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dc.contributor.authorDudeja, Vikas
dc.contributor.authorHabermann, Elizabeth B.
dc.contributor.authorAbraham, Anasooya
dc.contributor.authorZhong, Wei
dc.contributor.authorParsons, Helen M.
dc.contributor.authorTseng, Jennifer F.
dc.contributor.authorAl-Refaie, Waddah B.
dc.date2022-08-11T08:10:58.000
dc.date.accessioned2022-08-23T17:26:40Z
dc.date.available2022-08-23T17:26:40Z
dc.date.issued2012-02-01
dc.date.submitted2012-09-19
dc.identifier.citation<p>J Gastrointest Surg. 2012 Feb;16(2):238-46; discussion 246-7. Epub 2011 Nov 17. <a href="http://dx.doi.org/10.1007/s11605-011-1756-7" target="_blank">Link to article on publisher's site</a></p>
dc.identifier.issn1091-255X (Linking)
dc.identifier.doi10.1007/s11605-011-1756-7
dc.identifier.pmid22089951
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49689
dc.description.abstractINTRODUCTION: The extent of lymphadenectomy and protocol design in gastric cancer trials limits interpretation of survival benefit of adjuvant therapy after surgery with adequate lymphadenectomy. We examined the impact of surgery with adequate nodal evaluation alone on gastric cancer survival. METHODS: Using 2001-2008 California Cancer Registry, we identified 2,229 patients who underwent gastrectomy with adequate nodal evaluation (>/=15 lymph nodes) for American Joint Committee on Cancer stage I-IV M0 gastric adenocarcinoma. Cox proportional hazard analyses were used to evaluate the impact of surgery alone on survival. RESULTS: Nearly 70% of our cohort had T1/2 tumors and 29% had N0 disease. Forty-nine percent of the cohort underwent surgery alone. These patients were more likely to be older, Medicare-insured, with T1 and N0 disease. On unadjusted analyses, persons who underwent surgery alone for stage I or N0 disease experienced 1- and 3-year overall and cancer-specific survival comparable to those who received adjuvant therapy. On multivariate analyses for stage I or N0 disease, surgery alone predicted superior survival outcomes than when combined with adjuvant therapies. CONCLUSION: Surgery alone with adequate nodal evaluation may have a role in low-risk gastric cancer. To corroborate these findings, surgery with adequate lymphadenectomy alone (as treatment arm) deserves consideration in the design of gastric cancer trials to provide effective yet resource-conserving, rather than maximally tolerated, treatments.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22089951&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1007/s11605-011-1756-7
dc.subjectAdenocarcinoma
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectChemoradiotherapy, Adjuvant
dc.subjectChemotherapy, Adjuvant
dc.subjectCohort Studies
dc.subjectFemale
dc.subject*Gastrectomy
dc.subjectHumans
dc.subjectKaplan-Meier Estimate
dc.subject*Lymph Node Excision
dc.subjectLymphatic Metastasis
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMultivariate Analysis
dc.subjectNeoplasm Staging
dc.subjectProportional Hazards Models
dc.subjectRegistries
dc.subjectRetrospective Studies
dc.subjectStomach Neoplasms
dc.subjectSurvival Rate
dc.subjectTreatment Outcome
dc.subjectYoung Adult
dc.subjectOncology
dc.subjectSurgery
dc.titleIs there a role for surgery with adequate nodal evaluation alone in gastric adenocarcinoma
dc.typeArticle
dc.source.journaltitleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
dc.source.volume16
dc.source.issue2
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/surgery_pp/117
dc.identifier.contextkey3335958
html.description.abstract<p>INTRODUCTION: The extent of lymphadenectomy and protocol design in gastric cancer trials limits interpretation of survival benefit of adjuvant therapy after surgery with adequate lymphadenectomy. We examined the impact of surgery with adequate nodal evaluation alone on gastric cancer survival.</p> <p>METHODS: Using 2001-2008 California Cancer Registry, we identified 2,229 patients who underwent gastrectomy with adequate nodal evaluation (>/=15 lymph nodes) for American Joint Committee on Cancer stage I-IV M0 gastric adenocarcinoma. Cox proportional hazard analyses were used to evaluate the impact of surgery alone on survival.</p> <p>RESULTS: Nearly 70% of our cohort had T1/2 tumors and 29% had N0 disease. Forty-nine percent of the cohort underwent surgery alone. These patients were more likely to be older, Medicare-insured, with T1 and N0 disease. On unadjusted analyses, persons who underwent surgery alone for stage I or N0 disease experienced 1- and 3-year overall and cancer-specific survival comparable to those who received adjuvant therapy. On multivariate analyses for stage I or N0 disease, surgery alone predicted superior survival outcomes than when combined with adjuvant therapies.</p> <p>CONCLUSION: Surgery alone with adequate nodal evaluation may have a role in low-risk gastric cancer. To corroborate these findings, surgery with adequate lymphadenectomy alone (as treatment arm) deserves consideration in the design of gastric cancer trials to provide effective yet resource-conserving, rather than maximally tolerated, treatments.</p>
dc.identifier.submissionpathsurgery_pp/117
dc.contributor.departmentDepartment of Surgery
dc.source.pages238-46; discussion 246-7


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