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  • 1
    Electronic Resource
    Electronic Resource
    The risk of second malignancy after adjuvant chemotherapy for stomach cancer (1999)
    Springer
    Gastric cancer 2 (1999), S. 206-209 
    Details
    ISSN: 1436-3305
    Keywords: Key words: second malignancy, adjuvant chemotherapy, stomach cancer, 5-fluorouracil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Background. Although many trials have been conducted to evaluate the feasibility and effectiveness of adjuvant chemotherapy (ACT) for patients with stomach cancer, the benefits of ACT remain unclear. Moreover, some authors have reported that ACT increased the incidence of second malignancy. The risk of second malignancy was evaluated in patients who underwent treatment for stomach cancer in the past 20 years at Osaka Medical Center for Cancer and Cardiovascular Diseases. Methods. The study population consisted of 1925 patients who underwent gastrectomies for stomach cancer between the years 1978 and 1992 and who received follow-up examinations to check for second malignancies. They included 1114 patients who underwent surgery only (group A) and 811 who underwent surgery and received chemotherapy (group B). The observed incidence of second malignancy (O) was compared with the expected incidence (E), calculated by the person-year method, using data from the Cancer Registry in Osaka. Results. The average follow-up period was 7.99 years. The total number of patients with a second malignancy was 127 (men, 97; women, 30); 72 patients had the second malignancy in digestive organs; 27 in respiratory organs; and 28 in other organs. The relative risks of a second malignancy in group A and B patients were 1.05 and 1.02 (differences between the two groups were not significant). The relative risks of a second malignancy in patients who received ACT with 5-fluorouracil, Tegafur and Uracil, and FT207 were 0.79, 1.01, and 1.06, respectively (differences between the groups were not significant). Conclusion. The risk of second malignancy after chemotherapy for stomach cancer was not high in comparison with the expected incidence. Adjuvant chemotherapy did not increase the risk of a second malignancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s101200050064
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  • 2
    Electronic Resource
    Electronic Resource
    Indications for hepatectomy for hepatocellular carcinoma — What stage of the disease is the best indication for surgery? (1998)
    Springer
    Journal of hepato-biliary-pancreatic surgery 5 (1998), S. 14-17 
    Details
    ISSN: 1436-0691
    Keywords: Key words: indications for hepatectomy for hepatocellular carcinoma ; hepatic resection ; TAE ; PEI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: To determine the clinical and tumor stage of hepatocellular carcinoma (HCC) that is the best indication for surgery, the postoperative long-term outcomes of patients who underwent hepatic resection were examined retrospectively. Of 975 patients with HCC who underwent regional therapy, 384 patients (39%) received hepatic resection (HR), 534 (55%) had transcatheter arterial chemoembolization (TACE), and the remaining 57 (6%) received percutaneous ethanol injection (PEI) into the tumor. The criteria defined by liver Cancer Study Group of Japan was used for staging and liver functional reserve (i.e., clinical staging).1 In the 133 patients with stage I HCC, there were no significant differences among the survivals of the HR, TACE, and PEI groups. In the 314 patients with stage II HCC, the 5- and 7-year survival rates were 51% and 46% in the HR group, 23% and 10% in the TACE group, and 0% and 0% in the PEI group. The survival of the HR group was significantly better than the survivals of the TACE and PEI groups (P 〈 0.001). The 5- and 10-year survivals of the stage II HCC patients who had HR were 64% and 47% in the clinical stage I (i.e., good liver function) group, significantly better than the 5; and 10-year survivals (32% and 23%) in the clinical stage II (i.e., bad liver function) group (P 〈 0.0001). Patients with good liver function in stage II are expected to have better survival and are considered to be the most suitable for HR.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00009944
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  • 3
    Electronic Resource
    Electronic Resource
    Clinical significance of disordered beta-catenin expression pattern in human gastric cancers (2000)
    Springer
    Gastric cancer 3 (2000), S. 193-201 
    Details
    ISSN: 1436-3305
    Keywords: Key words Gastric cancer ; Beta-catenin ; E-cadherin ; Immunohistochemistry ; Western blot
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Background. Beta-catenin plays two distinct roles, in intercellular adhesion by E-cadherin, and in transcriptional activation via TCF/LEF. Theoretically, the former role is tumor-suppressive, while the latter is oncogenic. We investigated the involvement of beta-catenin in the histogenesis and clinical outcome of gastric cancers. Methods. The expression pattern of beta-catenin was evaluated in stomach and lymph nodes from 82 patients with gastric cancer by immunohistochemistry and Western blot. Its association with E-cadherin expression and clinicopathological factors, including histological type and postoperative survival, was examined. Results. Beta-catenin expression was classified into two patterns, normal (23.2%; 19 patients) and disordered (76.8%; 63 patients), the latter being subclassified as overexpressed (7.3%; 6 patients) and reduced (69.5%; 57 patients). A disordered beta-catenin expression pattern was significantly correlated with diffuse type adenocarcinoma and deep tumor infiltration (P = 0.0154), but was not associated with lymph node metastasis (P = 0.7877). E-cadherin was always expressed at the cell membrane, and disordered beta-catenin expression was significantly associated with reduced E-cadherin expression (P 〈 0.0001). On univariate analysis, the beta-catenin pattern, as well as depth of invasion and lymph node metastasis, was associated with postoperative prognosis; however, only lymph node metastasis was an independent prognostic factor on multivariate analysis. Interestingly, different disordered patterns of beta-catenin expression, both overexpressed and reduced, were associated with E-cadherin reduction and poorer postoperative survival. Conclusion. Although disordered patterns of beta-catenin expression varied in gastric cancers, they were consistently associated with cancer progression.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011717
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  • 4
    Electronic Resource
    Electronic Resource
    Phase II Study of Limited Surgery for Early Gastric Cancer: Segmental Gastric Resection (1999)
    Springer
    Annals of surgical oncology 6 (1999), S. 166-170 
    Details
    ISSN: 1534-4681
    Keywords: Early gastric cancer ; Limited operation ; Nerve preservation ; Segmental resection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Endoscopic resection for treatment of early gastric cancer (EGC) is widely performed. Recently, however, surgeons began performing a limited operation for EGC when endoscopic resection was not indicated. This report discusses the surgical technique and the results of the limited operation, which is generally referred to as “segmental resection” (SR). Methods: Since 1990, a total of 50 patients with intramucosal invasive EGC of the middle stomach underwent SR. The procedure included a limited gastrectomy, limited lymph node dissection, and preservation of the vagal nerve. We examined the surgical risk, postoperative complications, and patient survival rates and compared the results for the SR-treated patients (group A) with results for patients with EGC who underwent subtotal gastrectomy and systemic lymph node dissection (group B). Results: Blood loss was less in group A (239±180 ml) than in group B (342±176 ml) (P〈.05). The incidence of postoperative complications was also lower in group A (2.0%) than in group B (14.0%) (P〈.05). The incidence of postoperative cholelithiasis was lower in group A (4.0%) than in group B (18.0%) (P〈.05). All patients in both groups are alive without recurrence. Conclusions: Compared with distal gastrectomy, SR for EGC of the middle stomach decreased the surgical risk and postoperative complications without increasing the recurrence rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s10434-999-0166-5
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  • 5
    Electronic Resource
    Electronic Resource
    Extended surgery—Left upper abdominal exenteration plus Appleby's method—For type 4 gastric carcinoma (1997)
    Springer
    Annals of surgical oncology 4 (1997), S. 209-214 
    Details
    ISSN: 1534-4681
    Keywords: Scirrhous gastric cancer ; Extended surgery ; Left upper abdominal exenteration ; Appleby's method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The prognosis after surgical treatment for type 4 gastric cancer, including linitis plastica, remains poor. The most frequent recurrence mode is retroperitoneal involvement. To remove the tumor and microinvasion surrounding the stomach, extended surgery, left upper abdominal exenteration plus the Appleby's method (LUAE + Apl), has been performed for type 4 cancers since 1983. Patients and Methods: A total of 54 patients with type 4 cancer underwent extended surgery (LUAE + Apl) over the past 11 years. In the LUAE + Apl surgical procedure, the whole stomach, pancreas body and tail, spleen, gallbladder, transverse colon, and left adrenal were removed en bloc. The results of this treatment are reported and the most beneficial application of this procedure (group A) is evaluated and compared with findings in similar patients who underwent common surgery between 1973 and 1983 (group B). Results: As postoperative complications, pancreatic fistula (30%; control 19%), liver dysfunction (15%; 14%), anastomosis failure (6%; 9%), and infection (4%; 1%) were observed (NS). In group A, one patient died of liver dysfunction and another of multiple organ failure due to major pancreatic fistula. In stage III, the 5-year survival rate of group A (40%) was better than that of group B (20%; p〈0.05). In stage IV, the 5-year survival rate of group A (5%; 3% in group B) was not improved. Conclusion: LUAE + Apl improved the survival of patients with scirrhous cancer in stage III, but it was not effective for those in stage IV. To improve the survival of patients in stage IV, a new concept of treatment and supportive therapy needs to be used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02306612
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  • 6
    Electronic Resource
    Electronic Resource
    Limited surgery for early gastric cancer in cardia (1998)
    Springer
    Annals of surgical oncology 5 (1998), S. 338-341 
    Details
    ISSN: 1534-4681
    Keywords: Early gastric cancer ; Cardia cancer ; Limited operation ; Fundectomy ; Total gastrectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Because there are some difficulties with the diagnosis of invasion or the endoscopic resection technique, almost all gastric tumors are resected surgically. Surgeons now are performing a limited operation for early gastric cancer of the upper stomach (EGCUS) without lymph node metastasis. This paper discusses and evaluates the surgical technique and the results of the limited operation for EGCUS. Patients and Methods: Since 1988, a total of 34 patients with EGCUS, diagnosed as intramucosal invasion, have undergone a limited operation—fundectomy—which includes a limited proximal gastrectomy, a limited lymph node dissection, and a procedure preserving the vagal nerve. The surgical risk, postoperative complications, and survival rates of the fundectomy patients (group A) were compared with those of patients undergoing a total gastrectomy for EGCUS (group B). Results: Blood loss was lower in group A (300±193 mL) than in group B (555±316 mL) (P〈.05). The incidence of postoperative pancreatic fistula also was lower in group A (0%) than in group B (15.0%) (P〈.05). All patients in both groups (except one who died of a cerebral infarction) are alive without recurrence. Conclusion: Compared to the results of a total gastrectomy, performance of a limited fundectomy for EGCUS decreased surgical risk and postoperative complications without decreasing the survival rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02303497
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