Aggressive Surgical Approach for XXXX : a Single-Center Experience from Northern India.

@entity1 @entity146 @entity5 @entity1086
BACKGROUND: @entity1086 ( @entity1086 ) is an @entity146 with dismal results of surgical treatment mainly because of advanced stage at presentation. The objective of this study was to investigate whether aggressive surgical treatment can be associated with reasonable survival for @entity1 with @entity1086 at acceptable morbidity and mortality. METHODS: A total of 113 @entity1 with proven or presumptive diagnosis of @entity1086 were recruited prospectively over a period of 2  years and evaluated for diagnosis and @entity5 by appropriate investigations. Seven out of 113 @entity1 were found to have benign pathology either intraoperatively or on histopathological examination hence excluded from follow-up and survival analysis. Out of 32 potentially resectable @entity1 , only 21 @entity1 could finally be resected with curative intent. @entity1 found unresectable/metastatic disease intraoperatively (n   =   11) were treated with palliative chemotherapy if eligible for the same. Short-term morbidity, perioperative mortality, disease-free survival (DFS), and median overall survival (OS) of surgically resected @entity1 were analyzed. Median OS of resected @entity1 was compared with that of unresectable @entity1 . RESULTS: Overall resectability rate in this study cohort was 19.8  % (21/106). Overall mortality was 4.7  % and morbidity was 42.8  %. Stage distribution of resected @entity1 was as follows: stage II (3), stage IIIA (9), stage IIIB (8), and stage IVA (1). DFS at 12 and 18  months was found to be 82.5 and 73.3  %, respectively. Mean DFS was 19.9  months (SE 1.42, 95  % CI). Mean OS for resected @entity1 was 21  months and that for unresectable @entity1 was 11.3  months only. Both groups were compared using log rank (Mantel-cox) test and statistically significant difference in OS was observed (p value <0.0001). CONCLUSION: Since curative resection is the only chance of cure, aggressive surgical approach adopted by us is justified with acceptable mortality and morbidity and encouraging overall survival.
