0 826

Cited 12 times in

Recursive partition analysis of peritoneal and systemic recurrence in patients with gastric cancer who underwent D2 gastrectomy: Implications for neoadjuvant therapy consideration

Authors
 Jee Suk Chang  ;  Kyung Hwan Kim  ;  Ki Chang Keum  ;  Sung Hoon Noh  ;  Joon Seok Lim  ;  Hyo Song Kim  ;  Sun Young Rha  ;  Yong Chan Lee  ;  Woo Jin Hyung  ;  Woong Sub Koom 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.114(7) : 859-864, 2016 
Journal Title
JOURNAL OF SURGICAL ONCOLOGY
ISSN
 0022-4790 
Issue Date
2016
MeSH
Adenocarcinoma/diagnosis ; Adenocarcinoma/prevention & control ; Adenocarcinoma/secondary* ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrectomy*/methods ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Peritoneal Neoplasms/diagnosis ; Peritoneal Neoplasms/prevention & control ; Peritoneal Neoplasms/secondary* ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Stomach Neoplasms/therapy
Keywords
gastrectomy ; gastric cancer ; recurrence ; recursive partition analysis ; survival
Abstract
BACKGROUND AND OBJECTIVES: To classify patients with nonmetastatic advanced gastric cancer who underwent D2-gastrectomy into prognostic groups based on peritoneal and systemic recurrence risks.

METHODS: Between 2004 and 2007, 1,090 patients with T3-4 or N+ gastric cancer were identified from our registry. Recurrence rates were estimated using a competing-risk analysis. Different prognostic groups were defined using recursive partitioning analysis (RPA).

RESULTS: Median follow-up was 7 years. In the RPA-model for peritoneal recurrence risk, the initial node was split by T stage, indicating that differences between patients with T1-3 and T4 cancer were the greatest. The 5-year peritoneal recurrence rates for patients with T4 (n?=?627) and T1-3 (n?=?463) disease were 34.3% and 9.1%, respectively. N stage and neural invasion had an additive impact on high-risk patients. The RPA model for systemic relapse incorporated N stage alone and gave two terminal nodes: N0-2 (n?=?721) and N3 (n?=?369). The 5-year cumulative incidences were 7.7% and 24.5%, respectively.

CONCLUSIONS: We proposed risk stratification models of peritoneal and systemic recurrence in patients undergoing D2-gastrectomy. This classification could be used for stratification protocols in future studies evaluating adjuvant therapies such as preoperative chemoradiotherapy.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.24405/abstract
DOI
10.1002/jso.24405
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Hyo Song(김효송) ORCID logo https://orcid.org/0000-0002-0625-9828
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152762
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links