Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2010, vol. 19, nr 1, January-February, p. 105–111

Publication type: original article

Language: English

Cancer of the Upper and Lower Gastrointestinal Tract – Analysis of Resective Treatment

Rak bliższego i dalszego odcinka przewodu pokarmowego – analiza resekcyjności

Marta Strutyńska-Karpińska1,, Piotr Szelachowski1,, Lidia Usnarska-Zubkiewicz2,, Barbara Śliwa1,

1 Department of Gastrointestinal and General Surgery, Wroclaw Medical University, Poland

2 Department of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Poland

Abstract

Background. Surgical excision is the best therapeutic option for esophageal, gastric, and colorectal cancer. Many authors believe that the low percentage of resections in patients with cancer of the proximal gastrointestinal tract is primarily attributable to delayed diagnosis.
Objectives. The aim of this study was to compare resective treatment for esophageal, gastric, and colorectal cancer with cancer staging on admission to the surgical unit. Stage of disease was evaluated using the TNM system.
Material and Methods. The analysis involved 323 patients with esophageal cancer (158), gastric cancer (98), and colorectal cancer (67) referred for surgical treatment in 2005–2006.
Results. The majority of the patients were male (76.5%), with significantly more males in the groups with esophageal and gastric cancer (p < 0.001). There were no gender-related differences among patients with colorectal cancer (p < 0.0001). The stage of disease differed for the different cancers. In the group with esophageal cancer, 0.6, 3.8, 1.3, and 94.3% of the patients were qualified to stages 1, 2, 3, and 4 of the TNM system, respectively. In the gastric cancer group, stages 1, 2A/2B, 3, and 4 involved 0, 7.1, 4.1, and 88.8% of the patients, respectively. In the colorectal cancer group, the majority of patients (94%) had stages 1, 2, and 3. Resection surgery was the therapeutic modality in 5.7% of the esophageal, 11.2% of the gastric cancers, and 94% of the colorectal cancers. The difference in the percentage of resection surgery for esophageal cancer compared with gastric cancer was on the borderline of statistical significance (p = 0.1). There was a statistically significant difference in the numbers of resections for upper digestive tract and colorectal cancer (p < 0.001).
Conclusion. The authors suggest that the popularization of screening examinations for esophageal and gastric cancer may have a positive effect on the early diagnosis of cancer in the upper gastrointestinal tract.

Streszczenie

Wprowadzenie. Zasadniczym sposobem leczenia raka przełyku, żołądka oraz jelita grubego jest leczenie chirurgiczne. W opinii wielu autorów mały odsetek resekcyjności w nowotworach bliższego odcinka przewodu pokarmowego należy łączyć przede wszystkim z opóźnieniem diagnozy.
Cel pracy. Porównawcza ocena resekcyjności raka przełyku, żołądka oraz jelita grubego na podstawie oceny stopnia zaawansowania choroby nowotworowej w chwili przyjęcia na oddział. Stopień zaawansowania raka oparto na ocenie cech TNM.
Materiał i metody. Analizie poddano 323 chorych na raka przełyku (158), żołądka (98) i jelita grubego (67) skierowanych do leczenia operacyjnego na oddziale w okresie 2005–2006.
Wyniki. W analizowanej grupie chorych większość stanowili mężczyźni (76,5%). Przewaga mężczyzn była istotna statystycznie w grupie chorych na raka przełyku i raka żołądka (p < 0,001). Nie wykazano różnic zależnych od płci w grupie chorych na raka jelita grubego (p < 0,0001). Stopień zaawansowania raka dla poszczególnych umiejscowień był różny. W grupie chorych na raka przełyku 0,6; 3,8; 1,3 i 94,3% zakwalifikowano odpowiednio do 1, 2, 3 i 4 stopnia w skali TNM. W grupie chorych na raka żołądka w stopniu 1, 2A/2B, 3 i 4 było odpowiednio: 0; 7,1; 4,1 i 88,8%. Wśród chorych na raka jelita grubego natomiast zdecydowana większość (94%) miała 1, 2 i 3 stopień zaawansowania w skali TNM. Resekcyjność w raku przełyku wynosiła 5,7%, żołądka – 11,2%, a w raku jelita grubego – 94%. Różnica w odsetku resekcyjności w raku przełyku w porównaniu z rakiem żołądka była na granicy istotności statystycznej (p = 0,1). Stwierdzono istotnie statystyczną różnicę w resekcyjności raka górnego odcinka przewodu pokarmowego w porównaniu z rakiem jelita grubego (p < 0,001).
Wnioski. Autorzy sugerują, że wprowadzenie badań przesiewowych w kierunku raka przełyku i raka żołądka może mieć pozytywny wpływ na wykrywalność wczesnych raków górnego odcinka przewodu pokarmowego.

Key words

esophageal cancer, gastric cancer, colorectal cancer, percentage of resection surgeries

Słowa kluczowe

rak przełyku, rak żołądka, rak jelita grubego, odsetek resekcyjności

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