Prognosis of distal diffuse gastric cancer depending on the extent of surgical procedure
- Authors: Torosyan R.O.1, Nered S.N.1,2, Kozlov N.A.1, Henian S.1, Kononets P.V.1, Stilidi I.S.1,3
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Affiliations:
- N.N. Blokhin National Medical Research Center of Oncology
- Russian Medical Academy of Continuous Professional Education
- N.I. Pirogov Russian National Research Medical University
- Issue: Vol 10, No 1 (2025)
- Pages: 56-62
- Section: Oncology and radiotherapy
- URL: https://journal-vniispk.ru/2500-1388/article/view/286966
- DOI: https://doi.org/10.35693/SIM643504
- ID: 286966
Cite item
Abstract
Aim – to study the clinical and morphological characteristics and conduct a comparative assessment of the survival of patients with locally advanced distal diffuse gastric cancer depending on the type of the surgical procedure.
Material and methods. We performed a retrospective review of the impact of the extent of surgery in the prognosis of 125 patients with diffuse gastric cancer of distal localization, who underwent total gastrectomy or distal subtotal gastrectomy at the N.N. Blokhin National Medical Research Center of Oncology in the period from 2005 to 2022.
Results. The depth of tumor invasion (T4), the lymph node status, and the tumor stage had a significant negative prognostic value in the univariate analysis. Resection margin (R1) tended to significantly affect the overall survival (p=0.082). The extent of the surgical procedure did not affect overall survival in the univariate analysis (p=0.75). The multivariate analysis revealed that only the tumor stage had a relative effect on the overall survival. In the distal gastrectomy group, the median overall survival and the 5-year OS rates were 85.0 months, 58.8% (95% CI: 0.487-0.711). In the total gastrectomy group, the median overall survival, 5-year OS rates were 89.0 months, 60.3% (95% CI: 0.460-0.791). However, the differences were statistically insignificant (p=0.75). In patients in the distal subtotal gastrectomy group, the recurrence was detected in 12.7% of all cases of recurrence (8/63): 6 of them with intramural recurrence and 2 of them with intramural and distant recurrence of the disease. In patients in the total gastrectomy group, intramural recurrence was found only in one patient (4.8%) in the esophago-enteroanastomosis.
Conclusions. Overall survival and relapse-free survival rates in patients with diffuse cancer of distal localization after total and distal subtotal gastrectomy do not have significant differences. However, distal subtotal gastrectomy in this category of patients is associated with a higher risk of local recurrence (12.7%) and can not be recommended as an alternative to total gastrectomy in patients with satisfactory functional status.
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##article.viewOnOriginalSite##About the authors
Rafael O. Torosyan
N.N. Blokhin National Medical Research Center of Oncology
Author for correspondence.
Email: rf.torosyan97@gmail.com
ORCID iD: 0009-0003-9711-5620
MD, oncologist, postgraduate student
Russian Federation, MoscowSergei N. Nered
N.N. Blokhin National Medical Research Center of Oncology; Russian Medical Academy of Continuous Professional Education
Email: nered@mail.ru
ORCID iD: 0000-0002-5403-2396
MD, Dr. Sci. (Medicine), Senior Research Scientist
Russian Federation, Moscow; MoscowNikolai A. Kozlov
N.N. Blokhin National Medical Research Center of Oncology
Email: newbox13@mail.ru
ORCID iD: 0000-0003-3852-3969
MD, Cand. Sci. (Medicine), pathologist
Russian Federation, MoscowSun Henian
N.N. Blokhin National Medical Research Center of Oncology
Email: sunalaric@gmail.com
ORCID iD: 0000-0001-5574-0047
MD, oncologist
Russian Federation, MoscowPavel V. Kononets
N.N. Blokhin National Medical Research Center of Oncology
Email: pvkononet@bk.ru
ORCID iD: 0000-0003-4744-6141
MD, Dr. Sci. (Medicine), Associate Professor, Director of the N.N. Trapeznikov Research Institute of Clinical Oncology, Head of the Thoracic Oncology Department, Head of the Abdominal Oncology Department No. 1
Russian Federation, MoscowIvan S. Stilidi
N.N. Blokhin National Medical Research Center of Oncology; N.I. Pirogov Russian National Research Medical University
Email: biochimia@yandex.ru
ORCID iD: 0000-0002-0493-1166
Academician of the Russian Academy of Sciences, Professor, MD, Dr. Sci. (Medicine), Director
Russian Federation, Moscow; MoscowReferences
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