2019, Number 09
Next >>
Revista Médica Sinergia 2019; 4 (09)
Esophagogastric junction adenocarcinoma and its surgical resolution in Guayaquil, Ecuador
Ulloa OP, Palomeque BJ, Vecilla CJ
Language: Spanish
References: 20
Page:
PDF size: 366.64 Kb.
ABSTRACT
Introduction: Adenocarcinoma is the most frequent cancer in the stomach,
one of the main causes of the poor survival of these patients is the
possibility or not of achieving a complete surgical tumor resection due to its
location or invasion. Siewert describes cardial tumors and this topography
generates a challenge for its therapeutic approach, due to its anatomical
relationships.
Methods: A descriptive, correlational, retrospective study was carried out in
17 patients diagnosed with gastric adenocarcinoma according to Siewert
from January 2011 to April 2018. The variables age, gender, oncological
stage, neoadjuvant, surgical, adjuvant, localization were analyzed. tumor
differentiation and infiltration, postsurgical complications and current
situation of the patient. The statistical association was determined by the
Chi square test and the Spearman coefficient for a level of significance of (p
‹0.05).
Results: The most frequent location was Siewert Type III in eleven patients
(64.7%), the majority of patients attended was in clinical stage III, the total
gastrectomy was the most used technique with 10 patients (67.9%), the
reconstruction was in Roux-en-Y 70.59%, the complications were not
related to the surgery, the superior survival was 27 months after the total
gastrectomy, the complications were not related to the surgery.
Conclusion: Patients with gastric cancer according to Siewert will require a
complete resection with safety oncological margins. The diagnosis of this
disease is still late and radical and non-partial surgical techniques should be
used. Patients with Siewert I and II will have greater esophageal
involvement, which impoverishes their prognosis due to its own
characteristics, unlike Siewert III. Survival presents correlation with the
tumor location, initial clinical stage and with the surgical technique that
fulfills a complete removal and safety oncological margins.
REFERENCES
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018 09 12;68(6):394-424. https://doi.org/10.3322/caac.21492
Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011 05 15;14(2):101-112. https://doi.org/10.1007/s10120-011-0041-5
Tsubono Y, Hisamichi S. Screening for gastric cancer in Japan. Gastric Cancer. 2000 08 04;3(1):9- 18. https://doi.org/10.1007/pl00011692
Abdalla EK, Pisters PW.. Staging and preoperative evaluation of upper gastrointestinal malignancies. Seminars in Oncology. 2004 08;31(4):513- 529. https://doi.org/10.1053/j.seminoncol.2004.04.014
Subsecretaría de Salud Pública División de prevención y Control de Enfermedades. Guía Práctica clínica, Cáncer Gástrico en personas de 15 años y más. Ministerio de Salud, Chile 2006.
F G. Técnicas quirúrgicas en cáncer gástrico II-225, pág. 1-20.. [Internet].; 2009 [Citado 2016 diciembre 24. Disponible from: www.sacd.org.ar.
Uyama I, Sugioka A, Fujita J, Hasumi A, Komori Y, Matsui H. Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer. 1999 Dec 31;2(4):230-234. https://doi.org/10.1007/s101200050069
Tanimura S, Higashino M, Fukunaga Y, Kishida S, Nishikawa M, Ogata A, Osugi H. Laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer. Surgical Endoscopy. 2005 07 28;19(9):1177-1181. https://doi.org/10.1007/s00464-004-8936-4
Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. The Lancet Oncology. 2010 05;11(5):439-449. https://doi.org/10.1016/s1470-2045(10)70070-x
Jiang L, Yang K, Guan Q, Zhao P, Chen Y, Tian J. Survival and recurrence free benefits with different lymphadenectomy for resectable gastric cancer: A meta-analysis. Journal of Surgical Oncology. 2013 03 19;107(8):807-814. https://doi.org/10.1002/jso.23325
Schmidt B, Yoon SS. D1 versus D2 lymphadenectomy for gastric cancer. Journal of Surgical Oncology. 2012 04 18;107(3):259-264. https://doi.org/10.1002/jso.23127
DeMeester SR. Adenocarcinoma of the Esophagus and Cardia: A Review of the Disease and Its Treatment. Annals of Surgical Oncology. 2006 01;13(1):12- 30. https://doi.org/10.1245/aso.2005.12.025
Lerut T, Moons J, Coosemans W, Van Raemdonck D, De Leyn P, Decaluwé H, Decker G, Nafteux P. Postoperative Complications After Transthoracic Esophagectomy for Cancer of the Esophagus and Gastroesophageal Junction Are Correlated With Early Cancer Recurrence. Annals of Surgery. 2009 Nov;250(5):798-807. https://doi.org/10.1097/sla.0b013e3181bdd5a8
Rüdiger Siewert J, Feith M, Werner M, Stein HJ. Adenocarcinoma of the Esophagogastric Junction. Annals of Surgery. 2000 09;232(3):353-361. https://doi.org/10.1097/00000658-200009000- 00007
Pu YW, Gong W, Wu YY, Chen Q, He TF, Xing CG. Proximal gastrectomy versus total gastrectomy for proximal gastric carcinoma. A meta-analysis on postoperative complications, 5-year survival, and recurrence rate. Saudi medical journal. 2013; 34: p. 1223-1228.
Zhao P. Proximal gastrectomy with jejunal interposition and TGRY anastomosis for proximal gastric cancer. World Journal of Gastroenterology. 2014;20(25):8268. https://doi.org/10.3748/wjg.v20.i25.8268
J. Alcaide-García, R.M. Villatoro-Roldán, D. Pérez-Martín, A. Rueda-Domínguez: Avances en el tratamiento de tumores digestivos del tracto superior: cáncer gástrico, esofágico, pancreático, y biliar. ¿ha cambiado algo en los últimos cinco años? Volumen: 33 Número: 1 04 Febrero 2010.
Siewert J, Stein H, Sendler A, Fink U. Surgical resection for cancer of the cardia. Seminars in Surgical Oncology. 1999 09;17(2):125-131. https://doi.org/10.1002/(sici)1098-2388(199909)17:2<125::aidssu7> 3.0.co;2-9
Henson DE DCYMNHASJ. Differential trends in the intestinal and diffuse types of gastric carcinoma in the United States, 1973-2000: increase in the signet ring cell type. Archives of Pathology and Laboratory Medicine. 2004 Julio; 128(7).
De Manzoni G, Pedrazzani C, Pasini F, Di Leo A, Durante E, Castaldini G, et al. Results of surgical treatment of adenocarcinoma of the gastric cardia. The Annals of thoracic surgery. 2002; 73: p. 1035- 1040. https://doi.org/10.1016/S0003-4975(01)03571-8