Med Bull Sisli Etfal Hosp. 2021; 55(1): 23-32 | DOI: 10.14744/SEMB.2020.14564

Analysis of the Factors Affecting Survival in the Patients who Underwent Curative-Intent Gastrectomy due to Gastric Adenocarcinoma

Serkan Karaisli¹, Ozlem Gur¹, Oguzhan Ozsay², Fevzi Cengiz¹, Ahmet Er¹, Murat Kemal Atahan¹, Yasin Peker¹, Osman Nuri Dilek¹, Mehmet Haciyanli^1
1Department of General Surgery, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
²Department of General Surgery, Ondokuz Mayýs University Faculty of Medicine, Samsun, Turkey

Objectives: Gastric cancer is the fifth most common cancer and the third most common cause of cancer-related deaths in the world. In this study, we aimed to evaluate the impact of clinicopathological factors on overall survival in the patients who underwent curative-intent gastrectomy due to gastric adenocarcinoma.
Methods: The medical records of 644 patients who underwent gastrectomy between January 2007 and January 2017 in our clinic were retrospectively reviewed. Among these patients, 359 patients were included in this study. The impact of several prognostic factors on survival was investigated.
Results: The mean age was 59.2±11.6 (29-83). Male/female ratio was 2.12. The median follow-up time was 19 months (CI=10.1-31.1). Median overall survival was 23±2.3 months (CI=18.3-27.6). Splenectomy, R1 (microscopically incomplete) resection, and advanced stage were independent risk factors for poor prognosis.
Conclusion: R1 resection, splenectomy, and advanced TNM stage were associated with poor prognosis in gastric cancer. Splenectomy should be avoided in the absence of direct invasion of the tumour or metastasis of lymph nodes on splenic hilum to prevent postoperative infectious complication-related mortality.

Keywords: Curative-intent gastrectomy, gastric adenocarcinoma; overall survival; prognostic factor; splenectomy.

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Mide Adenokarsinomu Nedeniyle Küratif Amaçlý Gastrektomi Uygulanan Hastalarda Saðkalýmý Etkileyen Faktörlerin Analizi

Serkan Karaisli¹, Ozlem Gur¹, Oguzhan Ozsay², Fevzi Cengiz¹, Ahmet Er¹, Murat Kemal Atahan¹, Yasin Peker¹, Osman Nuri Dilek¹, Mehmet Haciyanli^1
1Ýzmir Katip Çelebi Üniversitesi Atatürk Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ýzmir
²Ondokuz Mayýs Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Samsun

Amaç: Mide kanseri, dünyada en yaygýn beþinci kanser ve kansere baðlý ölümlerin üçüncü en yaygýn nedenidir. Bu çalýþmada, mide adenokarsinomuna baðlý olarak küratif amaçlý gastrektomi uygulanan hastalarda klinikopatolojik faktörlerin genel saðkalýma etkisini deðerlendirmeyi amaçladýk.
Yöntem: Ocak 2007 - Ocak 2017 tarihleri arasýnda kliniðimizde gastrektomi yapýlan 644 hastanýn týbbi kayýtlarý retrospektif olarak incelendi. Bu hastalardan 359 hasta çalýþmaya dahil edildi. Çeþitli prognostik faktörlerin saðkalýma etkisi araþtýrýldý.
Bulgular: Ortalama yaþ 59,2 ± 11,6 (29-83) idi. Erkek / kadýn oraný 2,12 olarak bulundu. Medyan takip süresi 19 ay (CI = 10,1-31,1) idi. Medyan genel saðkalým 23 ± 2.3 aydý (CI = 18,3-27,6). Splenektomi, R1 (mikroskobik inkomplet) rezeksiyon ve ileri evre tümör kötü prognoz için baðýmsýz risk faktörleri olarak bulundu.
Sonuç: Mide kanserinde R1 rezeksiyon, splenektomi ve ileri TNM evresi kötü prognoz ile iliþkili bulundu. Tümör invazyonu veya dalak hilusunda lenf nodu metastazý olmadýðý durumda postoperatif enfeksiyöz komplikasyonlara baðlý mortalite riski nedeniyle splenektomiden kaçýnýlmalýdýr. (SETB-2020-09-183)

Anahtar Kelimeler: küratif amaçlý gastrektomi, mide adenokarsinomu; genel saðkalým; prognostik faktör; splenektomi

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