TITLE:
Improved Survival after Implementation of Multidisciplinary Team Meetings, Perioperative Chemotherapy, Extended Lymphnode Dissection and Laparoscopic Surgery in the Treatment of Advanced Gastric Cancer
AUTHORS:
Robin Gaupset, Lars Lohne Eftang, Odd Langbach, Katrin Fridrich, Arne Borthne, Jonn Terje Geitung, Sutharsan Suntharalingam, Dejan Ignjatovic, Ola Røkke
KEYWORDS:
Gastric Cancer, Chemotherapy, Laparoscopy, Survival, D2 Lymphadenectomy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.2,
February
2,
2018
ABSTRACT: Aims: The treatment of gastric cancer has changed in the
western countries during the last decade. This includes multidisciplinary team
(MDT) meetings, perioperative chemotherapy,
extended lymph node dissection, and laparoscopic surgery, all of which
were gradually implemented at our department from 2008. The aim of the present
study was to determine the effect of these changes on morbidity and survival. Material
and Methods: 185 patients with gastric cancer were operated with curative
intent from 2000 until 2016 in this retrospective, observational, follow-up study; 83
before implementation of modern principles in 2008 (period 1) and 102 were
treated after 2008 (period 2). Results: The resection rate (94% vs 92.8%) and
mortality rates (4.8% vs 2.9%) did not differ between the two periods. In
period 2, 48 patients (47.1%), received neoadjuvant chemotherapy. In 36
patients (35.3%), laparoscopic surgery with D2 lymphadenectomy was performed.
There was a significantly higher yield in the number of lymph nodes in period 2 compared to period 1 (14 vs 8, p pparent between laparoscopic and open surgery in the second period (32 vs 10, p The
five-year survival rate was significantly improved after the change in
treatment principles with an estimated improvement from 30% to 40% between the
periods (p = 0.033). Conclusion: The combined effect of MDT meetings,
neoadjuvant chemotherapy, extended lymphnode dissection and laparoscopy has
improved the prognosis of gastric cancer patients.