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Leiomyosarcoma of the stomach: A case report

World Journal of Clinical Cases 2019年第21期7卷 3575-3582页

作者： wen-zhe kang Li-Yan Xue Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer CenterNational Clinical Research Center for CancerCancer HospitalAcademy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Pathology National Cancer CenterNational Clinical Research Center for CancerCancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND Leiomyosarcoma of the stomach is extremely rare,and only 13 cases have been reported in the *** the advent of KIT immunohistochemistry,gastrointestinal stromal tumors(GISTs)were misdiagnosed as leiomyomas and *** rarely occurs in organs besides the uterus and is rarely located in the *** SUMMARY A 57-year-old woman presented with the symptom of melena over a one-month *** had suffered weight loss,weakness,nausea and vomiting for fifteen *** a local hospital,computed tomography showed a very large mass in the stomach,and the results of endoscopic examination and histopathological diagnosis were *** received transfusion therapy and was transferred to our *** arrival at our hospital,the patient was *** denied any family history and had no specific past *** signs of pulmonary metastasis were found on chest *** resonance imaging and computed tomography confirmed a very large tumor in the stomach,and no visible signs of metastatic disease were *** October 30,2013,the patient underwent resection of the stomach tumor and did not undergo any adjuvant *** margins were negative and she had an uneventful recovery and was discharged after 12 *** year after surgery,the patient died at home,and the cause of death were gastrointestinal obstruction and *** that time,she was treated with Chinese medicine but the effect was not *** of gastrointestinal obstruction,the patient did not receive any *** Surgical resection is the standard treatment for gastric *** diagnosis of this tumor mainly depends on histopathological *** case may suggest the aggressive behavior and poor prognosis of this tumor.

关键词： Leiomyosarcoma Stomach Case report KIT Gastrointestinal stromal tumor Targeted next-generation sequencing

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A new scoring system to evaluate adjuvant chemotherapy for patients with T2N0M0 gastric cancer after D2 gastrectomy

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World Journal of Gastroenterology 2022年第38期28卷 5626-5635页

作者： Quan Xu wen-zhe kang Jian-Ping Xiong Xin-Xin Shao Wei-Kun Li Hai-Tao Hu Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND At present,there is insufficient medical evidence to determine whether adjuvant chemotherapy is necessary for T2N0M0 gastric *** To obtain a risk score to assess the need for adjuvant chemotherapy in patients with T2N0M0 gastric *** We identified 325 patients with pathological T2N0M0 stage primary gastric cancer at the National Cancer Center between 2011 and *** and multivariate Cox regression analyses were performed to predict factors affecting *** invasion,tumor site,and body mass index were assessed,and a scoring system was *** compared the survival outcomes and benefits of adjuvant chemotherapy between the different *** Five-year survival rates of the score 0,1,2,and 3 groups were 92%,95%,80%,and 50%,respectively(P<0.001).In the score 2-3 group,five-year survival rates for patients in the adjuvant chemotherapy group and postoperative observation group were 95%and 61%,respectively(P=0.021).CONCLUSION For patients with T2N0M0 stage gastric cancer and two or more risk factors,adjuvant chemotherapy after D2 gastrectomy may have a survival benefit.

关键词： Gastric cancer Risk score T2N0M0 Adjuvant chemotherapy D2

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Feasibility of totally laparoscopic gastrectomy without prophylactic drains in gastric cancer patients

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World Journal of Gastroenterology 2021年第26期27卷 4236-4245页

作者： Hao Liu Peng Jin Xu Quan Yi-Bin Xie Fu-Hai Ma Shuai Ma Yang Li wen-zhe kang Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Gastrointestinal Surgery The Second HospitalJilin UniversityChangchun 130041Jilin ProvinceChina

BACKGROUND Prophylactic drains have been used to remove intraperitoneal collections and detect complications early in open *** the last decades,minimally invasive gastric cancer surgery has been performed ***,reports on routine prophylactic abdominal drainage after totally laparoscopic distal gastrectomy are *** To evaluate the feasibility performing totally laparoscopic distal gastrectomy without prophylactic drains in selected *** Data of patients with distal gastric cancer who underwent totally laparoscopic distal gastrectomy with and without prophylactic drainage at China National Cancer Center/Cancer Hospital from February 2018 to August 2019 were *** outcomes between patients with and without prophylactic drainage were *** A total of 457 patients who underwent surgery for gastric cancer were *** these,125 patients who underwent totally laparoscopic distal gastrectomy were *** propensity score matching,data of 42 pairs were *** incidence of concurrent illness was higher in the drain group(42.9%vs 31.0%,P=0.258).The overall postoperative complication rates were 19.5%and 10.6%in the drain(n=76)and no-drain groups(n=49),respectively;there were no significant differences between the two groups(P>0.05).The difference between the two groups based on the need for percutaneous catheter drainage was also not significant(9.8%vs 6.4%,P=0.700).However,patients with a larger body mass index(≥29 kg/m2)were prone to postoperative complications(P=0.042).In addition,the number of days from surgery until the first flatus(4.33±1.24 d vs 3.57±1.85 d,P=0.029)was greater in the drain *** Omitting prophylactic drainage may reduce surgery time and result in faster *** prophylactic drains are not necessary in selected patients.A prophylactic drain may be useful in high-risk patients.

关键词： Gastric cancer Prophylactic drainage Totally laparoscopic gastrectomy Enhanced recovery after surgery Minimally invasive surgery Early gastric cancer

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Feasibility and nutritional impact of laparoscopic assisted tailored subtotal gastrectomy for middle-third gastric cancer

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World Journal of Gastroenterology 2020年第43期26卷 6837-6852页

作者： Hao Liu Peng Jin Fu-Hai Ma Shuai Ma Yi-Bin Xie Yang Li Wei-Kun Li wen-zhe kang Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Gastrointestinal Surgery The Second HospitalJilin UniversityChangchun 130041Jilin ProvinceChina Department of Pancreatic Stomach Surgery National Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND Laparoscopic assisted total gastrectomy(LaTG)is associated with reduced nutritional status,and the procedure is not easily carried out without extensive expertise.A small remnant stomach after near-total gastrectomy confers no significant nutritional benefits over total *** this study,we developed a modified laparoscopic subtotal gastrectomy procedure,termed laparoscopicassisted tailored subtotal gastrectomy(LaTSG).AIM To evaluate the feasibility and nutritional impact of LaTSG compared to those of LaTG in patients with advanced middle-third gastric cancer(GC).METHODS We retrospectively analyzed surgical and oncological outcomes and postoperative nutritional status in 92 consecutive patients with middle-third GC who underwent radical laparoscopic gastrectomy at Department of Pancreatic Stomach Surgery,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,and Peking Union Medical College between 2013 and *** these 92 patients,47 underwent LaTSG(LaTSG group),and the remaining underwent LaTG(LaTG group).RESULTS Operation time(210±49.8 min vs 208±50.0 min,P>0.05)and intraoperative blood loss(152.3±166.1 mL vs 188.9±167.8 mL,P>0.05)were similar between the *** incidence of postoperative morbidities was lower in the LaTSG group than in the LaTG group(4.2%vs 17.8%,P<0.05).Postoperatively,nutritional indices did not significantly differ,until postoperative 12 ***,prealbumin,total protein,hemoglobin levels,and red blood cell counts were significantly higher in the LaTSG group than in the LaTG group(P<0.05).No significant differences in Fe or C-reaction protein levels were found between the two *** examination demonstrated that reflux oesophagitis was more common in the LaTG group(0%vs 11.1%,P<0.05).Kaplan–Meier analysis showed a significant improvement in the overall survival(OS)and disease free survival(DFS)in the LaTSG *** analysis showed that LaTSG was an independent prognostic facto

关键词： Gastric cancer Laparoscopy assisted tailored gastrectomy Nutritional status Morbidity Reflux oesophagitis Resection margin

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Retrospective analysis of surgically treated pT4b gastric cancer with pancreatic head invasion

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World Journal of Clinical Cases 2021年第29期9卷 8718-8728页

作者： Peng Jin Hao Liu Fu-Hai Ma Shuai Ma Yang Li Jian-Ping Xiong wen-zhe kang Hai-Tao Hu Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND For advanced gastric cancer patients with pancreatic head invasion,some studies have suggested that extended multiorgan resections(EMR)improves ***,other reports have shown high rates of morbidity and mortality after *** for T4b gastric cancer remains *** To evaluate the surgical approach for pT4b gastric cancer with pancreatic head *** A total of 144 consecutive patients with gastric cancer with pancreatic head invasion were surgically treated between 2006 and 2016 at the China National Cancer *** cancer was confirmed in 76 patients by postoperative pathology and retrospectively *** patients were divided into the gastrectomy plus en bloc pancreaticoduodenectomy group(GP group)and gastrectomy alone group(GA group)by comparing the clinicopathological features,surgical outcomes,and prognostic factors of these *** There were 24 patients(16.8%)in the GP group who had significantly larger lesions(P<0.001),a higher incidence of advanced N stage(P=0.030),and less neoadjuvant chemotherapy(P<0.001)than the GA group *** morbidity(33.3%vs 15.3%,P=0.128)and mortality(4.2%vs 4.8%,P=1.000)were not significantly different in the GP and GA *** overall 3-year survival rate of the patients in the GP group was significantly longer than that in the GA group(47.6%,median 30.3 mo vs 20.4%,median 22.8 mo,P=0.010).Multivariate analysis identified neoadjuvant chemotherapy[hazard ratio(HR)0.290,95%confidence interval(CI):0.103–0.821,P=0.020],linitis plastic(HR 2.614,95%CI:1.024–6.675,P=0.033),surgical margin(HR 0.274,95%CI:0.102–0.738,P=0.010),N stage(HR 3.489,95%CI:1.334–9.120,P=0.011),and postoperative chemoradiotherapy(HR 0.369,95%CI:0.163–0.836,P=0.017)as independent predictors of survival in patients with pT4b gastric cancer and pancreatic head *** Curative resection of the invaded pancreas should be performed to improve survival in selected *** of t

关键词： Gastric cancer T4 R0 resection Prognostic factors Extended multiorgan resection Pancreatectomy

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Adjuvant chemoradiotherapy vs adjuvant chemotherapy in locally advanced Siewert type Ⅱ/Ⅲ adenocarcinoma of gastroesophageal junction after D2/R0 resection

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World Journal of Gastrointestinal Oncology 2022年第8期14卷 1540-1551页

作者： wen-zhe kang Jin-Ming Shi Bing-Zhi Wang Jian-Ping Xiong Xin-Xin Shao Hai-Tao Hu Jing Jin Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Pathology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Radiation Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeShenzhen 518116Guangdong ProvinceChina

BACKGROUND For Siewert type Ⅱ/Ⅲ adenocarcinoma of gastroesophageal junction(AGE), the efficacy of adjuvant chemoradiotherapy(CRT) after D2/R0 resection remains *** To determine whether CRT was superior to chemotherapy(CT) alone after D2/R0 resection for locally advanced Siewert type Ⅱ/Ⅲ *** We identified 316 locally advanced Siewert type Ⅱ/Ⅲ AGE patients who were treated with D2/R0 resection at National Cancer Center from 2011 to 2018.57 patients received adjuvant CRT and 259 patients received adjuvant *** followed patients for overall survival(OS), relapse-free survival, and recurrence *** Five-year OS rates of the CRT group and the CT group for all patients were 66.7% and 41.9%(P = 0.010).Five-year OS rates of the CRT group and the CT group for Siewert type Ⅲ AGE patients were 65.7% and 43.9%(P = 0.006).Among the 195 patients whose recurrence information could be obtained, 18 cases(34.6%) and 61 cases(42.7%) were diagnosed as recurrence in the CRT group and CT group, *** local and regional recurrence rates in the CRT group were lower than that in the CT group(22.2% vs 24.6%, 27.8% vs 39.3%).Multivariable cox regression analysis showed that vascular invasion, nerve invasion, and adjuvant CRT were important prognostic factors for Siewert type Ⅲ *** For locally advanced Siewert type Ⅲ AGE, adjuvant CRT may prolong OS and reduce the regional recurrence rate.

关键词： Siewert typeⅡ/Ⅲ Gastroesophageal junction Adjuvant chemoradiotherapy Adjuvant chemotherapy Survival Recurrence

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Liposarcoma of the stomach: Report of two cases and review of the literature

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World Journal of Gastroenterology 2018年第25期24卷 2776-2784页

作者： wen-zhe kang Li-Yan Xue Gui-Qi Wang Fu-Hai Ma Xiao-Long Feng Lei Guo Yang Li Wei-Kun Li Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Pathology National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Department of Endoscope National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

Liposarcoma of the stomach is extremely rare, and only 37 cases have been reported worldwide. We herein report two cases of liposarcoma of the stomach. The first patient was referred to our hospital with upper abdominal discomfort. The endoscopic examination revealed a tumor mass about 3 cm in diameter. The patient underwent a partial gastrectomy and had an uneventful recovery. The histopathological examination revealed a welldifferentiated liposarcoma. The second patient had symptoms of upper abdominal discomfort combined with nausea and anorexia. Several palpable masses were found with endoscopy. Endoscopic submucosal dissection was the treatment used, and the postoperative course was uneventful. The histopathological diagnosis was a well-differentiated liposarcoma. The two patients did not undergo any adjuvant therapy. They are both currently in good condition without recurrence. Therefore, we believe that the outcome of liposarcoma of the stomach is positive, and surgical resection may be the first choice for treatment at present.

关键词： Pathology Signs and symptoms Diagnosis Liposarcoma Therapeutics

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Treatment strategies for gastric cancer during the COVID-19 pandemic

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World Journal of Clinical Cases 2020年第21期8卷 5099-5103页

作者： wen-zhe kang Yu-Xin Zhong Fu-Hai Ma Hao Liu Shuai Ma Yang Li Hai-Tao Hu Wei-Kun Li Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

The coronavirus disease 2019 pandemic has become a major global public health *** are taking the necessary steps to reduce the movement of people to contain the spread of the ***,these measures have caused considerable distress to patients with gastric cancer who are newly diagnosed or are undergoing *** addition to the cancer,they must deal with longer waiting times for surgery and poor communication with ***,gastric cancer patients generally have low immunity and a poor nutritional status,so they are a high-risk group for infection with the novel ***,it is necessary to formulate reasonable outpatient management strategies to reduce the adverse effects of the pandemic on their *** summarize the management strategies for patients with gastric cancer during the pandemic.

关键词： COVID-19 pandemic Gastric cancer Treatment Strategies Management Outside the hospital

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Low body mass index is an independent predictor of poor long-term prognosis among patients with resectable gastric cancer

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World Journal of Gastrointestinal Oncology 2021年第3期13卷 161-173页

作者： Shuai Ma Hao Liu Fu-Hai Ma Yang Li Peng Jin Hai-Tao Hu wen-zhe kang Wei-Kun Li Jian-Ping Xiong Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND The association between body mass index(BMI)and clinical outcomes remains unclear among patients with resectable gastric *** To investigate the relationship between BMI and long-term survival of gastric cancer *** This retrospective study included 2526 patients who underwent radical gastrectomy for gastric cancer between September 2013 and June *** patients were divided into four groups:Group A(low BMI,<18.5 kg/m2),group B(normal BMI,18.5-24.9 kg/m2),group C(overweight,25-29.9 kg/m2),and group D(obese,≥30 kg/m2).Clinicopathological findings and survival outcomes were recorded and *** Preoperative weight loss was more common in the low-BMI group,while diabetes was more common in the obese ***-third gastric cancer accounted for a large proportion of cases in the higher BMI *** perioperative complications tended to increase with *** 5-year overall survival rates were 66.4%for group A,75.0%for group B,77.1%for group C,and 78.6%for group *** 5-year overall survival rate was significantly lower in group A than in group C(P=0.008)or group D(P=0.031).Relative to a normal BMI value,a BMI of<18.5 kg/m^(2)was associated with poor survival(hazard ratio:1.558,95%confidence interval:1.125-2.158,P=0.008).CONCLUSION Low BMI,but not high BMI,independently predicted poor survival in patients with resectable gastric cancer.

关键词： Gastric cancer Malnutrition Obesity Body mass index Survival benefit

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Laparoscopic vs open total gastrectomy for advanced gastric cancer following neoadjuvant therapy:A propensity score matching analysis

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World Journal of Gastrointestinal Surgery 2022年第2期14卷 161-173页

作者： Hai-Tao Hu Fu-Hai Ma Jian-Ping Xiong Yang Li Peng Jin Hao Liu Shuai Ma wen-zhe kang Yan-Tao Tian Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021Beijing ProvinceChina

BACKGROUND Laparoscopic total gastrectomy(LTG)has drawn increasing attention over the *** LTG has shown surgical benefits compared to open TG(OTG)in early stage gastric cancer(GC),little is known about the surgical and oncological outcomes of LTG for advanced GC following neoadjuvant therapy(NAT).AIM To compare the long-and short-term outcomes of advanced GC patients who underwent LTG vs OTG following *** Advanced GC patients who underwent TG following NAT between April 2011 and May 2018 at the Cancer Hospital of the Chinese Academy of Medical Sciences were enrolled and stratified into two groups:LTG and *** score matching analysis was performed at a 1:1 ratio to overcome possible *** In total,185 patients were enrolled(LTG:78;OTG:109).Of these,138 were paired after propensity score *** adjustment for propensity score matching,baseline parameters were similar between the two *** to OTG,LTG was associated with a significantly shorter length of hospital stay(P=0.012).The rates of R0 resection,lymph node harvest,and postoperative morbidity did not significantly differ between the two *** survival(OS)outcomes were comparable between the two *** T and N stages were found to be independent risk factors for *** LTG can be a feasible method for advanced GC patients following NAT,as it appears to be associated with better short-and comparable long-term outcomes compared to OTG.

关键词： Gastric cancer Laparoscopic total gastrectomy Open total gastrectomy Neoadjuvant therapy Propensity score matching

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