A consensus reached by experts identified key quality performance indicators for management of oesophagogastric cancer, enhancing patient care and outcomes. The two-round modified Delphi process resulted in a standardized list which includes specialized multi-disciplinary discussions, pertinent imaging and staging procedures, as well as specific surgical benchmarks. Notably, indicators unique to gastric and oesophageal cancers were […]
Category: Upper Gastrointestinal Tract
Nomograms effectively predict treatment outcomes in esophageal cancer patients.
In a study of 188 patients undergoing neoadjuvant therapy for locally advanced esophageal cancer, researchers developed predictive nomograms showing strong performance for estimating tumor regression grade (TRG) and ypTNM stage. Notably, 129 patients reached TRG grades 0-1, while 118 achieved ypTNM stage I. Five independent TRG predictors included pulmonary function tests and combination immunotherapy. The […]
Total neoadjuvant therapy shows promising survival in gastric cancer.
A study involving 203 gastric cancer patients revealed that total neoadjuvant therapy (TNT) resulted in a 5-year overall survival (OS) rate of 65.2% and a disease-specific survival (DSS) rate of 70.8%. Notably, patients achieving pathologic complete response (PCR) had significantly better outcomes, with 5-year OS at 89.1% and DSS at 96.9%. High rates of treatment […]
CHAMPS Score Outperforms Existing Tools in Predicting Mortality
The CHAMPS score proved highly effective in predicting mortality in patients with non-variceal upper gastrointestinal bleeding, showing an area under the receiver operating characteristic curve (AUROC) of 0.89. It significantly outperformed the Glasgow-Blatchford score (0.72) and AIM65 score (0.71). In low-risk categories, mortality and rebleeding rates were zero; however, 58.8% of patients in the low-risk […]
Prognostic models enhance survival predictions for gastric carcinoma
Development and validation of prognostic models for gastric carcinoma were achieved using data from 1,650 patients post-gastrectomy. The nomogram for node-negative lymphatic metastasis (c-index 0.719) and node-positive metastasis (c-index 0.674) outperformed the AJCC 8th edition TNM staging. Key variables included age, tumor stage, and maximum diameter for node-negative cases, while additional factors like neural invasion […]
Higher frailty predicts serious complications in gastric cancer surgery
Increased frailty, as measured by the modified 5-item frailty index (mFI-5), significantly predicts adverse postoperative outcomes for gastric cancer patients undergoing gastrectomy. Among 7,438 patients, those with an mFI-5 score of 2 or higher faced a 1.43 times greater risk of overall complications and a 2.91 times increased risk of myocardial infarction. This correlation underscores […]
Participating hospitals show reduced mortality after esophagectomy.
Higher-level care at hospitals participating in the ACS NSQIP targeted registry significantly improves esophagectomy outcomes. Analysis indicated targeted centers had a lower mortality rate (2% vs. 4%) and failure-to-rescue rate (11% vs. 17%), alongside a greater likelihood of optimal outcomes (62% vs. 58%). Notably, Ivor Lewis esophagectomies at these facilities were linked to approximately half […]
Proximal gastrectomy with double-tract offers viable surgical option.
The meta-analysis examined outcomes of proximal gastrectomy versus total gastrectomy in 1154 patients. Results indicated that while proximal gastrectomy had a slightly longer operating time, it yielded better results in hemoglobin levels and reduced need for vitamin B12 supplementation. Early and late-phase complications were comparable between both groups. Importantly, the 5-year overall survival rates were […]
Lymph node metastasis differs significantly between gastric carcinoma types.
A study of 891 Chinese patients revealed distinct risk factors for lymph node metastasis (LNM) and prognosis in submucosal early gastric cardiac (SEGCC) versus noncardiac (SEGNCC) carcinomas. Elderly patients and specific tumor characteristics were more prevalent in SEGCC, which correlated with poorer prognoses. Univariate and multivariate analyses identified female sex and lymphovascular invasion as key […]
Single-vessel transection reconstruction reduces surgery time and bleeding
The clinical study revealed that single-vessel transection Roux-en-Y reconstruction following total gastrectomy significantly shortened operation time (162.5 min vs. 178.5 min) and reduced intraoperative bleeding (167.2 ml vs. 207.8 ml) compared to conventional Roux-en-Y reconstruction in patients with proximal gastric cancer. No notable differences were found in baseline characteristics, mesentery tension, peritoneal drainage durations, postoperative […]