Outcome of D2 Gastrectomy with Curative Intent for Patients with Linitis Plastica: 10-Year Experience

Authors

  • Chakrapan Euanorasetr Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400

Abstract

Background: Survival in patients with linitis plastica is poorer than that in patients with other macroscopic types of gastric carcinoma. No consensus has been reached regarding the therapeutic value of radical surgery for this condition. The aim of this study was to review and analyze the clinicopathological features and surgical outcome in patients with linitis plastica who underwent D2 gastrectomy with curative intent.

Patients and Methods: Medical records of 97 patients with gastric carcinoma who underwent D2 gastrectomy with curative intent during the 10-year period between October 1995 and September 2005 were retrospectively reviewed.

Results: Linitis plastica was diagnosed in 14 patients (14.4%). Significant differences were found with respect to tumor location, histology, angiolymphatic invasion, peritoneal washing cytology and TNM staging with other macroscopic type of gastric carcinoma. The survival outcome in patients with linitis plastica was worse than in patients with other macroscopic type of gastric carcinoma, with 5-year overall survival rate of 10% VS 68%, respectively.

Conclusions: D2 gastrectomy should be performed only in patients with linitis plastica with a chance of cure. 

References

1. Borchard F. Classification of gastric carcinoma. Hepato-gastroenterology 1990; 73: 233-32.

2. Kim DY, Kim HR, Kim YJ, et al, Clinicopathological features of patients with Borrmann type IV gastric carcinoma. ANZJ Surg 2002;72: 739-42.

3. Liu Y, Yoshimura K, Yamaguchi N, et al. Causation of Borrmann type 4 gastric cancer: heritable factors or environmental factors? Gastric Cancer 2003;6:17-23.

4. Hamilton SR, Aaltonen LA, editors. World Health Organization classification of tumors. Pathology and genetics of tumor of the digestive system. Lyon: IARC Press; 2000.

5. Kodera Y, Yamamura Y, Ito S, et al. Is Borrmann type IV gastric carcinoma a surgical disease? An old problem revisited with reference to the result of peritoneal washing cytology. J Surg Oncol 2001; 78: 175-81.

6. Kodera Y, Nakanishi H, Ito S, et al. Detection of disseminated cancer cells in linitis plartica-type gastric carcinoma. JPN J Clin Oncol 2004; 34: 525-31.

7. Park MS, Ha HK, Choi BS, et al, Scirrhous gastric carcinoma: endoscopy versus upper gastrointestinal radiography. Radiology 2004; 231: 421-6.

8. Yokota T, Teshima S, Saito T, et al, Borrmann's type IV gastric cancer: clinicopathologic analysis. Can J Surg 1999; 42:371-6.

9. Maehara Y, Moriguchi S, Orita H, et al, Lower survival rate for patients with carcinoma of the stomach of Borrmann type IV after gastric resection. Surg Gynecol Obstet 1992;175:13-6

10. Otsuji E, Kuriu Y, Okamoto K, et al, Outcome of surgical treatment for patients with scirrhous carcinoma of the stomach. Am J Surg 2004; 188: 327-32.

11. Fang J, Al-abbadi M. Cytologic diagnosis of gastric linitis plastica by endoscopic ultrasound guided fine-needle aspiration. Diagnostic Cytopathology 2005; 34: 177-9.

12. Furukawa H, Hiratsuka M, Iwanaga T, et al. Extended surgery-left upper abdominal exenteration plus Appleby's method-for type 4 gastric carcinoma. Ann Surg Oncol 1997;4:209-14.

13. Aranha GV, Georgen R. Gastric linitis plastica is not a surgical disease. Surgery 1989; 106: 758-62.

14. Sobin LH, Wittekind DH, editors. UICC TNM Classification on malignant tumors, 6th ed. New York: Wiley-Liss 2002.

15. Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma. 2nd English Ed. Gastric Cancer 1998; 1: 10-24.

16, Maruyama K, Sasako M, Kinoshita T, et al. Pancreas-preserving total gastrectomy for proximal gastric carcinoma. World J Surg 1995; 19: 532-6.

17. Kitamura K, Beppu R, Anai H, et al. Clinicopathological study of patients with Borrmann type IV gastric carcinoma. J Surg Oncol 1995; 58: 112-7.

18. Levine MS, Kong V, Rubesin SE, et al, Scirrhous carcinoma of the stomach: radiologic and endoscopic diagnosis. Radiology 1990; 175: 151-4.

19. Takahashi I, Matsusaka T, Onohara T, et al. Clinicopathological features of long-term survivors of scirrhous gastric cancer. Hepatogastroenterology 2000; 47:1485-8.

20. Kunisaki C, Shimada H, Nomura M, et al. Therapeutic strategy for scirrhous type gastric cancer. Hepatogastroenterology 2005;52: 314-8.

21. Yoshikawa T, Tsuburaya A, Kobayashi O, et al. Should scirrhous gastric carcinoma be treated surgically? Clinical experiences with 233 cases and a retrospective analysis of prognosticators. Hepatogastroenterol 2001; 48: 1509-12.

22. Chen CY, Wu CW, Lo SS, et al. Peritoneal carcinomatosis and lymph node metastasis are prognostic indicators in patients with Borrmann type IV gastric carcinoma. Hepatogastroenterology 2002; 49: 874-7.

23. Furukawa H, Hiratsuka M, Iwanaga T. A rational technique for surgical operation on Borrmann type 4 gastric carcinoma: left upper abdominal evisceration plus Appleby's method. Br J Surg 1988; 75: 116-9.

24. Hamy A, Letessier E, Bizouarn P, et al, Study of survival and prognostic factors in patients undergoing resection for gastric linitis plastica: a review of 86 cases, Int Surg 1999;84: 337-43.

25. Kinugasa S, Abe S, Tachibana M, et al. Surgically curable and incurable scirrhous gastric carcinomas of the stomach. J Surg Oncol 1997;58:112-7.

26. Kodera Y, Nakanishi H, Ito S, Yamamura Y, Kanemitsu Y, Shimizu Y, et al. Quantitative detection of disseminated free cancer cells in peritoneal washes with real-time RT-PCR: a sensitive predictor of outcome for gastric carcinoma patients. Ann Surg 2002; 235: 499-506.

27. Kodera Y, Yamamura Y, Shimizu Y, Tori A, Hirai T, Yasui K, et al. Peritoneal washing cytology: prognostic value of positive findings in patients with gastric carcinoma undergoing a potentially curative resection. J Surg Oncol 1999;72:60-5.

28. Bando E, Yonemura Y, Takeshita Y, Taniguchi K, Yasui T, Yoshimitsu Y, et al. Intraoperative lavage for cytological examination in 1297 patients with gastric carcinoma. Am J Surg 1999; 178:256-62.

29. Otsuji E, Yamaguchi T, Sawai K, et al. Regional lymph node metastasis as a predictor of peritoneal carcinomatosis in patients with Borrmann type IV gastric carcinoma. Am J Gastroenterol 1999;94: 434-7.

30. Haruma K, Yoshihara M, Tanaka S, et al. Rapid growth and difficulty of early detection of scirrhous carcinoma of the stomach. Am J Gastroenterol 1992; 87:31-5.

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Published

2006-09-29

How to Cite

1.
Euanorasetr C. Outcome of D2 Gastrectomy with Curative Intent for Patients with Linitis Plastica: 10-Year Experience. Thai J Surg [Internet]. 2006 Sep. 29 [cited 2024 Dec. 23];27(3):101-7. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/242000

Issue

Vol. 27 No. 3 (2006): July - September

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.