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The impact of the extent of surgical resection on survival of gastric cancer patients

Authors Angelov K, Vasileva M, Grozdev K, Toshev S, Sokolov M, Todorov G

Received 6 October 2015

Accepted for publication 8 April 2016

Published 28 July 2016 Volume 2016:9 Pages 4687—4694

DOI https://doi.org/10.2147/OTT.S97699

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Professor Min Li


Kostadin Georgiev Angelov, Mariela Borisova Vasileva, Konstantin Savov Grozdev, Svetoslav Yordanov Toshev, Manol Bonev Sokolov, Georgi Todorov Todorov

Department of Surgery, Medical University of Sofia, Aleksandrovska University Hospital, Sofia, Bulgaria


Objective: The aim of this study was to examine the significance of the extent of gastric resection on the postoperative and overall gastric cancer survival.
Background: Resection with clean margins (4 cm or more) is widely accepted as the standard­ized goal for radical treatment of gastric cancer according to current guidelines, while the type of resection (subtotal or total) is still a matter of debate.
Patients and methods: The study included 155 patients diagnosed and treated in the Department of Surgery, Aleksandrovska University Hospital between January 2005 and December 2014. In order to determine the significance of the resection volume, we excluded from the study 54 patients receiving palliative intervention or staging exploratory laparoscopy. The remaining 101 patients were divided into two groups based on the volume of the performed gastric resection (total and subtotal) and compared based on overall survival and perioperative mortality. We also investigated the 3-year survival in the two groups as well as the overall survival only in the subgroup of patients with D2 lymphadenectomy.
Results: We could not determine any statistically significant difference in overall survival and 3-year survival (P=0.990) based on the extent of surgical resection (P=0.824) or perioperative mortality. The statistical analysis on patients with D2 lymph node dissection only did not show significance for overall survival.
Conclusion: Our study shows no difference in safety and long-term survival rate of patients with gastric carcinoma based on the volume of stomach resection. Comparison with other studies also shows no difference in survival based on volume of the resection.

Keywords: gastric cancer, perioperative mortality, overall survival

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