Comparação da sobrevivência e dos fatores prognósticos em pacientes com adenocarcinoma gástrico T2 e T3

OBJECTIVE: To compare the survival and prognosis after surgical treatment of patients with gastric adenocarcinoma which extends to the muscular layer (T2), and patients whose tumor invades the subserosa (T3). METHODS: This was a retrospective study of 122 patients with gastric cancer invading the mu...

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Detalles Bibliográficos
Autores: Jucá, Patrícia Campos, Lourenço, Laércio Gomes [UNIFESP], Kesley, Rubens, Mello, Eduardo Linhares Riello de, Oliveira, Ivanir Martins de, Correa, José Humberto Simões
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2012
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:portugués
OAI Identifier:oai:repositorio.unifesp.br:11600/7334
Acceso en línea:http://dx.doi.org/10.1590/S0100-69912012000500007
http://repositorio.unifesp.br/handle/11600/7334
Access Level:acceso abierto
Palabra clave:Prognosis
Neoplasms
Stomach neoplasms
Adenocarcinoma
Survival rate
Prognóstico
Neoplasias
Neoplasias gástricas
Taxa de sobrevida
Descripción
Sumario:OBJECTIVE: To compare the survival and prognosis after surgical treatment of patients with gastric adenocarcinoma which extends to the muscular layer (T2), and patients whose tumor invades the subserosa (T3). METHODS: This was a retrospective study of 122 patients with gastric cancer invading the muscularis propria and subserosa, undergoing surgical treatment from January 1997 to December 2008 and followed-up until December 2010. We analyzed demographic, surgical and pathological variables. RESULTS: Of the 122 patients, 22 (18%) were excluded from the final analysis because they showed: positive margin or less than 15 lymph nodes in the surgical specimen, early postoperative mortality and second primary tumors. Among the 100 patients included, 75 had tumors inveding the muscularis propria (T2) and 25 with extension to the subserosa (T3). Overall survival was 83.8%, and 90.6% for T2 and 52.1% or T3. Univariate analysis showed statistical significance in: lymph node metastasis (p = 0.02), tumor size (p = 0.000), tumor pathological stage (p = 0.000), lymph node pathologic stage (p = 0.000) and staging by classification of groups TNM-UICC/AJCC, 2010 (p = 0.000). In multivariate analysis, independent prognostic factors were tumor size and lymph node pathological staging (pN). CONCLUSION: The lymph node status and tumor size are independent prognostic factors in tumors with invasion of the muscularis propria and in tumors with invasion of subserosa. T2 lesions have smaller size, lower rate of lymph node metastasis and therefore better prognosis than T3.