☆ 4.5 Article

Metastatic Lymph Node Ratio: A New Staging System for Gastric Cancer

WORLD JOURNAL OF SURGERY (2009)

Journal

WORLD JOURNAL OF SURGERY

Volume 33, Issue 10, Pages 2106-2111

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SPRINGER

DOI: 10.1007/s00268-009-0157-5

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Abstract

This study was designed to analyze the prognostic significance of the staging system based on the ratio of metastatic lymph nodes (TRM) compared with the TNM staging system in patients with gastric cancer. We reviewed the data of 219 patients who underwent gastrectomy for node-positive M0 cancer. Node Ratio (NR) categories (NR1: 1-15%; NR2: 16-40%; NR3: > 40%) were determined by the best cutoff approach at log-rank test. After confirming the prognostic validity of NR in a collinearity-free Cox regression analysis, among different combinations of pT and NR categories we selected five prognostically homogeneous TRM classes. To compare the prognostic power of the TRM vs. TNM systems, we plotted TRM and TNM classes against the mortality estimates. Both of the TRM and TNM classifications significantly stratified patients outcomes (p < 0.0001), but the TRM system identified prognostic subgroups more homogeneous than the TNM system. The TRM staging system is a simple and reliable tool to stratify patients with gastric cancer and has a higher prognostic power than the current system.

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Glauco Chisci, Roberto Cuomo, Alessandro Francia, Daniele Fusario, Bruno Gargiulo, Edoardo Pasqui, Leonardo Pasquetti, Pasquale Puoti, Luca Resca, Jacopo Cumbo, Stefano Ganio, Giuseppe Vizzielli, Marco Anastasi, Domenico Guerra, Andrea Romanzi, Alberto Vannelli, Marco Baia

Summary: COVID-19 had a negative impact on surgical activity, but the potential benefits of adopted measures remain unclear. Italian surgeons' perspective on the change in surgical activity and potential benefits from COVID-19 measures were evaluated through a nationwide online survey. The survey explored the effects of COVID-19 hospital-related measures on surgical patients' management and professional development.

UPDATES IN SURGERY (2023)

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Article Surgery

Predictors of Clostridium difficile infection after stoma reversal following TaTME surgery

Flavio Tirelli, Laura Lorenzon, Alberto Biondi, Lodovica Langellotti, Gloria Santoro, Annamaria Agnes, Roberto Persiani, Roberto Persiani, Domenico D'Ugo

Summary: This study aimed to determine the occurrence of Clostridium Difficile infection (CDI) after stoma reversal in patients who underwent TaTME and to identify variables associated with this post-operative infection. Results showed that stoma reversal surgery can result in a moderate rate of in-hospital CDI. Time-to stoma reversal is a crucial variable significantly related to this adverse outcome.

UPDATES IN SURGERY (2023)

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Article Surgery

'4-Check' protocol for intraoperative anastomotic assessment during transanal total mesorectal excision: retrospective cohort study

Flavio Tirelli, Laura Lorenzon, Alberto Biondi, Ilaria Neri, Gloria Santoro, Roberto Persiani

Summary: The study investigated the efficacy of a protocol called 4-Check during TaTME for rectal cancer. The protocol allowed for the intraoperative detection and repair of anastomotic defects, leading to a lower 30-day complication rate.

BJS OPEN (2023)

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Article Oncology

Quality Over Volume: Modeling Centralization of Gastric Cancer Resections in Italy

Laura Lorenzon, Alberto Biondi, Annamaria Agnes, Ottavio Scrima, Roberto Persiani, Domenico D'Ugo

Summary: This study analyzed GC surgical volumes and 30-day postoperative mortality in Italy and modeled centralization of GC resections based on district case volumes. The results showed a correlation between hospital volume and postoperative mortality, and most Italian districts can achieve a high-volume threshold. However, discrepancies in mortality rates are alarming.

JOURNAL OF GASTRIC CANCER (2022)

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