Kirurško liječenje karcinoma želuca i uloga limfadenektomije

master's thesis

• Title (english): Surgical treatment of gastric cancer and the role of lymphadenectomy
• Author: Monika Cepanec
• Mentor: Igor Petrović (mentor)
• Committee member: Hrvoje Silovski (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Igor Petrović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2022-09-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Karcinom želuca jedan je od najčešćih malignih tumora u svijetu te se povezuje s visokim mortalitetom. Stoga je potrebno utvrditi čimbenike koji utječu na njegovo pojavljivanje, odrediti adekvatne metode dijagnostike i utvrditi najučinkovitije metode liječenja. Kirurška resekcija je za sada jedini oblik terapije koji daje mogućnost izlječenja osobama oboljelih od karcinoma želuca.
U ovom su radu analizirani pacijenti koji su kirurški liječeni zbog karcinoma želuca u Kliničkom bolničkom centru Zagreb, u petogodišnjem razdoblju (2016. - 2020. godine). Cilj je ovog rada bio utvrditi učinkovitost različitih metoda limfadenektomije u sklopu kirurškog liječenja karcinoma želuca te njihov utjecaj na preživljenje pacijenata.
Ukupno je 135 pacijenata liječeno operativnim zahvatima s kurativnom svrhom, a kod njih 73 primijenjena je D2 limfadenektomija. Jednogodišnje, trogodišnje i petogodišnje preživljenje pacijenata liječenih D2 limfadenektomijom iznose 61%, 39% i 29%, te su nešto niža u odnosu na preživljenja pacijenata kod kojih je provedena limfadenektomija manjeg opsega i koja iznose 68%, 44% i 38%. Usporednom analizom vrste primijenjene limfadenektomije i stadija bolesti u pacijenata pokazalo se da je D2 limfadenektomija češće bila primjenjivana u pacijenata s višim stadijima bolesti.
Zaključno, provedena analiza nije pokazala da D2 limfadenektomija unaprjeđuje preživljenje pacijenata u odnosu na manje opsežne limfadenektomije. Vjerojatni uzrok ovakvim rezultatima je to što se ova metoda primjenjivala češće u pacijenata s višim stadijima bolesti koji neovisno o liječenju imaju lošiju prognozu. Preživljenja pacijenata su i općenito niska jer su povezana s čestim otkrivanjem karcinoma u već uznapredovalim fazama kada su šanse za izlječenje značajno manje.

Abstract (english)

Gastric cancer is one of the most frequent malignant tumours worldwide and it is linked to a high mortality. Henceforth, it is necessary to determine the factors contributing to its occurrence, the adequate diagnostic methods and the most effective treatment. Currently, surgery is the only form of therapy providing the possibility of fully curing patients with gastric cancer.
This paper includes an analysis of patients with gastric cancer surgically treated in a five-year period (2016 - 2020) at University Hospital Centre Zagreb. The goal of this analysis was to determine the efficacy of various types of lymphadenectomy as a part of surgical gastric cancer treatment and their effect on the patients’ survival.
In total, 135 patients were treated using surgical procedures with curative intent, 73 of which were treated with D2 lymphadenectomy. The 1-year, 3-year and 5-year survival rates of patients treated with D2 lymphadenectomy were 61%, 39% and 29%, respectively. These survival rates were somewhat lower than in patients treated with less extensive lymphadenectomies (68%, 44% and 38%, respectively). Using comparative analysis of the lymphadenectomy type and the cancer stage, it was found that D2 lymphadenectomies were more frequently applied in patients with higher cancer stages.
In conclusion, the performed analysis did not prove that a D2 lymphadenectomy has an effect on the long-term survival of patients compared to the less extensive lymphadenectomies. The probable cause of the lower survival rate of the patients treated with D2 lymphadenectomies is the fact that this method was mostly applied in patients with higher cancer stages which have a poorer prognosis irrespectively of the treatment. The overall survival rates of patients are also low, mostly due to late diagnoses when the chances of curing the patients are significantly lower.

• Keywords: karcinom želuca; kirurško liječenje; limfadenektomija
• Keywords (english): gastric cancer; surgical treatment; lymphadenectomy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:217368
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-04 10:52:27