This journal is
indexed in Scopus
Year 2016 Vol. 24 No 3
A.V. PROCHOROV1, I.N. LABUNETS1, M.N. SHAPETSKA1, V.Y. MAVRICHEV2, A.S. MATYLEVICH1
THE LONG-TERM RESULTS OF SURGICAL TREATMENT OF GASTROESOPHAGEAL CANCER
EE "Belorusian State Medical University"1,
ME "Minsk City Clinical Oncology Dispansery"2,
The Republic of Belarus
Objectives. To study the long-term results of surgical treatment of gastroesophageal cancer in the dependent on the main prognostic factors of the disease, tumor resectability and extent of lymph node dissection.
Methods. The analysis of surgical treatment results was carried out in 329 patients with gastroesophageal cancer who underwent transpleural resection of the stomach and esophagus: gastrectomy with the resection of the lower third of the esophagus by Garlock (n=155); proximal resection of the stomach with the lower third of the esophagus by Garlock (n=96); proximal resection of the stomach with subtotal resection of the esophagus by Lewis (n=78).
Results. Postoperative mortality composed 5,2%: after gastrectomy by Garlock – 3,9%, after proximal gastrectomy by Garlock – 5,2%, after Lewis’s surgery – 7,7%. Overall five-year survival rate was 26.2%. 43.6% of patients without metastatic lymph nodes and 18,4% with nodal metastases had survived this period of observation. Survival of patients didn’t depend of the number of metastatic lymph nodes (N1, N2, N3). Five-year survival after radical resection of the stomach and the esophagus amounted 29,1%, after palliative – 9,4%. After the combined surgeries with the resection of adjacent organs in comparison with those after conventional surgery. After a combiened operations with resection of adjacent organs compared with those afte conventional surgery the survived 5 years (12,5% and 31,3%), respectively. The analysis of treatment results in patients depending on the morphological type of the gastroesophageal tumor didn’t reveal statistically reliable differences in the patients’ survival.
Conclusion. The survival rate of patients after surgical treatment of gastroesophageal cancer remains low. The prognosis depends mainly on the extent of the tumor process. Survival of patients without nodal metastases (all types of operations) is two-fold higher than in those with the regional lymphogenous metastasis. The number of affected groups of lymph nodes doesn’t influence the overall and recurrence-free survival rate. The combined and palliative resections can provide the 5-year relative survival rate only at the level of 10-15%.
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220116, Republic of Belarus,
Minsk, pr. Dzerzhinskogo, d. 83,
UO "Belorusskiy gosudarstvennyiy meditsinskiy universitet",
tel. office: 375172902971,
Prochorov Aleksandr Viktorovich
Prochorov A.V. MD, professor, a head of the oncology chair of EE "Belarusian State Medical University".
Labunets I.N. PhD, an associate professor of the oncology chair of EE "Belarusian State Medical University".
Shapetska M.N. PhD, an associate professor of the oncology chair of EE "Belarusian State Medical University".
Mavrichev V.Y. A head of the oncology-surgical unit ¹4 of ME "Minsk City Clinical Oncology Dispensary".
Matylevich A.S. A 5-year student of the medical faculty of EE "Belarusian State Medical University".