Surgery for gastric cancer combined with cardiac and aortic surgery.
OBJECTIVE
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.


METHODS
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.


METHODS
Tertiary referral university hospital.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Tsuji
Yoshihiko
Y
Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. ytsuji@med.kobe-u.ac.jp
Morimoto
Naoto
N
Tanaka
Hiroshi
H
Okada
Kenji
K
Matsuda
Hitoshi
H
Tsukube
Takuro
T
Watanabe
Yoshihisa
Y
Okita
Yutaka
Y
D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome