following non-curative resection (P < 0.0001). For D2 R0 subgroup of patients, a pathological serosa and a node state-based classification into three groups, proved to be of clinical implication. Risk of recurrence after a median follow-up of 92 months was low among patients with both serosa and node-negative cancer (first group; 11%), moderate among those with either serosa or node-positive cancer (second group; 53%) and very high among those with both serosa and node-positive cancer (third group; 83%). In multivariate analysis, the relative risks of recurrence and death from gastric cancer among patients in the second and third groups, as compared to those in the first, were 7.07 (95% CI, 2.36-21.17; P = 0.0002) and 16.19 (95% CI, 5.76-45.54; P < 0.0001) respectively. First site-specific recurrence analysis revealed: low rate of loco-regional recurrence alone (12%), serosa state determinant factor of the site-recurrence (peritoneal for serosa-positive and haematogenous for serosa-negative cancers) and dramatic increase of all types of recurrence by the presence of nodal metastases. Our findings demonstrate that a pathological serosa- and node-based classification is very simple and predicts accurately site-specific recurrence-risks. Furthermore they reveal that risk of recurrence following curative D2 surgery alone is low for serosa- and node-negative cancers, but very high in serosa- and node-positive cancers suggesting the need for new therapeutic strategies in this subgroup of patients.
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pubmed:commentsCorrections |
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10089184,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10089191,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10188901,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10440302,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10684910,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10718807,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10818606,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10819363,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-10913380,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-11129418,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-2370254,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-3630186,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-7799019,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-8239772,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-8336183,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-8696727,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-9591011,
http://linkedlifedata.com/resource/pubmed/commentcorrection/11401312-9790335
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:month |
Jun
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pubmed:issn |
0007-0920
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pubmed:author |
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pubmed:copyrightInfo |
Copyright 2001 Cancer Research Campaign.
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pubmed:issnType |
Print
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pubmed:day |
15
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pubmed:volume |
84
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1602-9
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pubmed:dateRevised |
2010-9-14
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pubmed:meshHeading |
pubmed-meshheading:11401312-Adult,
pubmed-meshheading:11401312-Aged,
pubmed-meshheading:11401312-Aged, 80 and over,
pubmed-meshheading:11401312-Female,
pubmed-meshheading:11401312-Follow-Up Studies,
pubmed-meshheading:11401312-Gastrectomy,
pubmed-meshheading:11401312-Humans,
pubmed-meshheading:11401312-Lymph Nodes,
pubmed-meshheading:11401312-Lymphatic Metastasis,
pubmed-meshheading:11401312-Male,
pubmed-meshheading:11401312-Middle Aged,
pubmed-meshheading:11401312-Neoplasm Invasiveness,
pubmed-meshheading:11401312-Neoplasm Recurrence, Local,
pubmed-meshheading:11401312-Neoplasm Staging,
pubmed-meshheading:11401312-Predictive Value of Tests,
pubmed-meshheading:11401312-Prognosis,
pubmed-meshheading:11401312-Prospective Studies,
pubmed-meshheading:11401312-Risk Assessment,
pubmed-meshheading:11401312-Sensitivity and Specificity,
pubmed-meshheading:11401312-Stomach Neoplasms,
pubmed-meshheading:11401312-Treatment Outcome
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pubmed:year |
2001
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pubmed:articleTitle |
Pathological serosa and node-based classification accurately predicts gastric cancer recurrence risk and outcome, and determines potential and limitation of a Japanese-style extensive surgery for Western patients: a prospective with quality control 10-year follow-up study.
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pubmed:affiliation |
Department of General and Vascular Surgery, Frankfurt Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
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pubmed:publicationType |
Journal Article,
Evaluation Studies
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