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Surgery for Gastric Cancer Combined With Cardiac and Aortic Surgery
Yoshihiko Tsuji, MD;
Naoto Morimoto, MD;
Hiroshi Tanaka, MD;
Kenji Okada, MD;
Hitoshi Matsuda, MD;
Takuro Tsukube, MD;
Yoshihisa Watanabe, MD;
Yutaka Okita, MD
Arch Surg. 2005;140:1109-1114.
Hypothesis Therapeutic strategies for patients who require procedures for both cardiac or aortic diseases and gastric cancer are controversial. Prognostic factors for them should be clearly identified.
Design Retrospective review of 14 patients who underwent surgical intervention for both gastric cancer and cardiac or aortic diseases between January 1, 2000, and June 30, 2004.
Setting Tertiary referral university hospital.
Patients Cardiac and aortic diseases included coronary artery disease in 5 patients, thoracic aortic aneurysms in 3 patients, and abdominal aortic aneurysms in 6 patients. Coronary artery bypass graftings were performed with an off-pump procedure, and aneurysms were replaced with prosthetic grafts in all of the cases. The surgical stages of gastric cancers were stage I in 8 patients, stage II in 2 patients, stage III in 3 patients, and stage IV in 1 patient. According to our original therapeutic strategies, 4 patients underwent simultaneous procedures and 10 received staged procedures.
Main Outcome Measure Overall survival rates.
Results There was 1 hospital death caused by multiple organ failure. No prosthetic graft infection was noted. Thirteen patients were discharged, and 3 died of cancer recurrence during an average follow-up period of 26.3 months. The cumulative survival rate was 76.6% at 1 year and 68.1% at 3 years. One-year survival rates were 90.0% in stages I and II gastric cancer and 50.0% in stages III and IV gastric cancer.
Conclusion Prognosis of patients who underwent surgical intervention for both gastric cancer and cardiac or aortic diseases was mainly limited by the clinical stage of gastric cancer.
Author Affiliations: Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
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