Evidence-Based Treatment for a Patient of Stage T2N0M0 Stomach Sinus Cancer_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Yan ling , YUE Ji rong , CAO Li

Department of Gariatrics; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Stomach sinus cancer; Treatment; Prognosis

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Stomach cancer is a malignancy arising from the stomach mucous epithelium. It accounts for 95% of all stomach malignancy cancer. The prevalence of stomach cancer is high in China and the treatment is debated, especially regarding choice of chemotherapy and treatment duration. In order to identify the best treatment and follow-up for patient with stage T2N0M0 stomach sinus cancer, we searched MEDLINE, SUMsearch, The Cochrane Library (Issue 4, 2004), Clinical Evidence (Issue 4, 2003) and CBMdisc (1981 to 2004). A total of 3 systematic reviews, 28 randomized controlled trails, 3 cohort studies and 3 observational studies were identified. We evaluated the quality of included studies.All studies were divided into 5 grades by the levels and grades of recommendation. We drew a conclusion by synthesizing the results of included studies: The primary treatment for the patient was surgery treatment including gastric deuto-total resection and D1 lymph node dissection. There was no evidence supporting chemotherapy use in either systematic or abdominal cavity after surgery. The survival rate was high in 5 years and 10 years, so the follow-up time should not be long and the follow-up infermission should not less than 1 year. Follow-up included the dynamic and delayed MR sequence with Gd-DTPA, the level of serum CA199, endoscope, and stool occult blood test.

Citation： ZHANG Yan ling,YUE Ji rong,CAO Li. Evidence-Based Treatment for a Patient of Stage T2N0M0 Stomach Sinus Cancer. Chinese Journal of Evidence-Based Medicine, 2005, 05(3): 246-250. doi: Copy

1.	胡建昆, 陈志新, 张波, 田静, 陈佳平, 周总光, 王莉, 王朝华, 陈红艳. 胃癌切除术后化疗治疗效果的系统评价[J]. 中国循证医学杂志, 2003; 3(1): 4～9.
2.	邱健, 李国威, 王小强, 阎立昆. 胃癌根治术中预防性腹腔温热灌注化疗治疗进展期胃癌的系统评价[J]. 中国循证医学杂志 2004; 4(12): 859～863.
3.	Boddie AW Jr, McMurtrey MJ, Giacco GG, McBride CM. Palliative total gastrectomy and esophagogastrectomy: A reevaluation[J]. Cancer, 1983; 51(7): 1 195-2 000.
4.	McCulloch P. Should general surgeons treat gastric carcinoma? An audit of practice and results, 1980-1985[J]. Br J Surg, 1994; 81(3): 417-420.
5.	Haugstvedt T. Benefits of resection in palliative surgery[J]. Dig Surgery, 1994; 11: 121-125.
6.	Bozzetti F, Marubini E, Bonfanti G, Miceli R, Piano C, Crose N, Gennari L. Total versus subtotal gastrectomy: surgical morbidity and mortality rates in a multicenter Italian randomized trial[J]. Ann Sury, 1997; 226(5): 613-620.
7.	Bozzetti F, Marubini E, Bonfanti G, Miceli R, Piano C, Gennari L. Subtotal versus total gastrectomy for gastric cancer: five-years survival rates in a multicenter randomized Italian trial[J]. Ann Surg, 1999; 230(2): 170-178.
8.	Gouzi JL, Huguier M, Fagniez PL, Launois B, Flamant Y, Lacaine F, Paquet JC, Hay JM. Total gastrectomy versus partial gastrectomy of adenocarcinoma of the antrum. A French prospective controlled study[J]. Ann Chir, 1989; 43(5): 356-360.
9.	Gouzi JL, Huguier M, Fagniez PL, Launois B, Flamant Y, Lacaine F, Paquet JC, Hay JM. Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum. A French prospective controlled study[J]. Ann Surg, 1989; 209(2): 162-166.
10.	Davies J, Johnston D, Sue-Ling H, Young S, May J, Griffith J, Miller G, Martin I. Total or subtotal gastrectomy for gastric carcinoma? A study of quality of life[J]. World J Surg, 1998; 22(10): 1 048-1 055.
11.	Wu CW, Hsieh MC, Lo SS, Lui WY, P’eng FK. Quality of life of patients with gastrectomy for gastric adenocarcinoma after curative gastrectomy[J]. World J surg, 1997; 21(7): 777-782.
12.	Svedlund J, Sullivan M, Liedman B, Lundell L, Sjodin I. Quality of life after gastrectomy for gastic carcinoma: controlled study of reconstructive procedures[J]. World J Surg, 1997; 21(4): 422-433.
13.	Roder JD, Stein HJ, Eckel F, Herschbach P, Henrich G, Bottcher K, Busch R, Siewert JR. Comparison of the quality of life after subtotal and total gastrectomy for stomach carcinoma[J]. Dtsch Med Wochenschr, 1996; 121(17): 543-549.
14.	McCulloch P, Nita ME, Kazi H, Gama-Rodrigues J. Extended versus limited lymph nodes dissection technique for adenocarcinoma of the stomach[M/CD]. In: The Cochrane library, Issue 4, 2004. Oxford: Update Software.
15.	Csendes A, Burdiles P, Rojas J, Braghetto I, Diaz JC, Maluenda F. A prospective randomized study comparing D2 total gastrectomy versus D2 total gastrectomy plus splenectomy in 187 patients with gastric carcinoma[J]. Surgery, 2002; 131(4): 401-407.
16.	Siewert JR, Bottcher K, Stein HJ, Roder JD. Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study[J]. Ann Surg, 1998; 228(4): 449-461.
17.	Janunger KG, Hafstrom L, Nygren P, Glimelius B; SBU-group. Swedish Council of Technology Assessment in Health Care.Asystematic overview of chemotherapy effects in gastric cancer[J]. Acta Oncol, 2001; 40(2-3): 309-326.
18.	Nakajima T, Nashimoto A, Kitamura M, Kito T, Iwanaga T, Okabayashi K, Goto M. Adjuvant mitomycin and fluorouracil followed by oral uracil plus tegafur in serosa-negative gastric cancer: a randomized troal. Gastric Cancer Surgical Study Group[J]. Lancet, 1999; 354(9 175): 273-277.
19.	Hu JK, Chen ZX, Zhang B, Tian J, Chen JP, Zhou ZG, Wang L, Wang CH, Chen HY. Intravenous chemotherapy for post-gastrectomy with gastric carcinomas a systematic review of randomized controlled trials[J]. Chinese Journal of Evidence-based Medicine; 2003; 3(1): 4-9.
20.	Qiu J, Li GW, Wang XQ, Yan LK. Prophylactic chemohyperthermic peritoneal perfusion during radical operation of gastric cancer for advancing gastric cancer: a systematic review[J]. Chinese Journal of Evidence-based Medicine; 2004; 4(12): 859-863.
21.	Tominaga K, Koyama Y, Sasagawa M, Yamaguchi E, Yoshinari M, Nagai M. A follow-up study of resected stomach cancer patients with special emphasis on the incidence of second primary cancers[J]. Jpn J Clin Oncol, 1993; 23(6): 331-335.
22.	Yokota T, Kunii Y, Teshima S, Yamada Y, Saito T, Takahashi M, Kikuchi S, Yamauchi H. Significant prognostic factors in patients with node-negative gastric cancer[J]. Int Surg, 1999; 84(4): 331-336.
23.	Kang BC, Kim JH, Kim KW, Lee DY, Baek SY, Lee SW, Jung WH. Value of the dynamic and delayed MR sequence with Gd-DTPA in the T-staging of stomach cancer: correlation with the histopathology[J]. Abdom Imaging, 2000; 25(1): 14-24.
24.	Hakama M, Stenman UH, Knekt P, Jarvisalo J, Leino A, Hakulinen T, Maatela J, Aromaa A. Tumour markers and screening for gastrointestinal cancer: a follow up study in Finland[J]. J Med Screen, 1994; 1(1): 60-64.

1. 胡建昆, 陈志新, 张波, 田静, 陈佳平, 周总光, 王莉, 王朝华, 陈红艳. 胃癌切除术后化疗治疗效果的系统评价[J]. 中国循证医学杂志, 2003; 3(1): 4～9.
2. 邱健, 李国威, 王小强, 阎立昆. 胃癌根治术中预防性腹腔温热灌注化疗治疗进展期胃癌的系统评价[J]. 中国循证医学杂志 2004; 4(12): 859～863.
3. Boddie AW Jr, McMurtrey MJ, Giacco GG, McBride CM. Palliative total gastrectomy and esophagogastrectomy: A reevaluation[J]. Cancer, 1983; 51(7): 1 195-2 000.
4. McCulloch P. Should general surgeons treat gastric carcinoma? An audit of practice and results, 1980-1985[J]. Br J Surg, 1994; 81(3): 417-420.
5. Haugstvedt T. Benefits of resection in palliative surgery[J]. Dig Surgery, 1994; 11: 121-125.
6. Bozzetti F, Marubini E, Bonfanti G, Miceli R, Piano C, Crose N, Gennari L. Total versus subtotal gastrectomy: surgical morbidity and mortality rates in a multicenter Italian randomized trial[J]. Ann Sury, 1997; 226(5): 613-620.
7. Bozzetti F, Marubini E, Bonfanti G, Miceli R, Piano C, Gennari L. Subtotal versus total gastrectomy for gastric cancer: five-years survival rates in a multicenter randomized Italian trial[J]. Ann Surg, 1999; 230(2): 170-178.
8. Gouzi JL, Huguier M, Fagniez PL, Launois B, Flamant Y, Lacaine F, Paquet JC, Hay JM. Total gastrectomy versus partial gastrectomy of adenocarcinoma of the antrum. A French prospective controlled study[J]. Ann Chir, 1989; 43(5): 356-360.
9. Gouzi JL, Huguier M, Fagniez PL, Launois B, Flamant Y, Lacaine F, Paquet JC, Hay JM. Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum. A French prospective controlled study[J]. Ann Surg, 1989; 209(2): 162-166.
10. Davies J, Johnston D, Sue-Ling H, Young S, May J, Griffith J, Miller G, Martin I. Total or subtotal gastrectomy for gastric carcinoma? A study of quality of life[J]. World J Surg, 1998; 22(10): 1 048-1 055.
11. Wu CW, Hsieh MC, Lo SS, Lui WY, P’eng FK. Quality of life of patients with gastrectomy for gastric adenocarcinoma after curative gastrectomy[J]. World J surg, 1997; 21(7): 777-782.
12. Svedlund J, Sullivan M, Liedman B, Lundell L, Sjodin I. Quality of life after gastrectomy for gastic carcinoma: controlled study of reconstructive procedures[J]. World J Surg, 1997; 21(4): 422-433.
13. Roder JD, Stein HJ, Eckel F, Herschbach P, Henrich G, Bottcher K, Busch R, Siewert JR. Comparison of the quality of life after subtotal and total gastrectomy for stomach carcinoma[J]. Dtsch Med Wochenschr, 1996; 121(17): 543-549.
14. McCulloch P, Nita ME, Kazi H, Gama-Rodrigues J. Extended versus limited lymph nodes dissection technique for adenocarcinoma of the stomach[M/CD]. In: The Cochrane library, Issue 4, 2004. Oxford: Update Software.
15. Csendes A, Burdiles P, Rojas J, Braghetto I, Diaz JC, Maluenda F. A prospective randomized study comparing D2 total gastrectomy versus D2 total gastrectomy plus splenectomy in 187 patients with gastric carcinoma[J]. Surgery, 2002; 131(4): 401-407.
16. Siewert JR, Bottcher K, Stein HJ, Roder JD. Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study[J]. Ann Surg, 1998; 228(4): 449-461.
17. Janunger KG, Hafstrom L, Nygren P, Glimelius B; SBU-group. Swedish Council of Technology Assessment in Health Care.Asystematic overview of chemotherapy effects in gastric cancer[J]. Acta Oncol, 2001; 40(2-3): 309-326.
18. Nakajima T, Nashimoto A, Kitamura M, Kito T, Iwanaga T, Okabayashi K, Goto M. Adjuvant mitomycin and fluorouracil followed by oral uracil plus tegafur in serosa-negative gastric cancer: a randomized troal. Gastric Cancer Surgical Study Group[J]. Lancet, 1999; 354(9 175): 273-277.
19. Hu JK, Chen ZX, Zhang B, Tian J, Chen JP, Zhou ZG, Wang L, Wang CH, Chen HY. Intravenous chemotherapy for post-gastrectomy with gastric carcinomas a systematic review of randomized controlled trials[J]. Chinese Journal of Evidence-based Medicine; 2003; 3(1): 4-9.
20. Qiu J, Li GW, Wang XQ, Yan LK. Prophylactic chemohyperthermic peritoneal perfusion during radical operation of gastric cancer for advancing gastric cancer: a systematic review[J]. Chinese Journal of Evidence-based Medicine; 2004; 4(12): 859-863.
21. Tominaga K, Koyama Y, Sasagawa M, Yamaguchi E, Yoshinari M, Nagai M. A follow-up study of resected stomach cancer patients with special emphasis on the incidence of second primary cancers[J]. Jpn J Clin Oncol, 1993; 23(6): 331-335.
22. Yokota T, Kunii Y, Teshima S, Yamada Y, Saito T, Takahashi M, Kikuchi S, Yamauchi H. Significant prognostic factors in patients with node-negative gastric cancer[J]. Int Surg, 1999; 84(4): 331-336.
23. Kang BC, Kim JH, Kim KW, Lee DY, Baek SY, Lee SW, Jung WH. Value of the dynamic and delayed MR sequence with Gd-DTPA in the T-staging of stomach cancer: correlation with the histopathology[J]. Abdom Imaging, 2000; 25(1): 14-24.
24. Hakama M, Stenman UH, Knekt P, Jarvisalo J, Leino A, Hakulinen T, Maatela J, Aromaa A. Tumour markers and screening for gastrointestinal cancer: a follow up study in Finland[J]. J Med Screen, 1994; 1(1): 60-64.

Chinese Journal of Evidence-Based Medicine

Evidence-Based Treatment for a Patient of Stage T2N0M0 Stomach Sinus Cancer

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