Min Xiang

Ruijin Hospital North, Shanghai, Shanghai Shi, China

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Publications (4)10.29 Total impact

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    ABSTRACT: The prognosis for gastric cancer patients with peritoneal dissemination is very poor. The purpose of this study was to evaluate the survival benefit from gastrectomy with hyperthermic intraperitoneal chemotherapy (HIPEC) for gastric cancer patients with peritoneal dissemination. From 1992 to 2002, 128 gastric cancer patients with peritoneal dissemination underwent surgery at the Department of Surgery, Ruijin Hospital, Shanghai, China. The clinicopathological characteristics and survival were compared between the resection and the non-resection groups, and between the resection alone and the resection with HIPEC groups. The 5-year survival rates were 5.5% for patients in the resection group and 0% for patients in the non-resection group (P < 0.001). Multivariate analysis showed surgical resection was significantly associated with better prognosis in gastric cancer patients with peritoneal dissemination. In the patients who underwent resection, the survival difference between the resection alone and the resection with HIPEC groups was significant (P = 0.025), and HIPEC was an independent prognostic factor by multivariate analysis. The HIPEC procedure was an independent prognostic factor after resection for patients with peritoneal dissemination. Therefore, gastrectomy with HIPEC may be an option for those patients. The survival benefit of this strategy should be validated by large cohort prospective clinical trials.
    Journal of Surgical Oncology 10/2010; 102(5):361-5. · 2.64 Impact Factor
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    ABSTRACT: BackgroundThe prognosis for gastric cancer patients with distant metastasis is very poor. The purpose of this study was to evaluate the survival benefit of non-curative gastrectomy for gastric cancer patients with synchronous distant metastasis. MethodsFrom 1992 to 2002, 253 gastric cancer patients with synchronous distant metastasis underwent surgery at the Department of Surgery, Ruijin Hospital, China. The clinicopathological characteristics and survival were compared between resection and non-resection groups. ResultsThe 5-year survival rate was 6.5% for patients in resection group and 0% for patients in non-resection group (P < 0.001). Multivariate analysis showed that liver metastasis, peritoneal dissemination, and non-resection were significantly associated with poor prognosis in gastric cancer patients with distant metastasis. The survival difference between resection and non-resection groups was only observed in patients with single peritoneal dissemination (P < 0.001), but were not in patients with single liver metastasis (P = 0.428), distant nodes involvement (P = 0.490) and multiple metastatic sites (P = 0.192), respectively. ConclusionsOur results suggests that there were no survival benefit from non-curative gastrectomy for patients with single liver, distant nodes, or multiple sites metastasis. However, only patients with single peritoneal dissemination had survival benefit from non-curative resection. The value of non-curative resection should be evaluated by well-designed clinical trials.
    Journal of Gastrointestinal Surgery 02/2010; 14(2):282-288. · 2.36 Impact Factor
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    ABSTRACT: To investigate the value of multidetector-row computed tomography (MDCT) in the preoperative T and N staging of gastric carcinoma and to further investigate the clinicopathological factors affecting the diagnostic accuracy. Seven hundred ninety gastric carcinoma patients underwent preoperative MDCT examination. The results of MDCT were compared with surgical and pathological findings. Early gastric carcinoma patients whose primary tumor was detected by MDCT had higher incidence of lymph node metastasis, larger tumor size, and deeper invasion. The overall accuracy of MDCT in determining T stage of gastric carcinoma was 73.80% (T1 45.93%, T2 53.03%, T3 86.49%, and T4 85.79%). The overall accuracy of MDCT in preoperative N staging was 75.22% (N0 76.17%, N1 68.81%, and N2 80.63%). The overall diagnostic sensitivity, specificity, and accuracy of MDCT for determining lymph node metastasis was 86.26%, 76.17%, and 82.09%, respectively. Multivariate analysis showed that the diagnostic sensitivity of MDCT in determining lymph node metastasis related with tumor size, N stage, and number of metastatic lymph nodes. The clinical value of MDCT in the preoperative T and N staging of gastric carcinoma is relatively high. MDCT can be the first choice for the preoperative evaluation of patients with gastric carcinoma.
    Journal of Surgical Oncology 07/2009; 100(3):205-14. · 2.64 Impact Factor
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    ABSTRACT: The prognosis for patients with stage IV gastric cancer is still very poor. The purpose of this study was to evaluate the surgical outcome and prognosis, and to determine the prognostic influence of sub-stages of stage IV gastric cancer. From 1992 to 2002, 287 patients histologically diagnosed with stage IV gastric cancer underwent gastrectomy at the Department of Surgery, Ruijin Hospital, China. Regarding TNM categories, we separated them into T1-3N3M0, T4N1-2M0, T4N3M0, and TanyNanyM1 groups. We compared the clinicopathological characteristics as well as the survival in these groups. There were largest proportions of patients who underwent extended lymphadenectomy and curative gastrectomy in T1-3N3M0 group followed by T4N1-2M0, T4N3M0, and TanyNanyM1 groups. The survival rate of patients with sub-stage IVa (T1-3N3M0 and T4N1-2M0) tumors was significant higher than that of patients with sub-stage IVb (T4N3M0 and TanyNanyM1) tumors (P = 0.008). Multivariate analysis showed that sub-stage with the highest risk ratio (1.454), and the surgical curability were independent prognostic factors in patients with stage IV gastric cancer. Sub-stages IVa (T1-3N3M0 and T4N1-2M0) and IVb (T4N3M0 and TanyNanyM1) may predict patients' prognosis more accurately. Curative resection should be performed whenever possible in patients with stage IV gastric cancer.
    Journal of Surgical Oncology 03/2009; 99(6):324-8. · 2.64 Impact Factor