Efficacy of laparoscopy-assisted distal gastrectomy for gastric cancer in the elderly.

Background: To date, it has been unclear whether laparoscopy-assisted distal gastrectomy (LADG) is a suitable treatment for elderly patients with early gastric cancer. This study retrospectively compared surgical outcomes between elderly and nonelderly patients with gastric cancer.

Methods: The study group was comprised of 211 patients who underwent distal gastrectomy between April 2000 and March 2007.

Effect of obesity on intraoperative bleeding volume in open gastrectomy with D2 lymph-node dissection for gastric cancer.

Background: To investigate the effect of obesity on open gastrectomy with D2 lymph-node dissection.

Methods: Between January 2005 and March 2007, 100 patients with preoperatively diagnosed gastric cancer who underwent open gastrectomy with D2 lymph-node dissection were enrolled in this study. Of these, 61 patients underwent open distal gastrectomy (ODG) and 39 patients underwent open total gastrectomy (OTG).

Clinicopathological significance of the gene expression of matrix metalloproteinases and reversion-inducing cysteine-rich protein with Kazal motifs in patients with colorectal cancer: MMP-2 gene expression is a useful predictor of liver metastasis from colorectal cancer.

Matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and membrane-type matrix metalloproteinase 1 (MT1-MMP) are involved in colorectal cancer invasion and metastasis. Reversion-inducing cysteine-rich protein with Kazal motifs (RECK) inhibits MMP-2, MMP-9 and MT1-MMP. We examined the clinicopathological significance of the relative expression of these genes in patients with colorectal cancer, especially with regard to metastasis.

Tumor diameter as a prognostic factor in patients with gastric cancer.

Background: The aim of this study was to evaluate the prognostic value of tumor diameter in gastric cancer.

Methods: The study group comprised a series of 1215 patients who underwent curative gastrectomy. The appropriate tumor diameter cutoff value was determined.

Reduced expression of the claudin-7 gene correlates with venous invasion and liver metastasis in colorectal cancer.

Claudins, members of a large family of adherent junction proteins, regulate the integrity and function of tight junctions and influence tumorigenesis. Studies have suggested that altered levels of different claudins are related to carcinoma-cell invasion and disease progression. This study examined the relationship between the relative expression of claudin genes and clinicopathological factors, especially invasion and metastasis, in patients with colorectal cancer.

Appropriate routes of reconstruction following transthoracic esophagectomy.

Background/aims: The effectiveness of reconstructive methods after esophagectomy remains controversial.

Methodology: A total of 211 patients who underwent transthoracic esophagectomy and esophagogastric anastomosis using the gastric conduit were enrolled in this study. A retromediastinal approach was used in 79 patients and a retrosternal approach in 132.

Surgical outcomes in esophageal cancer patients with tumor recurrence after curative esophagectomy.

This study aimed to identify predictive factors and to evaluate appropriate treatments for recurrence of esophageal cancer after curative esophagectomy. About 166 consecutive patients, who underwent curative esophagectomy, were enrolled between April 1994 and March 2003. Recurrence was classified as loco-regional or distant.

Modified POSSUM to predict postoperative morbidity following gastrectomy.

Background/aims: In order to predict morbidity after gastrectomy for gastric cancer in aged patients, the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) scoring system was applied.

Methodology: A total of 123 patients who had gastrectomies for gastric cancer at the age of 75 or above, between 1994 and 2002, were enrolled in this study. Postoperative morbidities and mortalities were analyzed and POSSUM scores were calculated.

Correlating purity by microdissection with gene expression in gastric cancer tissue.

Microdissection is a feasible tool for the purification of target cells from heterogeneous tissue components. However, the extent to which cells need to be purified by microdissection for use in gene expression analysis has not been determined. In the present study, we obtained diffuse-type gastric cancer tissues at varying purities, and evaluated the corresponding expression of a cancer-specific gene, KRT19, by quantitative real-time PCR.

Impact of splenectomy in patients with gastric adenocarcinoma of the cardia.

Previous reports have suggested that splenectomy treatment of gastric carcinoma of the cardia results in poor patient outcome, but the reason for this is unclear. This study aimed to clarify the impact of splenectomy for gastric carcinoma patients. A total of 118 patients with gastric carcinoma of the cardia were enrolled in this study.

Spleen-preserving distal pancreatectomy combined with distal gastrectomy for distal pancreatic lesion and gastric cancer: Report of a case.

Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein was recently devised as a feasible operation. We report the case of a patient who underwent spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein, combined with distal gastrectomy, for gastric cancer and a distal pancreatic lesion. Thus, unnecessary total gastrectomy was avoided.

[Clinical efficacy and safety of weekly paclitaxel therapy as second-line chemotherapy for patients with advanced and recurrent gastric cancer who were previously treated with TS-1 therapy].

The clinical efficacy and safety of weekly paclitaxel therapy were studied retrospectively in 17 patients with advanced and recurrent gastric cancer who had previously been treated with TS-1 therapy. The overall response rate was 0%, but MST was 495 days. The adverse effects observed were grade 3 leukopenia in 2 patients (11.

Lymph node status in patients with submucosal gastric cancer.

Background: The aim of this study was to clarify the lymph node status in patients with submucosal gastric cancer.

Methods: Between April 1994 and December 1999, 615 patients with histologically proven submucosal gastric cancer who underwent curative resection were included in this study. The results of the surgery and predictive factors for lymph node metastasis were evaluated by univariate and multivariate analyses.

[Clinical results of single therapy with TS-1 for advanced/recurrent gastric cancer].

In cases with advanced/recurrent gastric cancer undergoing single therapy with TS-1, we retrospectively discussed the antitumor effects and adverse events and considered the clinical utility of TS-1. The subjects consisted of 131 cases with advanced/recurrent gastric cancer who received one or more courses of therapy with TS-1 alone between July 1999 and August 2003. We carried out 4-week administration of 80-120 mg/day of TS-1 according to body surface area, followed by a 2-week discontinuation, then repeated administration which adjusting the dosage according to the incidence of side effects, and discussed the antitumor effects and adverse events.

Therapeutic strategy for patients with pN0 gastric carcinoma.

Background And Objectives: The prognosis for patients with pN0 gastric cancer is moderately hopeful (expected 5-year survival: 80%). However, the relevant prognostic factors and most appropriate surveillance protocol have not been identified.

Methods: We investigated 733 gastric cancer patients without lymph node metastasis for prognostic factors by uni- and multi-variate analysis and by documenting causes of death and recurrence patterns.

Clinicopathological features of gastric carcinoma in younger and middle-aged patients: a comparative study.

Gastric carcinoma is relatively rare in patients under the age of 40. This study was undertaken to clarify the clinicopathological characteristics and surgical outcomes of gastric carcinoma in younger patients compared with those of middle-aged patients. The surgical results from 131 younger patients (aged < or = 40 years) and 918 middle-aged patients (aged 55-65 years) were compared retrospectively.

Pharmacokinetics of S-1 in patients with peritoneal dissemination of gastric cancer.

The response of gastric cancer with peritoneal dissemination to systemic chemotherapy may be negatively affected by poor drug delivery due to the blood-peritoneal barrier. However, S-1 has been reported to be effective. We examined the pharmacokinetics of S-1 in 14 patients who had gastric cancer with peritoneal dissemination.

Therapeutic outcomes of continuous hyperthermic peritoneal perfusion against advanced gastric cancer with peritoneal carcinomatosis.

Background/aims: To clarify the efficacy of therapeutic continuous hyperthermic peritoneal perfusion in peritoneal carcinomatosis of gastric cancer.

Methodology: The subjects of this study were 73 advanced gastric cancer patients who underwent palliative surgery between 1992 and 1999. Therapeutic continuous hyperthermic peritoneal perfusion (T-CHPP) was performed in 21 patients, who had macroscopic peritoneal carcinomatosis or positive lavage cytology, were under 65 years old, had no concomitant disease, and gave informed consent.

Distribution of lymph node metastasis in gastric carcinoma.

Background/aims: In gastric cancer, appropriate lymph node dissection increases survival, and hence it is of value to determine lymph node metastasis distribution in the early phase of progression.

Methodology: This study involved a series of 274 consecutive patients with 1-6 lymph node metastases occurring after resection. The pattern of lymph node metastases was analyzed retrospectively.

Prognostic factors after chemoradiotherapy for patients with inoperable esophageal squamous cell carcinoma.

Background/aims: It is important to clarify the predictive and prognostic factors for chemoradiotherapy (CRT) in patients with inoperable esophageal cancer.

Methodology: Forty-one patients with inoperable advanced esophageal cancer were evaluated. The predictive factors for the response to CRT (low-dose 5-FU and Cisplatin (FP) therapy plus 60 Gy of radiation) and the prognostic factors after CRT were analyzed.

Clinicopathological properties of poorly-differentiated adenocarcinoma of the stomach: comparison of solid- and non-solid-types.

Background: The purpose of this study was to clarify the clinicopathological and biological properties of the poorly-differentiated types of gastric carcinoma (solid-type and non-solid-type).

Patients And Methods: A total of 1,558 patients with primary gastric adenocarcinomas were enrolled in this study. The surgical results were compared.

[A case of radiation-induced rectal cancer].

We report a case of radiation-induced rectal cancer, which is thought to originate from dysplasia due to radiation colitis. The patient is a 73 year-old woman, who underwent radical hysterectomy and radiotherapy for uterine cervical cancer 31 years ago. She visited to our hospital complaining of hematochezia.

Comparison of results of surgery in the upper third and more distal stomach.

The results of surgery for gastric cancer in the upper third of the stomach and the more distal region were compared to explain the comparatively poor outcomes in the former. Characteristics and therapeutic results of 1245 patients who underwent curative gastrectomy (244 with tumors in the upper third of the stomach and 1001 with more distal cancers) were compared. Survival was significantly lower in patients with cancer of the upper third of the stomach than in patients with more distal cancers.

Clinicopathologic characteristics and surgical outcomes of mucinous gastric carcinoma.

Background: The clinicopathologic characteristics of mucinous gastric carcinoma (MGC), an uncommon subtype of gastric carcinoma, were examined by comparing 45 MGC and 1255 non-MGC (NGC) cases.

Methods: Of 1300 gastric cancer patients, 1184 (early, n=568; advanced, n=616) underwent potentially curative or palliative resection. Age, sex, tumor location, tumor diameter, macroscopic appearance, depth of invasion, lymph node metastasis, lymphatic invasion, and venous invasion were monitored.