Outcome of distal gastric cancer with pyloric stenosis after curative resection

J. H. Chen, C. W. Wu, S. S. Lo, A. F.Y. Li, Mao-Chih Hsieh, K. H. Shen, W. Y. Lui

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims: Pyloric stenosis usually presents with symptoms, and this may lead patients to consult their physician. We evaluate whether distal gastric cancer patients with pyloric stenosis had a better outcome than those without. Methods: A total of 551 distal gastric cancer patients who received curative subtotal gastrectomy between January 1988 and December 2003 at Taipei Veterans General Hospital were analyzed. Among them, 174 patients were sorted into the pyloric stenosis group according to obstructive symptoms. Their clinicopathological features, survival and prognostic factors were evaluated. Results: The 5-year overall and disease-free survival rate of distal third gastric adenocarcinoma for the pyloric stenosis group was significantly lower than those without pyloric stenosis. Multivariate analysis revealed the pyloric stenosis group had deeper cancer invasion (relative to pT1, RR of pT2 3.1, p = 0.009; pT3 6.1, p < 0.001; pT4 16.5, p < 0.001), and more lymph node metastasis (RR 3.6; p = 0.001). The pyloric stenosis group had a tendency to lymph node metastasis toward the hepatoduodenal ligament, but this did not reach statistical difference. However, the pyloric stenosis group had significantly higher lymph node metastasis in the retropancreatic region (5.17% vs. 0.53%; p = 0.001). Conclusions: Distal gastric cancers with pyloric stenosis have worse biological behavior than those without, and consequently have a poor outcome.

Original languageEnglish
Pages (from-to)556-560
Number of pages5
JournalEuropean Journal of Surgical Oncology
Volume33
Issue number5
DOIs
Publication statusPublished - Jun 1 2007
Externally publishedYes

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Pyloric Stenosis
Stomach Neoplasms
Lymph Nodes
Neoplasm Metastasis
Veterans Hospitals
Gastrectomy
Ligaments
General Hospitals
Disease-Free Survival
Stomach
Adenocarcinoma
Multivariate Analysis
Survival Rate
Physicians

Keywords

  • Curative resection
  • Distal third gastric cancer
  • Pyloric stenosis

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Outcome of distal gastric cancer with pyloric stenosis after curative resection. / Chen, J. H.; Wu, C. W.; Lo, S. S.; Li, A. F.Y.; Hsieh, Mao-Chih; Shen, K. H.; Lui, W. Y.

In: European Journal of Surgical Oncology, Vol. 33, No. 5, 01.06.2007, p. 556-560.

Research output: Contribution to journalArticle

Chen, J. H. ; Wu, C. W. ; Lo, S. S. ; Li, A. F.Y. ; Hsieh, Mao-Chih ; Shen, K. H. ; Lui, W. Y. / Outcome of distal gastric cancer with pyloric stenosis after curative resection. In: European Journal of Surgical Oncology. 2007 ; Vol. 33, No. 5. pp. 556-560.
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AB - Aims: Pyloric stenosis usually presents with symptoms, and this may lead patients to consult their physician. We evaluate whether distal gastric cancer patients with pyloric stenosis had a better outcome than those without. Methods: A total of 551 distal gastric cancer patients who received curative subtotal gastrectomy between January 1988 and December 2003 at Taipei Veterans General Hospital were analyzed. Among them, 174 patients were sorted into the pyloric stenosis group according to obstructive symptoms. Their clinicopathological features, survival and prognostic factors were evaluated. Results: The 5-year overall and disease-free survival rate of distal third gastric adenocarcinoma for the pyloric stenosis group was significantly lower than those without pyloric stenosis. Multivariate analysis revealed the pyloric stenosis group had deeper cancer invasion (relative to pT1, RR of pT2 3.1, p = 0.009; pT3 6.1, p < 0.001; pT4 16.5, p < 0.001), and more lymph node metastasis (RR 3.6; p = 0.001). The pyloric stenosis group had a tendency to lymph node metastasis toward the hepatoduodenal ligament, but this did not reach statistical difference. However, the pyloric stenosis group had significantly higher lymph node metastasis in the retropancreatic region (5.17% vs. 0.53%; p = 0.001). Conclusions: Distal gastric cancers with pyloric stenosis have worse biological behavior than those without, and consequently have a poor outcome.

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