Sanae Kaji

Feasibility of Laparoscopic Distal Gastrectomy for Stage I Gastric Cancer in Patients Outside of Clinical Trials

BackgroundRandomized controlled trials, including the Japan Clinical Oncology Group (JCOG) 0912 trial, have shown the safety of laparoscopy-assisted distal gastrectomy (LADG) for select healthy patients. It is unclear whether LADG is feasible in patients who do not meet trial eligibility criteria.MethodsThe present study retrospectively reviewed 547 patients with clinical stage I gastric cancer who underwent distal or pylorus-preserving gastrectomy. Of these, 185 were identified as not fulfilling the eligibility criteria of JCOG 0912; the short-term surgical outcomes between LADG and open distal gastrectomy (ODG) were compared in this group before and after propensity score matching.ResultsPatients who were not eligible for inclusion in the trial comprised 33.8% of the total. After matching, there were 59 patients each in the LADG and ODG groups, with an improved balance of confounding factors between the two groups. LADG was associated with significantly longer operation time, less blood loss, and shorter postoperative hospital stay than ODG. The rate of overall postoperative complications of Clavien–Dindo Grade II or higher did not differ significantly between the LADG and ODG groups (23.7 vs. 18.6%, respectively; p = 0.653). The incidence of pneumonia (6.8 vs. 5.1%), intra-abdominal infectious complications (5.1 vs. 3.4%), and stasis syndrome (5.1 vs. 3.4%) was also comparable between the two groups.ConclusionLADG was as safe as ODG in patients who did not meet the eligibility criteria of JCOG 0912. LADG could be a standard treatment option for patients with stage I gastric cancer, regardless of their general condition.

Metabolomic profling in gastric cancer tissues using time-of-flight mass spectrometry.

66Background: To explore carcinogenic and prognostic biomarkers for gastric cancer, genomics, transcriptomics and proteomics approaches have been extensively applied;however, little has been invest...

Impact of extra-nodal metastasis on survival in gastric cancer patients with lymph node involvement.

57Background: Extra-nodal metastasis (ENM) is defined as a tumor nodule without lymph node structure, and distinguished from lymph node metastasis by histological findings. Despite the possible difference in metastatic mechanism, both are counted as metastasized lymph nodes according to the 3rd English edition of Japanese Classification of Gastric Carcinoma, and thus the prognostic value of ENM remains unclear. The aim of this study was to clarify the clinicopathogical characteristics and prognostic impact of ENM in gastric cancer patients with lymph node involvement. Methods: This study included 388 patients who underwent curative gastrectomy for primary gastric cancer between January 2009 and August 2013. A total of 2093 pathologically positive tumor nodules, including both metastatic lymph nodes and ENM, were examined. Clinicopathological characteristics and survival outcomes were compared between an ENM positive (ENMP) group (95 patients) and an ENM negative (ENMN) group (293 patients). In addition, m...

Prognostic factor of resection of hepatic and pulmonary metastases from colorectal cancer: A multi-institutional questionaire study.

590 Background: Resection of hepatic or pulmonary metastases (HPM) has been accepted as appropriate therapy. However whether aggressive surgery of both hepatic and pulmonary metastases from colorectal cancer (CRC) is of value has not been verified in detail. Methods: 1,179 patients undergone complete pulmonary resection were collected from 110 institutions by the 78th Congress of the Japanese Society of Cancer of the Colon and Rectum. Data on 209 of 1,179 patients who had undergone resection of HPM from CRC were included in this study. Results: (1) Outcome of surgery: In 970 patients undergoing pulmonary resection alone, 5-year relapse free survival and 5-year survival after pulmonary resection were 41.9% and 65.3%. In 209 patients undergoing hepatic and pulmonary resection, 5-year relapse free survival and 5-year survival after pulmonary resection were 33.5% (p = 0.0016) and 57.8% (p = 0.0021). The outcomes after resection were significantly better in patients with sequentially detected metastases (5-yea...