BACKGROUND: In The Netherlands, standardised limited D1 and extended D2 lymph node dissections in the treatment of resectable gastric cancer were introduced nationwide within the framework of the Dutch D1-D2 Gastric Cancer Trial between 1989 and 1993. In a population-based study, we evaluated whether the survival of patients with resectable gastric cancer improved over time on a regional level. METHODS: We compared 5-year overall and relative survival of patients with curatively resected non-cardia gastric cancer in the regional cancer registry of the Comprehensive Cancer Centre West in The Netherlands before the Dutch D1-D2 trial (1986 to mid 1989; n = 273), during the trial period (mid 1989 to mid 1993; n = 255), and after the trial (mid 1993 to 1999; n = 219), adjusting for prognostic variables. RESULTS: Unadjusted survival was highest in the post-trial period: 5-year overall and relative survival were 42% and 52%, respectively, compared to 34% and 41% in the pre-trial period, and 39% and 46% in the trial period (p = 0.31 and p = 0.06, respectively). After adjustment for age, gender, tumour site, pT-stage, nodal status and hospital volume, the effect of period on survival was more apparent (p = 0.009). Compared to the pre-trial period, the hazard ratio was 0.83 (95% confidence interval, 0.68-1.02) for the trial period, and 0.72 (0.58-0.89) after the trial. Less than 1% of the patients received adjuvant therapy. CONCLUSION: Survival of patients with curatively resected non-cardia gastric cancer has improved. Standardisation and surgical training in D1 and D2 lymph node dissection are the most likely explanation for this improvement.
BACKGROUND: In The Netherlands, standardised limited D1 and extended D2 lymph node dissections in the treatment of resectable gastric cancer were introduced nationwide within the framework of the Dutch D1-D2 Gastric Cancer Trial between 1989 and 1993. In a population-based study, we evaluated whether the survival of patients with resectable gastric cancer improved over time on a regional level. METHODS: We compared 5-year overall and relative survival of patients with curatively resected non-cardia gastric cancer in the regional cancer registry of the Comprehensive Cancer Centre West in The Netherlands before the Dutch D1-D2 trial (1986 to mid 1989; n = 273), during the trial period (mid 1989 to mid 1993; n = 255), and after the trial (mid 1993 to 1999; n = 219), adjusting for prognostic variables. RESULTS: Unadjusted survival was highest in the post-trial period: 5-year overall and relative survival were 42% and 52%, respectively, compared to 34% and 41% in the pre-trial period, and 39% and 46% in the trial period (p = 0.31 and p = 0.06, respectively). After adjustment for age, gender, tumour site, pT-stage, nodal status and hospital volume, the effect of period on survival was more apparent (p = 0.009). Compared to the pre-trial period, the hazard ratio was 0.83 (95% confidence interval, 0.68-1.02) for the trial period, and 0.72 (0.58-0.89) after the trial. Less than 1% of the patients received adjuvant therapy. CONCLUSION: Survival of patients with curatively resected non-cardia gastric cancer has improved. Standardisation and surgical training in D1 and D2 lymph node dissection are the most likely explanation for this improvement.
Authors: Giuseppe Verlato; Simone Giacopuzzi; Maria Bencivenga; Paolo Morgagni; Giovanni De Manzoni Journal: World J Gastroenterol Date: 2014-09-28 Impact factor: 5.742
Authors: Johan L Dikken; Marcel Verheij; Annemieke Cats; Edwin P M Jansen; Henk H Hartgrink; Cornelis J H van de Velde Journal: Gastric Cancer Date: 2011-08-12 Impact factor: 7.370
Authors: Radoslaw Jaworski; Elfriede Bollschweiler; Arnulf H Holscher; Stefan P Monig; Jaroslaw Skokowski; Jacek Zielinski; Maciej Swierblewski; Andrzej Kopacz; Janusz Jaskiewicz Journal: Gastric Cancer Date: 2011-03-26 Impact factor: 7.370
Authors: Sung Hwan Hwang; Hyun Il Kim; Jun Seong Song; Min Hong Lee; Sung Joon Kwon; Min Gyu Kim Journal: J Gastric Cancer Date: 2016-12-20 Impact factor: 3.720