RESUMO
OBJECTIVES: To determine the prognostic significance of size tumor in the survival of patients with advanced gastric carcinoma. MATERIAL AND METHODS: This retrospective study evaluated 95 patients with advanced gastric adenocarcinoma with a diameter smaller than 7 centimeters (Group I) and 85 cases with lesions equal or greater than 7 centimeters (Group II) whom underwent radical gastrectomy with lymphadenectomy D0-D1 (n=148) or D2-D3-D4 (n=32) at Belen Hospital, Trujillo, Peru, between 1966 and 1998. RESULTS: The median age of the Group I and II was of 58.1 12.9 and 58.5 15.3 years, respectively. The patients of the group II had a lower level of seric hemoglobin (p=0.007) and more frequency of lesions Borrmann type II and IV (p= 0.003). Using the log-rank test, there was no statistically significant difference with relation to five-year survival between both groups using the multivariate analysis of Cox regression. There was not statistically significance difference between the size tumoral and the survival but there were independent factors statistically related with the survival: depth of invasion (p=0.017) and lymph nodes compromised (p=0.014). CONCLUSIONS: Clinically the size of the tumor was not a factor to take as parameter in the prediction of the actuarial survival in patients with advanced gastric cancer.
Assuntos
Adenocarcinoma/patologia , Neoplasias Gástricas/patologia , Análise Atuarial , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Adulto , Idoso , Feminino , Gastrectomia , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Cuidados Paliativos , Peru/epidemiologia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/cirurgia , Análise de SobrevidaRESUMO
The intestinal obstruction by Meckel s diverticulum is caused by an adherence, volvulus or invagination affecting this diverticulum. This is not a very frequent event and our purpose is to describe a case of intestinal obstruction by a bridle formed by Meckel s diverticulum. Clinically, the patient experienced pain in the periumbilical region, abdominal distension and bilious vomits. The exploratory laparotomy evidenced the existence of Meckel s diverticulum without signs of inflammation.