Gastrectomy is commonly performed for both benign and malignant lesions.Although the incidence of post-gastrectomy acute pancreatitis(PGAP)is low compared to other well-recognized post-operative complications,it has b...Gastrectomy is commonly performed for both benign and malignant lesions.Although the incidence of post-gastrectomy acute pancreatitis(PGAP)is low compared to other well-recognized post-operative complications,it has been reported to be associated with a high mortality rate.In this article,we describe a 70-year-old man with asymptomatic pancreatic divisum who underwent palliative subtotal gastrectomy for an advanced gastric cancer with liver metastasis.His postoperative course was complicated by acute pancreatitis and intra-abdominal sepsis.The patient eventually succumbed to multiple organ failure despite surgical debridement and drainage,together with aggressive antibiotic therapy and nutritional support.For patients with pancreas divisum or dominant duct of Santorini who fail to follow the normal post-operative course after gastrectomy,clinicians should be alert to the possibility of PGAP as one of the potential diagnoses. Early detection and aggressive treatment of PGAP might improve the prognosis.展开更多
Objective:The aim of this study was to evaluate the effect of the excision repair cross-complementing(ERCC1) expression on survival in advanced gastric cancer patients who underwent surgical resection and treated with...Objective:The aim of this study was to evaluate the effect of the excision repair cross-complementing(ERCC1) expression on survival in advanced gastric cancer patients who underwent surgical resection and treated with oxaliplatin-based adjuvant chemotherapy.Methods:Sixty-three patients who underwent surgical resection for cure and treated with oxaliplatin-based adjuvant chemotherapy were included in this study.The expressions of ERCC1 of gastric cancer were examined by immunohistochemistry and the patients were categorized into ERCC1-(+) and ERCC1-(-) groups.The relation between ERCC1 expression and survival of patients was examined.Results:Of the 63 eligible patients,36 patients(57.1%) had tumor with a positive expression of ERCC1 and the remaining 27 patients had tumor with a negative ERCC1 expression.Expression differences of ERCC1 didn't correlated with age(P = 0.827),gender(P = 0.12),differentiation(P = 0.113),histological type(P = 0.942),site of tumor(P = 0.221),size of tumor(P = 0.608),stage(P = 0.815) and lymphatic invasion(P = 0.165).Overall survival(OS) was significantly longer in patients without ERCC1 expression,when compared to patients with ERCC1 expression(P = 0.023).Multivariate analysis revealed that ERCC1 expression significantly impacted on OS(HR:4.049;P = 0.000).Conclusion:We concluded that resected and treated with oxaliplatin-based adjuvant chemotherapy gastric cancer patients without ERCC1 expression have a better survival when compared to patients with ERCC1 expression.ERCC1 expression will hopefully provide a rational basis for improving adjuvant chemotherapeutic strategies for gastric cancer patients.ERCC1,itself,may be a prognostic factor for gastric cancer.展开更多
Objective: There is controversy about the best therapeutic surgical approach for treatment of patients with T4 gastric cancer. We evaluated the survival benefit of resection in this group of patients. Methods: We retr...Objective: There is controversy about the best therapeutic surgical approach for treatment of patients with T4 gastric cancer. We evaluated the survival benefit of resection in this group of patients. Methods: We retrospectively reviewed the hospital records of 288 patients with T4 gastric carcinoma to compare the clinicopathological results in patients with curative resection (n = 49) with patients with non-curative resection (n = 113) from 1980 to 2000. Results: Curative resection was performed in 49 (30.2%) patients, with the pancreas being the most frequently resected organ. The 5-year survival rate was 9.3% and the median survival time was 12 months for all 162 registered patients. The 5-year survival rates in patients after curative and non-curative resection were 14.3% vs 7.1% respectively. These values differed considerably between the two groups (P = 0.033). Operative type and curability were independent statistically significant prognostic parameters. Conclusion: Curability was an independent prognostic factor among all registered patients. Patients with T4 gastric carcinoma might be benefited from curative resection.展开更多
文摘Gastrectomy is commonly performed for both benign and malignant lesions.Although the incidence of post-gastrectomy acute pancreatitis(PGAP)is low compared to other well-recognized post-operative complications,it has been reported to be associated with a high mortality rate.In this article,we describe a 70-year-old man with asymptomatic pancreatic divisum who underwent palliative subtotal gastrectomy for an advanced gastric cancer with liver metastasis.His postoperative course was complicated by acute pancreatitis and intra-abdominal sepsis.The patient eventually succumbed to multiple organ failure despite surgical debridement and drainage,together with aggressive antibiotic therapy and nutritional support.For patients with pancreas divisum or dominant duct of Santorini who fail to follow the normal post-operative course after gastrectomy,clinicians should be alert to the possibility of PGAP as one of the potential diagnoses. Early detection and aggressive treatment of PGAP might improve the prognosis.
文摘Objective:The aim of this study was to evaluate the effect of the excision repair cross-complementing(ERCC1) expression on survival in advanced gastric cancer patients who underwent surgical resection and treated with oxaliplatin-based adjuvant chemotherapy.Methods:Sixty-three patients who underwent surgical resection for cure and treated with oxaliplatin-based adjuvant chemotherapy were included in this study.The expressions of ERCC1 of gastric cancer were examined by immunohistochemistry and the patients were categorized into ERCC1-(+) and ERCC1-(-) groups.The relation between ERCC1 expression and survival of patients was examined.Results:Of the 63 eligible patients,36 patients(57.1%) had tumor with a positive expression of ERCC1 and the remaining 27 patients had tumor with a negative ERCC1 expression.Expression differences of ERCC1 didn't correlated with age(P = 0.827),gender(P = 0.12),differentiation(P = 0.113),histological type(P = 0.942),site of tumor(P = 0.221),size of tumor(P = 0.608),stage(P = 0.815) and lymphatic invasion(P = 0.165).Overall survival(OS) was significantly longer in patients without ERCC1 expression,when compared to patients with ERCC1 expression(P = 0.023).Multivariate analysis revealed that ERCC1 expression significantly impacted on OS(HR:4.049;P = 0.000).Conclusion:We concluded that resected and treated with oxaliplatin-based adjuvant chemotherapy gastric cancer patients without ERCC1 expression have a better survival when compared to patients with ERCC1 expression.ERCC1 expression will hopefully provide a rational basis for improving adjuvant chemotherapeutic strategies for gastric cancer patients.ERCC1,itself,may be a prognostic factor for gastric cancer.
文摘Objective: There is controversy about the best therapeutic surgical approach for treatment of patients with T4 gastric cancer. We evaluated the survival benefit of resection in this group of patients. Methods: We retrospectively reviewed the hospital records of 288 patients with T4 gastric carcinoma to compare the clinicopathological results in patients with curative resection (n = 49) with patients with non-curative resection (n = 113) from 1980 to 2000. Results: Curative resection was performed in 49 (30.2%) patients, with the pancreas being the most frequently resected organ. The 5-year survival rate was 9.3% and the median survival time was 12 months for all 162 registered patients. The 5-year survival rates in patients after curative and non-curative resection were 14.3% vs 7.1% respectively. These values differed considerably between the two groups (P = 0.033). Operative type and curability were independent statistically significant prognostic parameters. Conclusion: Curability was an independent prognostic factor among all registered patients. Patients with T4 gastric carcinoma might be benefited from curative resection.
