KẾT QUẢ PHẪU THUẬT CẮT TOÀN BỘ DẠ DÀY SAU HOÁ CHẤT TIỀN PHẪU ĐIỀU TRỊ UNG THƯ BIỂU MÔ DẠ DÀY TẠI BỆNH VIỆN K

Abstract

Objective: To describe the clinical and paraclinical characteristics as well as early and long-term outcomes in patients with gastric adenocarcinoma undergoing total gastrectomy after neoadjuvant chemotherapy at K Hospital. Subjects and Methods: A total of 55 gastric adenocarcinoma patients underwent neoadjuvant chemotherapy followed by total gastrectomy at K Hospital from January 2017 to January 2023. Results: The median age was 55 years, with a male-to-female ratio of 1.4:1. Only 25.5% of patients had a history of peptic ulcer disease. The most common symptom was epigastric pain (96.4%), which was also the main reason for hospital admission (63.6%). Tumor location was most frequently at the cardia (49.1%), followed by the body (38.2%), and antrum (1.8%). Six patients (10.9%) had diffuse type gastric cancer. The most common morphological types were infiltrative ulceration (40%) and fungating tumors (36.4%). 60% had T4a tumors, 30.9% had T3 tumors, and 9.1% (5 patients) had T4b tumors invading adjacent organs such as the transverse colon, spleen, or pancreas. Bulky lymph nodes were observed in 29.1% of cases, and 2 patients had solitary ovarian metastases. Complete response was achieved in 5 patients (9.1%), while 8 patients (14.5%) experienced disease progression. Extended total gastrectomy was required in 10.9% of cases. No intraoperative complications were reported. The average number of lymph nodes resected was 14.7 ± 6.2, with a postoperative lymph node metastasis rate of 56.4% and lymphovascular or perineural invasion detected in 41.8% of patients. The postoperative complication rate was 25.5%. Overall survival rates at 1, 3, and 5 years were 75.6%, 52.0%, and 42.6%, respectively. Progression-free survival rates at 1, 3, and 5 years were 62.7%, 39.2%, and 33.6%, respectively.