Oncological outcomes of function-preserving gastrectomy for early gastric cancer: a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy

Masaki Aizawa, Michitaka Honda, Naoki Hiki, Takahiro Kinoshita, Hiroshi Yabusaki, Souya Nunobe, Hidehito Shibasaki, Atsushi Matsuki, Masahiro Watanabe, Takayuki Abe

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: This study aimed to clarify the oncological safety of pylorus-preserving gastrectomy (PPG) compared with conventional distal gastrectomy (DG). Methods: From three institutions specializing in cancer, the medical records for a cohort of 2898 consecutive patients who had undergone DG (n = 2208) or PPG (n = 690) for clinical stage I gastric cancer between January 2006 and December 2012 were analyzed. A propensity score for each patient was estimated on the basis of 38 preoperative clinical and tumor-related factors. After propensity score matching had been done, 1004 patients (502 DG patients, 502 PPG patients) were included in the analysis. The overall survival, relapse-free survival, and occurrence of secondary gastric cancer were then compared. The median observation period was 48.6 months (range 1–109.8 months). Results: The 5-year overall survival rate was 98.4 % for the PPG group and 96.6 % for the DG group (hazard ratio 0.48, 95 % confidence interval 0.21–1.09, P = 0.07). The 3-year relapse-free survival rate was 99.5 % for the PPG group and 98.0 % for the DG group (hazard ratio 0.39, 95 % confidence interval 0.12–1.33, P = 0.12). Postoperative secondary gastric cancer was encountered in eight patients (1.6 %) in the PPG group and four patients (0.8 %) in the DG group. No significant differences in either overall survival, relapse-free survival, or the occurrence of secondary gastric cancer were observed between the two groups. Conclusions: Given the adequate estimation of the clinical tumor stage, the oncological safety of PPG for clinical T1N0 gastric cancer in the middle portion of the stomach was comparable to that of DG.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalGastric Cancer
DOIs
Publication statusAccepted/In press - 2016 Sep 26

Fingerprint

Propensity Score
Pylorus
Gastrectomy
Stomach Neoplasms
Cohort Studies
Survival
Recurrence
Survival Rate
Confidence Intervals
Safety
Neoplasms
Medical Records

Keywords

  • Gastric cancer
  • Propensity-matched score
  • Pylorus-preserving gastrectomy

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Oncological outcomes of function-preserving gastrectomy for early gastric cancer : a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy. / Aizawa, Masaki; Honda, Michitaka; Hiki, Naoki; Kinoshita, Takahiro; Yabusaki, Hiroshi; Nunobe, Souya; Shibasaki, Hidehito; Matsuki, Atsushi; Watanabe, Masahiro; Abe, Takayuki.

In: Gastric Cancer, 26.09.2016, p. 1-9.

Research output: Contribution to journalArticle

Aizawa, Masaki ; Honda, Michitaka ; Hiki, Naoki ; Kinoshita, Takahiro ; Yabusaki, Hiroshi ; Nunobe, Souya ; Shibasaki, Hidehito ; Matsuki, Atsushi ; Watanabe, Masahiro ; Abe, Takayuki. / Oncological outcomes of function-preserving gastrectomy for early gastric cancer : a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy. In: Gastric Cancer. 2016 ; pp. 1-9.
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abstract = "Objective: This study aimed to clarify the oncological safety of pylorus-preserving gastrectomy (PPG) compared with conventional distal gastrectomy (DG). Methods: From three institutions specializing in cancer, the medical records for a cohort of 2898 consecutive patients who had undergone DG (n = 2208) or PPG (n = 690) for clinical stage I gastric cancer between January 2006 and December 2012 were analyzed. A propensity score for each patient was estimated on the basis of 38 preoperative clinical and tumor-related factors. After propensity score matching had been done, 1004 patients (502 DG patients, 502 PPG patients) were included in the analysis. The overall survival, relapse-free survival, and occurrence of secondary gastric cancer were then compared. The median observation period was 48.6 months (range 1–109.8 months). Results: The 5-year overall survival rate was 98.4 {\%} for the PPG group and 96.6 {\%} for the DG group (hazard ratio 0.48, 95 {\%} confidence interval 0.21–1.09, P = 0.07). The 3-year relapse-free survival rate was 99.5 {\%} for the PPG group and 98.0 {\%} for the DG group (hazard ratio 0.39, 95 {\%} confidence interval 0.12–1.33, P = 0.12). Postoperative secondary gastric cancer was encountered in eight patients (1.6 {\%}) in the PPG group and four patients (0.8 {\%}) in the DG group. No significant differences in either overall survival, relapse-free survival, or the occurrence of secondary gastric cancer were observed between the two groups. Conclusions: Given the adequate estimation of the clinical tumor stage, the oncological safety of PPG for clinical T1N0 gastric cancer in the middle portion of the stomach was comparable to that of DG.",
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T2 - a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy

AU - Aizawa, Masaki

AU - Honda, Michitaka

AU - Hiki, Naoki

AU - Kinoshita, Takahiro

AU - Yabusaki, Hiroshi

AU - Nunobe, Souya

AU - Shibasaki, Hidehito

AU - Matsuki, Atsushi

AU - Watanabe, Masahiro

AU - Abe, Takayuki

PY - 2016/9/26

Y1 - 2016/9/26

N2 - Objective: This study aimed to clarify the oncological safety of pylorus-preserving gastrectomy (PPG) compared with conventional distal gastrectomy (DG). Methods: From three institutions specializing in cancer, the medical records for a cohort of 2898 consecutive patients who had undergone DG (n = 2208) or PPG (n = 690) for clinical stage I gastric cancer between January 2006 and December 2012 were analyzed. A propensity score for each patient was estimated on the basis of 38 preoperative clinical and tumor-related factors. After propensity score matching had been done, 1004 patients (502 DG patients, 502 PPG patients) were included in the analysis. The overall survival, relapse-free survival, and occurrence of secondary gastric cancer were then compared. The median observation period was 48.6 months (range 1–109.8 months). Results: The 5-year overall survival rate was 98.4 % for the PPG group and 96.6 % for the DG group (hazard ratio 0.48, 95 % confidence interval 0.21–1.09, P = 0.07). The 3-year relapse-free survival rate was 99.5 % for the PPG group and 98.0 % for the DG group (hazard ratio 0.39, 95 % confidence interval 0.12–1.33, P = 0.12). Postoperative secondary gastric cancer was encountered in eight patients (1.6 %) in the PPG group and four patients (0.8 %) in the DG group. No significant differences in either overall survival, relapse-free survival, or the occurrence of secondary gastric cancer were observed between the two groups. Conclusions: Given the adequate estimation of the clinical tumor stage, the oncological safety of PPG for clinical T1N0 gastric cancer in the middle portion of the stomach was comparable to that of DG.

AB - Objective: This study aimed to clarify the oncological safety of pylorus-preserving gastrectomy (PPG) compared with conventional distal gastrectomy (DG). Methods: From three institutions specializing in cancer, the medical records for a cohort of 2898 consecutive patients who had undergone DG (n = 2208) or PPG (n = 690) for clinical stage I gastric cancer between January 2006 and December 2012 were analyzed. A propensity score for each patient was estimated on the basis of 38 preoperative clinical and tumor-related factors. After propensity score matching had been done, 1004 patients (502 DG patients, 502 PPG patients) were included in the analysis. The overall survival, relapse-free survival, and occurrence of secondary gastric cancer were then compared. The median observation period was 48.6 months (range 1–109.8 months). Results: The 5-year overall survival rate was 98.4 % for the PPG group and 96.6 % for the DG group (hazard ratio 0.48, 95 % confidence interval 0.21–1.09, P = 0.07). The 3-year relapse-free survival rate was 99.5 % for the PPG group and 98.0 % for the DG group (hazard ratio 0.39, 95 % confidence interval 0.12–1.33, P = 0.12). Postoperative secondary gastric cancer was encountered in eight patients (1.6 %) in the PPG group and four patients (0.8 %) in the DG group. No significant differences in either overall survival, relapse-free survival, or the occurrence of secondary gastric cancer were observed between the two groups. Conclusions: Given the adequate estimation of the clinical tumor stage, the oncological safety of PPG for clinical T1N0 gastric cancer in the middle portion of the stomach was comparable to that of DG.

KW - Gastric cancer

KW - Propensity-matched score

KW - Pylorus-preserving gastrectomy

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