dc.contributor.advisor | Ramadori, Giuliano Prof. Dr. Dr. h.c. | de |
dc.contributor.author | Röper, Dierck-Henrik | de |
dc.date.accessioned | 2013-01-14T15:19:50Z | de |
dc.date.available | 2013-01-30T23:50:52Z | de |
dc.date.issued | 2012-06-08 | de |
dc.identifier.uri | http://hdl.handle.net/11858/00-1735-0000-000D-EFC7-1 | de |
dc.identifier.uri | http://dx.doi.org/10.53846/goediss-1544 | |
dc.description.abstract | Hintergrund
Aktuelle Studien zeigen für Patienten mit resektablem Magenkarzinom
einen Prognosevorteil hinsichtlich des Gesamtüberlebens bei
zusätzlicher perioperativer Chemotherapie verglichen mit
chirurgischer Resektion alleine. Ebenso scheint eine größtmögliche
Anzahl resektierter Lymphknoten unter Einbeziehung des 2. und 3.
Drainagekompartiments mit einem Prognosevorteil verbunden zu sein.
Diese Arbeit bewertet den Verlauf und den Benefit einer
perioperativen Chemotherapie sowie die Radikalität der
Lymphadenektomie und stellet diese Parameter international
publizierten Daten gegenüber. Methoden
Zwischen November 2007 und Juli 2010 wurde in der Abteilung für
Gastroenterologie und Endokrinologie bei 20 Patienten mittels | de |
dc.format.mimetype | application/pdf | de |
dc.language.iso | ger | de |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/ | de |
dc.title | Die perioperative Chemotherapie des lokal fortgeschrittenen Magenkarzinoms nach Göttinger Erfahrung | de |
dc.type | doctoralThesis | de |
dc.title.translated | Perioperative chemotherapy of locally advanced gastric carcinoma based on the experiences of Göttingen medical school | de |
dc.contributor.referee | Ramadori, Giuliano Prof. Dr. Dr. h.c. | de |
dc.date.examination | 2012-06-20 | de |
dc.subject.dnb | 610 Medizin, Gesundheit | de |
dc.subject.gok | MED 410 | de |
dc.description.abstracteng | Background
Recent studies demonstrated an improved outcome of patients with
resectable adenocarcinoma of the stomach treated with a
perioperative chemotherapy compared with surgery alone. Besides, a
maximum number of resected lymph nodes including D2 and D3
resections seem to correlate with a higher likelihood of overall
survival. This study evaluates the course and the benefit of a
methodic perioperative chemotherapy and radicality of
lymphadenectomy by contrasting these parameters with international
published studies. Methods
Between November 2007 and July 2010, 20 patients with locally
advanced gastric cancer were detected by endoscopy of the upper
gastrointestinal tract with a simultaneous sampling from suspect
areas of the gastric mucosa. Subsequently, 17 patients underwent a
neoadjuvant chemotherapy followed by gastrectomy. The present study
evaluates tumor remission by preoperative chemotherapy, number of
cycles,lapse of time between the cycles and the gastrectomy as well
as postoperative survival. To assess the surgical radicality, the
extent of lymphadenectomy, the lymph node ratio plus the duration
of gastrectomy were analyzed among all surgical interventions. A
comparison between staging precision of endoscopic ultrasound (EUS)
and computertomography (CT) allows an evaluation of preoperative
lymph node diagnostics. Results
Tumor remission rate after perioperative chemotherapy was 88.2%
among all patients. The average interval between preoperative
chemotherapy and gastrectomy was 47.5 days. 18 months after
surgical intervention in 56.25% of all patients no death has been
reported. There was no case of immediate postoperative death. The
median lymph node ratio was 17.7%. Average time for a gastrecteomy
including lymphadenectomy was 180.75 minutes. Both CT and EUS
showed a sensitivity of 37.5% in determining the N-category.
Lessons learned are consistent with the results of current studies
regarding the benefit of perioperative chemotherapy. A high
prognostic relevance of a low LNR is supported by supported by this
work. | de |
dc.contributor.coReferee | Liersch, Torsten PD Dr. | de |
dc.contributor.thirdReferee | Mausberg, Rainer Prof. Dr. | de |
dc.subject.topic | Medicine | de |
dc.subject.ger | Magenkarzinom Lymphadenektomie Lymphknotenbefallsrate | de |
dc.subject.eng | Gastric carcinoma gastrectomy lymph node ratio | de |
dc.subject.bk | 44.61 Medizin | de |
dc.identifier.urn | urn:nbn:de:gbv:7-webdoc-3549-2 | de |
dc.identifier.purl | webdoc-3549 | de |
dc.affiliation.institute | Medizinische Fakultät | de |
dc.identifier.ppn | 729040526 | de |