Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in pati...Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in patients who participated in a phase 3 randomized clinical trial of ICG-guided laparoscopic radical gastrectomy vs.conventional laparoscopic radical gastrectomy from November 2018 to July 2019.The VFA was calculated based on preoperative computed tomography images.Short-term efficacy included the quality of lymph node(LN)dissection and surgical outcomes,while long-term efficacy included overall survival(OS)and recurrence-free survival(RFS).Results:This study included 126 patients each in the ICG(high-VFA,n=43)and non-ICG groups(high-VFA,n=38).Compared with the non-ICG group,the ICG group had significantly more retrieved LNs(low-VFA:50.1 vs.43.9,P=0.001;high-VFA:49.6 vs.37.5,P<0.001)and a significantly lower LN noncompliance rate(low-VFA:32.5%vs.50.0%,P=0.020;high-VFA:32.6%vs.73.7%,P<0.001),regardless of the VFA.The ICG group had a shorter postoperative hospital stay and fewer intra-abdominal infections than the ICG group in the high-VFA patients(P=0.025 and P=0.020,respectively)but not in the low-VFA patients.Regardless of the VFA,the 3-year OS(RFS)was better in the ICG group than in the non-ICG group[low-VFA:83.1%(76.9%)vs.73.9%(67.0%);high-VFA:90.7%(90.7%)vs.73.7%(73.5%);P for interaction=0.474(0.547)].Conclusions:The short-and long-term efficacies of ICG tracing were not influenced by visceral obesity.展开更多
Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods: We retrospectively assessed 1,694 patients who underwent curative gastrect...Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods: We retrospectively assessed 1,694 patients who underwent curative gastrectomy from January 2010 to August 2014. Patients stratified according to lymph node status and recurrence patterns among different subgroups were compared.Results: Of all, 517(30.5%) patients developed recurrent disease, and complete data of recurrence could be obtained in 493(95.4%) patients. For p^(N0) patients, the patterns of recurrence were different according to p T stage: locoregional recurrence was most common in patients with p T1-2 disease(57.1%), distant recurrence was most common in patients with p T3 disease(57.1%), and peritoneal recurrence was most common in patients with p T4 a disease(66.7%). For p^(N+) patients, distant metastasis was most common pattern irrespective of p T stage. The site-specific trend of recurrence showed that locoregional recurrence increased within 5 years in patients with p^(N0)-2 disease but plateaued 3 years after surgery in patients with p N3 disease. Time to recurrence was significantly longer for the p^(N0) patients compared with the p^(N+) patients(median: 25 vs. 16 months, P=0.001).Moreover, post-recurrence survival was significantly better for the p^(N0) patients than for the p^(N+) patients(median:12 vs. 6 months, P<0.001), especially in patients with non-peritoneal recurrence, late recurrence, single recurrence,and receipt of potential curative treatment.Conclusions: Among clinicopathologic factors, lymph node status is the most important factor associated with recurrence patterns after curative gastrectomy. Lymph node status may be used as an adjunct in clinical decisionmaking about postoperative therapeutic and follow-up strategies.展开更多
基金supported by the Construction Funds for“High-level Hospitals and Clinical Specialties”of Fujian Province(No.[2021]76)。
文摘Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in patients who participated in a phase 3 randomized clinical trial of ICG-guided laparoscopic radical gastrectomy vs.conventional laparoscopic radical gastrectomy from November 2018 to July 2019.The VFA was calculated based on preoperative computed tomography images.Short-term efficacy included the quality of lymph node(LN)dissection and surgical outcomes,while long-term efficacy included overall survival(OS)and recurrence-free survival(RFS).Results:This study included 126 patients each in the ICG(high-VFA,n=43)and non-ICG groups(high-VFA,n=38).Compared with the non-ICG group,the ICG group had significantly more retrieved LNs(low-VFA:50.1 vs.43.9,P=0.001;high-VFA:49.6 vs.37.5,P<0.001)and a significantly lower LN noncompliance rate(low-VFA:32.5%vs.50.0%,P=0.020;high-VFA:32.6%vs.73.7%,P<0.001),regardless of the VFA.The ICG group had a shorter postoperative hospital stay and fewer intra-abdominal infections than the ICG group in the high-VFA patients(P=0.025 and P=0.020,respectively)but not in the low-VFA patients.Regardless of the VFA,the 3-year OS(RFS)was better in the ICG group than in the non-ICG group[low-VFA:83.1%(76.9%)vs.73.9%(67.0%);high-VFA:90.7%(90.7%)vs.73.7%(73.5%);P for interaction=0.474(0.547)].Conclusions:The short-and long-term efficacies of ICG tracing were not influenced by visceral obesity.
基金supported by Scientific and Technological Innovation Joint Capital Projects of Fujian Province, China (No. 2017Y9011)Minimally Invasive Medical Center of Fujian Province (No. [2017]171)+1 种基金Project supported by the Science Foundation of the Fujian Province, China (No. 2018J01307)Joint Funds for the innovation of science and Technology, Fujian province (No. 2018Y9041)。
文摘Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods: We retrospectively assessed 1,694 patients who underwent curative gastrectomy from January 2010 to August 2014. Patients stratified according to lymph node status and recurrence patterns among different subgroups were compared.Results: Of all, 517(30.5%) patients developed recurrent disease, and complete data of recurrence could be obtained in 493(95.4%) patients. For p^(N0) patients, the patterns of recurrence were different according to p T stage: locoregional recurrence was most common in patients with p T1-2 disease(57.1%), distant recurrence was most common in patients with p T3 disease(57.1%), and peritoneal recurrence was most common in patients with p T4 a disease(66.7%). For p^(N+) patients, distant metastasis was most common pattern irrespective of p T stage. The site-specific trend of recurrence showed that locoregional recurrence increased within 5 years in patients with p^(N0)-2 disease but plateaued 3 years after surgery in patients with p N3 disease. Time to recurrence was significantly longer for the p^(N0) patients compared with the p^(N+) patients(median: 25 vs. 16 months, P=0.001).Moreover, post-recurrence survival was significantly better for the p^(N0) patients than for the p^(N+) patients(median:12 vs. 6 months, P<0.001), especially in patients with non-peritoneal recurrence, late recurrence, single recurrence,and receipt of potential curative treatment.Conclusions: Among clinicopathologic factors, lymph node status is the most important factor associated with recurrence patterns after curative gastrectomy. Lymph node status may be used as an adjunct in clinical decisionmaking about postoperative therapeutic and follow-up strategies.
