A phase-II clinical trial of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer patients.

Objectives: This study was conducted to determine whether laparoscopy-assisted distal gastrectomy (LADG) with complete D2 lymph node dissection for gastric cancer is a safe and effective surgical option.

Methods: During an 8-month period, 64 patients, who were diagnosed preoperatively as having T1-2, N0-1 or M0 gastric cancer, were prospectively enrolled to undergo LADG with D2 lymph node dissection; two surgeons with experience of over 50 cases of laparoscopic gastrectomy performed the procedures. The compliance rate, defined as cases with no more than one missing lymph node station according to the Japanese Research Society of Gastric Cancer (JRSGC) lymph node grouping, for the open gastrectomy with D2 lymph node dissection was 66.

Abdominal shape of gastric cancer patients influences short-term surgical outcomes.

Background: There is a prevailing belief that both obesity and abdominal shape influence abdominal accessibility, and thus affect short-term surgical outcomes of gastric cancer surgery.

Methods: We measured the thickness of subcutaneous fat (SCF), abdominal anterior-posterior diameter (APD), transverse diameter (TD), and intra-abdominal fat volume (IFV) at the umbilicus level by using the abdominal CT scans of 291 gastric cancer patients who had undergone subtotal gastrectomy and D2 lymph node dissection. Clinicopathological factors including body mass index (BMI), APD, TD, IFV, and SCF and surgical outcomes, i.

Decisions for extent of gastric surgery in gastric cancer patients: younger patients require more attention than the elderly.

Background And Objectives: There is a prevailing belief that young patients with gastric adenocarcinomas have a more aggressive disease.

Methods: We reviewed the prospectively collected database of 753 gastric adenocarcinomas patients who had undergone curative gastrectomy. Clinicopathological factors and the survival rates for each pathological TNM stage were compared between patients younger than 40 years of age and the others.

Health-related quality of life among disease-free stomach cancer survivors in Korea.

Previous studies about the quality of life (QOL) in stomach cancer survivors focused on selected clinical parameters and did not consider the broader implications for overall health and QOL. We evaluated the impact of demographic and treatment-related factors on the QOL of stomach cancer survivors. We asked 391 stage I-III stomach cancer survivors who had been disease-free for at least 1 year after surgery to complete a demographic questionnaire, the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire, and its stomach module, QLQ-STO22.

Candidates for curative resection in advanced gastric cancer patients who had equivocal para-aortic lymph node metastasis on computed tomographic scan.

Background: The aim of this study was to determine how to select potential candidates for curative resection among advanced gastric patients with equivocal findings of para-aortic lymph node metastasis on computed tomography (CT).

Methods: We analyzed the clinicopathologic results of 23 advanced gastric cancer patients who were diagnosed as having equivocal findings of para-aortic lymph node metastasis on a CT scan and who underwent gastrectomy with D2 and para-aortic lymph node dissection.

Results: Twenty-two patients were male, and one patient was female.

Learning curve for total gastrectomy with D2 lymph node dissection: cumulative sum analysis for qualified surgery.

Background: This study was conducted to evaluate the leaning curve of D2 lymph node dissection for patients with gastric cancer in a high-volume center.

Methods: The authors prospectively reviewed the data of all patients who underwent total gastrectomy with D2 lymph node dissection during a 4-year period. Retrieved lymph node number was used as a surrogate marker of oncological outcome.

Sentinel node biopsy using dye and isotope double tracers in early gastric cancer.

Background: The results of sentinel node (SN) biopsy have been improved by the use of dye and isotope double tracers in melanoma and breast cancer. However, the usefulness of this double tracer technique has not been determined in gastric cancer. The aim of this study was to investigate the possibility of improving SN biopsy results by using double tracers in gastric cancer.

Use of a combination of computed tomography and endoscopy to assess the response to 5-fluorouracil/cisplatin and predict survival in gastric cancer.

Background: Response of metastatic sites on computed tomography (CT) has been used to assess response in metastatic gastric carcinoma (MGC); however, the role of endoscopy to evaluate the response of the primary gastric lesion is unclear. We undertook a prospective study to compare prognostic values of endoscopy-based response criteria with those of CT-based response criteria in MGC patients treated with 5-fluorouracil (5-FU) and cisplatin.

Methods: MGC patients naïve to chemotherapy were treated with 5-FU (1000 mg/m(2), days 1-5) and cisplatin (60 mg/m(2), day 1) (FP) every 21 days.

Gastric cancer patients at high-risk of having synchronous cancer.

Aim: To identify patients with a high-risk of having a synchronous cancer among gastric cancer patients.

Methods: We retrospectively analyzed the prospective gastric cancer database at the National Cancer Center, Korea from December 2000 to December 2004. The clinicopathological characteristics of patients with synchronous cancers and those of patients without synchronous cancers were compared.

Liquiritigenin, an aglycone of liquiritin in Glycyrrhizae radix, prevents acute liver injuries in rats induced by acetaminophen with or without buthionine sulfoximine.

Glycyrrhizae radix has been used as one of the oldest and most frequently employed botanicals in both western and oriental countries. Previously, we showed that liquiritigenin (LQ), an aglycone of liquiritin in G. radix, exerts cytoprotective effects against heavy metal-induced toxicity in vitro.

Unilateral spondylolysis combined with contralateral lumbar pediculolysis in a military parachutist.

A few cases of unilateral pediculolysis combined with contralateral spondylolysis have been reported, and most of them were related to athletic activities. A case of unilateral spondylolysis combined with contralateral lumbar pediculolysis in a military parachutist is reported. A 34-year-old man experienced low back pain and right sciatica for 3 months.

Characteristics of synchronous cancers in gastric cancer patients.

Purpose: The primary objective of the current study was to investigate the characteristics of synchronous cancers in gastric cancer patients.

Materials And Methods: We analyzed the 2,237 patients who were diagnosed between December 2000 and December 2003 with gastric cancer and synchronous cancers of organs other than the stomach.

Results: 73 (3.

Assessment of lymph node metastases using 18F-FDG PET in patients with advanced gastric cancer.

Purpose: The aim of this study was to assess the diagnostic accuracy of (18)F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) with respect to lymph node (LN) metastasis in patients with advanced gastric cancer, and to ascertain the factors that affect this accuracy.

Methods: Seventy-three patients with advanced gastric cancer, verified in all cases by endoscopic biopsy, were enrolled in this prospective study. We conducted FDG PET and other routine preoperative studies, including abdominal computed tomography (CT).

Phase II study of low-dose docetaxel/fluorouracil/cisplatin in metastatic gastric carcinoma.

Objectives: In several recent reports, docetaxel (75-85 mg/m2) combined with fluorouracil (5-FU) and cisplatin has shown considerable efficacy but significant toxicities, especially neutropenia, in patients with advanced gastric cancer. The authors tested the efficacy and safety of a lower dose (50 mg/m2) of docetaxel, combined with 5-FU and cisplatin, in metastatic gastric cancer (MGC).

Methods: Chemonaive patients with MGC received docetaxel (50 mg/m2 on day 1), cisplatin (80 mg/m2 on day 1), and 5-FU (1200 mg/m2 on days 1-3) every 21 days.

Lead optimization of 7-benzyloxy 2-(4'-pyridylmethyl)thio isoflavone aromatase inhibitors.

Aromatase, the enzyme responsible for estrogen biosynthesis, is a particularly attractive target in the treatment of hormone-dependent breast cancer. The synthesis and biological evaluation of a series of 2-(4'-pyridylmethyl)thio, 7-alkyl- or aryl-substituted isoflavones as potential aromatase inhibitors are described. The isoflavone derivatives demonstrate IC(50) values from 79 to 553 nM and compete with the endogenous substrate, androstenedione.

Synthesis and characterization of azole isoflavone inhibitors of aromatase.

The synthesis and biological evaluation of a series of 2-azole and 2-thioazole isoflavones as potential aromatase inhibitors are described. Differences in inhibitory activity of triazole and imidazole inhibitors are rationalized with density functional theory to expose a key difference in the electronic structure of these molecules. In addition, difference binding spectra of inhibitors to immunoaffinity-purified aromatase produces classical Type II spectra consistent with coordination of the nitrogen lone pair electrons to the aromatase P450 heme.

Management of ascites after radical surgery in gastric cancer patients with liver cirrhosis and minimal hepatic dysfunction.

A radical lymph node dissection is important for the cure of gastric cancer. However, such a procedure in patients with liver cirrhosis (LC) could develop serious complications such as massive ascites. To determine the management of postoperative ascites, 26 gastric cancer patients with LC were reviewed retrospectively.

Weekly docetaxel in combination with capecitabine in patients with metastatic gastric cancer.

Docetaxel (T) and capecitabine (X) are active agents against gastric cancer with synergistic antitumor effects. We conducted the current phase II study to assess the response rate and toxicity of combination TX regimen in patients with metastatic gastric cancer. Eligible patients were treated with docetaxel (36 mg/m2 intravenously) on days 1 and 8 and capecitabine (1000 mg/m2 orally twice a day) on days 1-14 of a 3-week schedule until progression occurred.

Synthesis and aromatase inhibitory activity of novel pyridine-containing isoflavones.

Aromatase, a cytochrome P450 hemoprotein that is responsible for estrogen biosynthesis by conversion of androgens into estrogens, has been an attractive target in the treatment of hormone-dependent breast cancer. As a result, a number of synthetic steroidal or nonsteroidal aromatase inhibitors have been successfully developed. In addition, there are several classes of natural products that exert potent activities in aromatase inhibition, with the flavonoids being most prominent.

Primary intraspinal primitive neuroectodermal tumor at conus medullaris.

A primary intraspinal primitive neuroectodermal tumor is very rare, with only 24 cases having been reported in the literature. In general this type of tumor is treated with surgery followed by radiotherapy and chemotherapy; however, the prognosis still remains poor. The case of a primary intraspinal primitive neuroectodermal tumor, at the conus medullaris in a 17 year old male patient is presented.

Weekly irinotecan in patients with metastatic gastric cancer failing cisplatin-based chemotherapy.

Background: The goal of this study is to determine the efficacy and toxicity of weekly irinotecan as second-line chemotherapy in advanced gastric cancer after failure of cisplatin-based regimen.

Methods: Gastric cancer patients failing cisplatin-based chemotherapy received 125 mg/m(2) of irinotecan weekly for 4 weeks followed by 2-week rest, until disease progression.

Results: Thirty-seven patients were enrolled into this study.

New operative method for fundal variceal bleeding: fundectomy with periesophagogastric devascularization.

Cirrhotic patients with gastric fundal bleeding occasionally require operative intervention. Fundal variceal bleeding may be controlled by performing a fundectomy in addition to periesophagogastric devascularization. For 23 patients with cirrhosis, preoperative nonsurgical intervention alone could not achieve definitive control of variceal bleeding from the gastric fundus, and periesophagogastric devascularization with the fundectomy--specifically resection of the varix-bearing lesion in the fundus--was performed.

Laparoscopic wedge resection with handsewn closure for gastroduodenal tumors.

Purpose: To evaluate the feasibility and efficacy of laparoscopic wedge resection with handsewn closure in gastroduodenal tumors.

Methods: Laparoscopic wedge resection was performed in 16 patients with gastroduodenal tumor between May 2000 and December 2002. Every case, except one, was performed via an extragastric approach; a transgastric approach was adopted in a single case.

Laparoscopy-assisted D2 subtotal gastrectomy in early gastric cancer.

The purpose of this study is to prove the safety and efficacy of laparoscopy-assisted subtotal gastrectomy and D2 lymph node dissection using 4 ports and an EEA stapler with a Billroth I anastomosis. From 1999 to 2001, 20 patients with EGC located in the distal stomach underwent laparoscopy-assisted Billroth I gastrectomy (LABIG). A 4-port-technique was performed for omentectomy, vascular ligation, and D2 lymph node dissection.