Gastric cancer quality of life
UMF Tg. Mures Rezumat Aceas articol este o trecere in revista a datelor din literatura de specialitate privind managementul evaluarii cancerului esofagian si gastric si stadializarea.
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Toti pacientii care sunt luati in evidenta pentru interventia chirurgicala trebuie sa fie supusi unei evaluari a statusului fizic in principal a capacitatii performante si a functiei respiratorii. Pentru pacientii cu cancer gastric sau esofagian,stadializarea tumorilor la diagnostic este principalul factor determinant al supravietuirii.
Implicarea ganglionilor limfatici este cel mai important si singurul factor,urmat de stadiul T. Cuvinte cheie:cancer esofagian,stadiu tumoral,ganglioni limfatici Gastric cancer quality of life This article is a review of the literature data colorectal cancer in the young management of oesophageal gastric cancer assesement and staging.
All patients being considered for surgery should undergo careful assessment of fitness with emphasis on performance status and respiratory function. For patients with gastric or oesophageal cancer, tumour stage at diagnosis is the main determinant of survival.
Lymph node involvement is the most important single factor, followed by T stage. Key words:oesophageal cancer,tumor stage,lymph node Introduction For patients with gastric or oesophageal cancer, tumour stage at diagnosis is the main determinant of survival.
The presence of more than four involved nodes or M1a node involvement is associated with significantly reduced gastric cancer quality of life, although it does not necessarily preclude long term survival following resection.
Long term survival is not seen in patients with junctional cancers who have cervical nodal disease or nodal gastric cancer quality of life in three body compartments neck, mediastinum and abdomen .
In patients with gastric cancer both the number of involved nodes and the ratio of involved to uninvolved nodes significantly influence long term outcome. T stage is the most significant factor in node negative cases. In patients with oesophageal cancer preoperative identification of lymph node involvement by EUS is associated with a poor prognosis.
Selected patients with T4 gastric cancer in the absence of extensive lymph node involvement can have long term survival five years and over following surgical resection[7,8]. The patients most likely to benefit from curative treatment are those without distant metastases and with limited lymph node involvement. Long term survival is possible in highly selected patients with more advanced disease but gastric cancer quality of life majority of patients in this category will survive for less than two years following resection.
Oesophageal cancer should undergo careful preoperative staging to enable targeting of potentially curative treatment to those gastric cancer quality of life to benefit. B Patients with oesophageal cancer who have distant metastases or patients with oesophageal cancer who have metastatic gastric cancer quality of life nodes in three compartments neck, mediastinum and abdomen on preoperative staging are not candidates for curative treatment.
C When M1a nodal involvement in oesophageal cancer, or extensive lymphadenopathy in any cancer, is identified on preoperative staging, the anticipated poor prognosis should gastric cancer quality of life carefully considered when discussing treatment options.
Where there is clear evidence of incurable disease following staging, attempts at resection should be avoided. Tumor stage and quality of life There is no evidence directly addressing the influence of tumour stage on quality of life in patients with oesophageal cancer.
Surgery results in a reduction in quality of life which only returns to preoperative levels in patients surviving more than two years. In these patients quality of life improves after three to four months and approaches preoperative levels at around nine months.
Laparoscopic Gastrectomy for Cancer
D The possibility of reduction in quality of life after surgery should be considered when discussing gastric cancer quality of life options, particularly when preoperative staging suggests that surgery would be unlikely to be curative. Complications can be reduced by removing those patients at greatest risk from the surgical cohort. This is most frequently achieved by exercising clinical judgement and there is evidence that this is predictive gastric cancer quality of life in-hospital mortality.
The more objective POSSUM gastric cancer quality of life and operative severity score for the enumeration of mortality and morbidity scoring system is also predictive of in-hospital death. Scoring systems for risk prediction specifically for patients with oesophageal cancer have been developed. Use of a composite scoring system based on general performance status as well as cardiac, hepatic and respiratory function has been shown to reduce postoperative mortality from 9.
A simpler but unvalidated scoring system based on age, spirometry gastric cancer quality of life performance status predicted an incrementally increasing risk of respiratory and cardiac complications viermi cilindrici it did not predict postoperative mortality.
This measure of cardiopulmonary reserve is not routinely available. In an American study of high-risk surgical patients, symptom-limited stair climbing predicted postoperative complications. The role of dynamic testing of cardiac function parazitii best of not been addressed in patients with oesophageal cancers.
B All patients being considered for surgery should undergo careful assessment of fitness with emphasis on performance status and respiratory function. Accurate completion of pathology reports is essential to ensure accurate pathological staging for comparison with clinical stagingto inform assessment of prognosis, to gastric cancer quality of life the completeness and adequacy of resection and to assist in audit.
Important pathological parameters Resection specimens need to be dissected carefully for accurate tumour gastric cancer quality of life. Tumour stage correlates with prognosis. The RCP standards also give information on the ideal preparation and dissection methods for resection specimens and the information which should be recorded for each resection.