Huang HB, Gao ZM, Sun AQ, Liang WT, Li K. Subtotal gastrectomy combined with chemotherapy: An effective therapy for patients with circumscribed Borrmann type IV gastric cancer. World J Gastrointest Oncol 2020; 12(11): 1325-1335 [PMID: 33250964 DOI: 10.4251/wjgo.v12.i11.1325]
Corresponding Author of This Article
Kai Li, PhD, Professor, Department of Surgical Oncology and General Surgery, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Street, Shenyang 110001, Liaoning Province, China. cmu_likai@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Nov 15, 2020; 12(11): 1325-1335 Published online Nov 15, 2020. doi: 10.4251/wjgo.v12.i11.1325
Subtotal gastrectomy combined with chemotherapy: An effective therapy for patients with circumscribed Borrmann type IV gastric cancer
Hai-Bo Huang, Zi-Ming Gao, An-Qi Sun, Wei-Tian Liang, Kai Li
Hai-Bo Huang, Zi-Ming Gao, An-Qi Sun, Wei-Tian Liang, Kai Li, Department of Surgical Oncology and General Surgery, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Huang HB and Li K designed the research; Gao ZM and Li K treated the patients and collected the material and clinical data from the patients; Huang HB and Sun AQ performed the assays; Liang WT and Huang HB analyzed the data; Huang HB wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of First Affiliated Hospital of China Medical University.
Informed consent statement: Written informed consent was obtained from each patient.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Li, PhD, Professor, Department of Surgical Oncology and General Surgery, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Street, Shenyang 110001, Liaoning Province, China. cmu_likai@163.com
Received: July 26, 2020 Peer-review started: July 26, 2020 First decision: August 9, 2020 Revised: August 20, 2020 Accepted: September 25, 2020 Article in press: September 25, 2020 Published online: November 15, 2020
ARTICLE HIGHLIGHTS
Research background
Borrmann type IV (B-4) gastric cancer (GC) accounts for about 10% of all GC cases in Asia. Some B-4 patients were found to have no distant metastasis by preoperative detection and underwent curative surgery, which was defined as circumscribed B-4 in our study.
Research motivation
Research of clinicopathological characteristics and prognosis in B-4 is rare, especially for the circumscribed B-4 patients.
Research objectives
In this study, we aimed to identify the factors related to prognosis and postoperative peritoneal cavity metastasis (PPCM) for circumscribed B-4 patients and to further explore the appropriate therapeutic strategies.
Research methods
A total of 117 circumscribed B-4 patients were included in this study. Survival analysis and Pearson correlation analyses were performed to identify the factors related to prognosis.
Research results
Subtotal gastrectomy combined with chemotherapy could significantly improve the long-term survival time for circumscribed B-4. Positive lymph node staus was the only factor correlated with PPCM, and chemotherapy was useful for suppressing PPCM in patients with subtotal gastrectomy but not in those with total gastrectomy.
Research conclusions
Lymph node status is an independent prognostic factor for circumscribed B-4 patients. Subtotal gastrectomy and chemotherapy could effectively improve prognosis and suppress PPCM.
Research perspectives
This study recommended reasonable treatment schedules for circumscribed B-4 patients, but a multi-center study on a larger scale is necessary in the future.
