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Clinical and Translational Oncology

, Volume 19, Issue 6, pp 750–760 | Cite as

Impact of clinicopathological parameters on survival after multiorgan resection among patients with T4 gastric carcinoma: a systematic review and meta-analysis

  • G. ZuEmail author
  • T. Zhang
  • W. Li
  • Y. Sun
  • X. ZhangEmail author
Research Article

Abstract

Background

The prognostic factors which can improve the overall survival (OS) of patients with T4 gastric carcinoma (GC) are still controversial: a meta-analysis was conducted to analyze the impact of clinicopathological parameters on survival after MOR among patients with T4 GC.

Methods

A systematic search was performed. Odd risks (ORs) of patients with T4 GC were used to calculate the relationship between clinicopathological parameters and OS.

Results

Nine studies involving 941 patients with T4 GC were identified. Well-moderate differentiation led to increased 1-, 3-, 5-year OS with an OR of 2.63, 1.58 and 1.45. Borrmann type I–II led to increased 1-, 3-year OS with an OR of 1.67 and 2.08. No lymph node metastasis led to increased 1-, 3-, 5-year OS with an OR of 7.16, 3.18 and 3.71. Total gastrectomy led to increased 1-, 3-year OS with an OR of 2.01 and 1.79. ≥2 Organs resected led to increased 1-, 3-year OS with an OR of 2.19 and 2.19. TNM stage II–III led to increased 1-, 3-year OS with an OR of 3.68 and 5.75. Curative resection led to increased 1-, 3-, 5-year OS with an OR of 4.46, 5.80 and 5.98.

Conclusion

Well-moderate differentiation, Borrmann type I–II, no lymph node metastasis, total gastrectomy, ≥2 organs resected, TNM stage II–III and curative resection were positive prognostic factors for OS of patients with T4 GC.

Keywords

Clinicopathological parameters Survival Multiorgan resection Gastric carcinoma 

Notes

Acknowledgements

G. Zu and X. Zhang designed the research; W. Li and T. Zhang conducted the research; W. Li and Y. Sun analyzed data; G. Zu wrote the draft; all authors read, reviewed and approved the final manuscript. G. Zu and X. Zhang had primary responsibility for final content.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. 1.
    Ferro A, Peleteiro B, Malvezzi M, Bosetti C, Bertuccio P, Levi F, et al. Worldwide trends in gastric cancer mortality (1980–2011), with predictions to 2015, and incidence by subtype. Eur J Cancer. 2014;50(7):1330–44.CrossRefPubMedGoogle Scholar
  2. 2.
    Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24(14):2137–50.CrossRefPubMedGoogle Scholar
  3. 3.
    Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.CrossRefPubMedGoogle Scholar
  4. 4.
    Catalano V, Labianca R, Beretta GD, Gatta G, de Braud F, Van Cutsem E. Gastric cancer. Crit Rev Oncol/Hematol. 2005;54(3):209–41.CrossRefGoogle Scholar
  5. 5.
    Spolverato G, Ejaz A, Kim Y, Squires MH, Poultsides G, Fields RC, et al. Prognostic performance of different lymph node staging systems after curative intent resection for gastric adenocarcinoma. Ann Surg. 2015;262(6):991–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Jeong O, Choi WY, Park YK. Appropriate selection of patients for combined organ resection in cases of gastric carcinoma invading adjacent organs. J Surg Oncol. 2009;100(2):115–20.CrossRefPubMedGoogle Scholar
  7. 7.
    Kunisaki C, Akiyama H, Nomura M, Matsuda G, Otsuka Y, Ono HA, et al. Surgical outcomes in patients with T4 gastric carcinoma. J Am Coll Surg. 2006;202(2):223–30.CrossRefPubMedGoogle Scholar
  8. 8.
    Kim DY, Joo JK, Seo KW, Park YK, Ryu SY, Kim HR, et al. T4 gastric carcinoma: the benefit of non-curative resection. ANZ J Surg. 2006;76(6):453–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Saito H, Kuroda H, Matsunaga T, Fukuda K, Tatebe S, Tsujitani S, et al. Prognostic indicators in node-negative advanced gastric cancer patients. J Surg Oncol. 2010;101(7):622–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Zu G, Ji A, Zhou T, Che N. Clinicopathological significance of SIRT1 expression in colorectal cancer: a systematic review and meta-analysis. Int J Surg. 2016;26(2):32–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Carboni F, Lepiane P, Santoro R, Lorusso R, Mancini P, Sperduti I, et al. Extended multiorgan resection for T4 gastric carcinoma: 25-year experience. J Surg Oncol. 2005;90(2):95–100.CrossRefPubMedGoogle Scholar
  12. 12.
    Oñate-Ocaña LF, Becker M, Carrillo JF, Aiello-Crocifoglio V, Gallardo-Rincón D, Brom-Valladares R, et al. Selection of best candidates for multiorgan resection among patients with T4 gastric carcinoma. J Surg Oncol. 2008;98(5):336–42.CrossRefPubMedGoogle Scholar
  13. 13.
    Ozer I, Bostanci EB, Orug T, Ozogul YB, Ulas M, Ercan M, et al. Surgical outcomes and survival after multiorgan resection for locally advanced gastric cancer. Am J Surg. 2009;198(1):25–30.CrossRefPubMedGoogle Scholar
  14. 14.
    Cheng CT, Tsai CY, Hsu JT, Vinayak R, Liu KH, Yeh CN, et al. Aggressive surgical approach for patients with T4 gastric carcinoma: promise or myth? Ann Surg Oncol. 2011;18(6):1606–14.CrossRefPubMedGoogle Scholar
  15. 15.
    Mita K, Ito H, Fukumoto M, Murabayashi R, Koizumi K, Hayashi T, et al. Surgical outcomes and survival after extended multiorgan resection for T4 gastric cancer. Am J Surg. 2012;203(1):107–11.CrossRefPubMedGoogle Scholar
  16. 16.
    Xiao L, Li M, Xu F, Ye H, Wu W, Long S, et al. Extended multi-organ resection for cT4 gastric carcinoma: a retrospective analysis. Pak J Med Sci. 2013;29(2):581–5.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Shan G, Rong Y, Jiang D, Zhu D, Zhang L, Jiang J. Prognostic analysis for patients with T4 gastric cancer undergoing radical resection. Chin J Gen Surg. 2013;22(10):1271–5.Google Scholar
  18. 18.
    Yiming L, Latengbaolide A, Bo C, Caigang L, Huimian X. Comparison of surgical methods and prognostic factors in T4 gastric cancer. Chin Ger J Clin Oncol. 2010;9(7):391–5.CrossRefGoogle Scholar
  19. 19.
    Lin D, Ping L, Liu C, Wang H, Altbad W, Zhao C, et al. Surgical outcomes in patients with T4 gastric carcinoma: a retrospective study of 162 patients. Chin Ger J Clin Oncol. 2009;8(10):599–602.CrossRefGoogle Scholar
  20. 20.
    McCulloch P. The role of surgery in patients with advanced gastric cancer. Best Pract Res Clin Gastroenterol. 2006;20(4):767–87.CrossRefPubMedGoogle Scholar
  21. 21.
    McCullough JA, Evoy D, Sweeney KJ, Meyers C, Ravi N, Keeling N, et al. D2 lymphadenectomy in the management of gastric cancer. Ir J Med Sci. 2003;172(3):132–5.CrossRefPubMedGoogle Scholar
  22. 22.
    Radovanović D, Stevanović D, Pavlović I, Bajec A, Vekić B, Mitrović N. Multiorgan resection in patients with gastric cancer. Med Pregl. 2004;57(9–10):480–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Kim ER, Lee H, Min BH, Lee JH, Rhee PL, Kim JJ, et al. Effect of rescue surgery after non-curative endoscopic resection of early gastric cancer. Br J Surg. 2015;102(11):1394–401.CrossRefPubMedGoogle Scholar
  24. 24.
    Isozaki H, Tanaka N, Tanigawa N, Okajima K. Prognostic factors in patients with advanced gastric cancer with macroscopic invasion to adjacent organs treated with radical surgery. Gastric Cancer. 2000;3(4):202–10.CrossRefPubMedGoogle Scholar
  25. 25.
    Kobayashi A, Nakagohri T, Konishi M, Inoue K, Takahashi S, Itou M, et al. Aggressive surgical treatment for T4 gastric cancer. J Gastrointestinal Surg. 2004;8(4):464–70.CrossRefGoogle Scholar
  26. 26.
    Kim JH, Jang YJ, Park SS, Park SH, Kim SJ, Mok YJ, et al. Surgical outcomes and prognostic factors for T4 gastric cancers. Asian J Surg. 2009;32(4):198–204.CrossRefPubMedGoogle Scholar
  27. 27.
    Climent M, Hidalgo N, Vidal Ó, Puig S, Iglesias M, Cuatrecasas M, et al. Postoperative complications do not impact on recurrence and survival after curative resection of gastric cancer. Eur J Surg Oncol. 2016;42(1):132–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Jiang N, Deng JY, Ding XW, Zhang L, Liu HG, Liang YX, et al. Effect of complication grade on survival following curative gastrectomy for carcinoma. World J Gastroenterol. 2014;20(25):8244–52.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2016

Authors and Affiliations

  1. 1.Department of Gastroenterology SurgeryThe Dalian Municipal Central Hospital Affiliated of Dalian Medical UniversityDalianPeople’s Republic of China

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