Treatment results of curative gastric resection from a specialist Australian unit: Low volume with satisfactory outcomes

Thomson I.G., Gotley D.C., Barbour A.P., Martin I., Jayasuria N., Thomas J. and Smithers B.M. (2014) Treatment results of curative gastric resection from a specialist Australian unit: Low volume with satisfactory outcomes. Gastric Cancer, 17 1: 152-160. doi:10.1007/s10120-013-0240-3


Author Thomson I.G.
Gotley D.C.
Barbour A.P.
Martin I.
Jayasuria N.
Thomas J.
Smithers B.M.
Title Treatment results of curative gastric resection from a specialist Australian unit: Low volume with satisfactory outcomes
Journal name Gastric Cancer   Check publisher's open access policy
ISSN 1436-3291
1436-3305
Publication date 2014-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.1007/s10120-013-0240-3
Open Access Status Not yet assessed
Volume 17
Issue 1
Start page 152
End page 160
Total pages 9
Place of publication Tokyo, Japan
Publisher Springer Japan KK
Language eng
Subject 2730 Oncology
2715 Gastroenterology
1306 Cancer Research
Abstract The incidence of gastric cancer is decreasing in Australia, yet it remains a common cause of cancer-related mortality. Surgical resection remains the cornerstone of curative treatment. High-volume specialized units have reported superior perioperative and oncological outcomes. The role of D2 lymphadenectomy has been controversial as a result of concerns over increased morbidity. Our aim is to report the perioperative and oncological outcomes of curative gastric resection from a specialist Australian upper GI unit.
Formatted abstract
Background:
The incidence of gastric cancer is decreasing in Australia, yet it remains a common cause of cancer-related mortality. Surgical resection remains the cornerstone of curative treatment. High-volume specialized units have reported superior perioperative and oncological outcomes. The role of D2 lymphadenectomy has been controversial as a result of concerns over increased morbidity. Our aim is to report the perioperative and oncological outcomes of curative gastric resection from a specialist Australian upper GI unit.
Methods: Data from a prospectively maintained database were reviewed for all patients undergoing curative resection for gastric adenocarcinoma from a single unit during a 12-year period. Perioperative and long-term outcomes were compiled.
Results: There were 255 curative gastric resections during 12 years. An R0 resection was performed in 96 % with a perioperative mortality rate of 1.6 %. A D2 dissection was performed in 85 % of cases in the past 6 years, with no increase in perioperative morbidity or mortality detected. The 5-year overall survival was 53 %.
Conclusion: Our results demonstrate that both short- and long-term outcomes of surgical resection in gastric cancer patients, comparable to international high-volume centers, can be achieved in an Australian upper GI unit. A D2 lymph node dissection can be performed safely without any increase in perioperative risk in a specialist unit that has the necessary training but also the perioperative support structures to manage these complex patients.
Keyword Gastrectomy
Gastric cancer
Surgical volume
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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