Improved Survival after Implementation of Multidisciplinary Team Meetings, Perioperative Chemotherapy, Extended Lymphnode Dissection and Laparoscopic Surgery in the Treatment of Advanced Gastric Cancer

• 作者: Arne Borthne Dejan Ignjatovic Jonn Terje Geitung Katrin Fridrich Lars Lohne Eftang Odd Langbach Ola R?kke Robin Gaupset Sutharsan Suntharalingam
• 来源期刊: 癌症治疗(英文)
• 学科: 医学
• 关键词: Gastric Cancer CHEMOTHERAPY LAPAROSCOPY SURVIVAL D2 LYMPHADENECTOMY
• 年，卷（期）: 2018,（2）
• 页码范围: 106-117
• 页数: 12页
• 分类号: R73

摘要

Aims: The treatment of gastric cancer has changed in the western countries during the last decade. This includes multidisciplinary team (MDT) meetings, perioperative chemotherapy, extended lymph node dissection, and laparoscopic surgery, all of which were gradually implemented at our department from 2008. The aim of the present study was to determine the effect of these changes on morbidity and survival. Material and Methods: 185 patients with gastric cancer were operated with curative intent from 2000 until 2016 in this retrospective, observational, follow-up study;83 before implementation of modern principles in 2008 (period 1) and 102 were treated after 2008 (period 2). Results: The resection rate (94% vs 92.8%) and mortality rates (4.8% vs 2.9%) did not differ between the two periods. In period 2, 48 patients (47.1%), received neoadjuvant chemotherapy. In 36 patients (35.3%), laparoscopic surgery with D2 lymphadenectomy was performed. There was a significantly higher yield in the number of lymph nodes in period 2 compared to period 1 (14 vs 8, p pparent between laparoscopic and open surgery in the second period (32 vs 10, p The five-year survival rate was significantly improved after the change in treatment principles with an estimated improvement from 30% to 40% between the periods (p = 0.033). Conclusion: The combined effect of MDT meetings, neoadjuvant chemotherapy, extended lymphnode dissection and laparoscopy has improved the prognosis of gastric cancer patients.