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Titolo:
Surgical therapy for adenocarcinoma of the cardia: modalities of recurrence and extension of resection
Autore:
Mattioli, S; Di Simone, MP; Ferruzzi, L; DOvidio, F; Pilotti, V; Carella, R; DErrico, A; Grigioni, WF;
Indirizzi:
Univ Bologna, Dept Surg Intens Care & Transplants, I-40138 Bologna, Italy Univ Bologna Bologna Italy I-40138 & Transplants, I-40138 Bologna, Italy Univ Bologna, Ctr Study & Therapy Dis Esophagus, Dept Oncol, F Addarii Inst,Pathol Div, I-40138 Bologna, Italy Univ Bologna Bologna Italy I-40138 st,Pathol Div, I-40138 Bologna, Italy
Titolo Testata:
DISEASES OF THE ESOPHAGUS
fascicolo: 2, volume: 14, anno: 2001,
pagine: 104 - 109
SICI:
1120-8694(2001)14:2<104:STFAOT>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
GASTRIC CARDIA; GASTROESOPHAGEAL JUNCTION; ESOPHAGOGASTRIC JUNCTION; PROGNOSTIC FACTORS; DISTAL ESOPHAGUS; CARCINOMA; ESOPHAGECTOMY; MANAGEMENT; CANCER;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Mattioli, S Univ Bologna, Dipartimento Discipline Chirurg Rianimatorie & Tr, Via Massarenti 9, I-40138 Bologna, Italy Univ Bologna Via Massarenti 9 Bologna Italy I-40138 na, Italy
Citazione:
S. Mattioli et al., "Surgical therapy for adenocarcinoma of the cardia: modalities of recurrence and extension of resection", DIS ESOPHAG, 14(2), 2001, pp. 104-109

Abstract

In order to define the optimal extent of resection for cancer of the cardia, we considered 116 patients operated upon with five different surgical techniques. The procedures were: transabdominal total gastrectomy associated with distal esophagectomy in 38 patients; transabdominal total gastrectomy and left thoracotomic esophageal resection at the inferior pulmonary vein level in 26 patients; transabdominal total gastrectomy and right thoracotomic esophageal resection at the azygos vein level in 27 patients; transabdominal total gastrectomy and transhiatal lower third esophagectomy in 18 patients; transhiatal total esophagectomy and upper third gastrectomy with cervical esophago-gastroplasty in seven patients. Grading, staging, neoplastic lymphangitis, satellite intramural metastases, infiltration of the resectionmargin, site of recurrence, and survival were analyzed. N+ was the single independent prognostic factor for survival. A poorly differentiated gradingwas related to T (P = 0.0009), N (P = 0.001), satellite growth (P = 0.05),and infiltration of the resection margin (P = 0.0001). Recurrence was local in 26% and distant in 74% of patients. The modalities of recurrence were not related to the aggressiveness parameters and the surgical technique. Infiltration of the esophageal resection margin was related to the type of operation (P = 0.005) and survival (P = 0.02), but it was not related to the site of recurrence. Transabdominal total gastrectomy and the right thoracotomic esophageal resection procedure achieved free margins and control of the lymph nodal metastatic spread. Transabdominal total gastrectomy and rightthoracotomic esophageal resection at the azygos vein level provides a radical oncologic resection, particularly in poorly differentiated tumors. However, surgery alone cannot cure the majority of adenocarcinomas of the cardia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 08:51:51