Detection value of free cancer cells in peritoneal washing in gastric cancer: a systematic review and meta-analysis

Intraperitoneal free cancer cells in gastric adenocarcinoma are associated with a poor outcome. However, the true prognostic value of intraperitoneal free cancer cells is still unclear, leading to a lack of consensus in the management of gastric cancer. The aim of the present study is to perform a systematic review and meta-analysis to analyze intraperitoneal free cancer cells-positive patients with regard to tumor oncologic stage, recurrence, grade of cellular differentiation, and survival rates and to analyze the clinical significance of intraperitoneal free cancer cells with regard to prognosis. Databases were searched up to January 2016 for prognostic factors associated with intraperitoneal free cancer cells, including oncologic stage, depth of neoplasm invasion, lymph nodal spread, differentiation grade of the tumor, and recurrence and survival rates. A total of 100 studies were identified. Meta-analysis revealed a clear association between intraperitoneal free cancer cells and a poor prognosis. intraperitoneal free cancer cells -positive patients had higher rates of nodal spread (risk difference: 0.29;

Impact of COVID-19 pandemic on the surgical treatment of gastric cancer

OBJECTIVE: The Coronavirus Disease 2019 (COVID-19) pandemic has been recognized as one of the most serious public health crises. This study aimed to evaluate the short-term impact of the pandemic on the surgical treatment of patients with gastric cancer (GC) in addition to their clinicopathological characteristics. We also verified adherence to the COVID-19 screening protocol adopted in the institution. METHODS: All patients with GC who underwent surgical treatment between 2015 and 2021 were retrospectively evaluated and divided into two groups according to the time period: control group (2015-2019) and COVID group (2020-2021). The institutional protocol recommends that patients referred for surgery undergo RT-PCR for severe acute respiratory syndrome coronavirus 2 infection. RESULTS: A total of 83 patients were classified into the COVID group and 535 into the control group. The number of surgical procedures performed in the control group was 107 (SD±23.8) per year. Diagnostic procedures (p=0.005), preoperative chemotherapy (p<0.001), and adenocarcinomas without Lauren’s subtype (p=0.009) were more frequent in the COVID group than in the control group. No significant difference was observed in the pathological characteristics and surgical outcomes of curative GC between the two groups. Evaluation of protocol compliance showed that of 83 patients with GC in the COVID group, 19 (22.9%) were not tested for COVID-19 before surgery. Two patients tested positive for COVID-19 (one preoperative and one postoperative). CONCLUSION: A decrease in the average number of surgeries and a higher frequency of diagnostic procedures occurred during the pandemic than in the previous time period. Tumor/node/metastasis classification, morbidity rates, and mortality rates in patients with GC during the pandemic did not differ from those in the previous time period. Accordingly, GC surgical treatment with acceptable screening protocol compliance could be safely performed during the COVID-19 pandemic

Partição gástrica para o tratamento paliativo de pacientes com tumores gástricos distais obstrutivos e irresecáveis

Gastric cancer is still a very prevalent decease. Most patients show up in latter stages of the decease, frequently with unresectable distal tumor and gastric outlet obstruction, in need of palliative care, which main purpose is to provide the patient a better quality of life. Among the therapeutic alternatives, gastrojejunostomy comes as a traditional choice. However, because of the high complication rates of this procedure, the gastric partitioning surgery emerged as an option. Given the relevant results presented in comparative studies between these two techniques, our service started performing the gastric partitioning surgery for the treatment of gastric outlet obstruction in patients with unresectable distal gastric cancer. We analyzed retrospectively the results in terms of survival rate and quality of life. ECOG performance status of all patients were 0,1 or 2 and 53,9% presented GOOSS grades 0 or 1. Mean operation time was 169 minutes. In the postoperative period, there were 4 grade II Clavien-Dindo patients and 2 grade V (two deaths, meaning an operative mortality of 6,9%). Mean time to achieve GOOSS grade 2 was 5 days and, throughout the follow up, 96,15% of the patients achieved GOOSS grades 2 or 3. Mean survival rate was 213 days. Based on the obtained satisfactory results, the gastric portioning surgery is safe and effective, allowing the patients pertinent survival rate, oral food intake and quality of life.O câncer gástrico é uma afecção que ainda se mostra muito prevalente. Como agravante, a maioria dos pacientes apresenta-se em estágios avançados da doença, frequentemente com tumores distais obstrutivos e irressecáveis, demandando tratamento paliativo, cujo objetivo é dar ao doente maior qualidade de vida. Dentre as opções terapêuticas, tradicionalmente se opta pela gastroenteroanastomose. Entretanto, devido às altas taxas de complicações desse procedimento, passou-se a empregar a técnica da partição gástrica. Frente aos resultados em estudos comparativos entre essas duas técnicas, nosso serviço passou a realizar a partição gástrica em casos de pacientes portadores de câncer gástrico avançado distal obstrutivo e irressecável, e analisamos retrospectivamente os resultados do emprego dessa técnica em 29 pacientes, em termos de sobrevida e qualidade de vida. Toda a população se apresentava com ECOG performance status de 0, 1 ou 2 e 53,9% dos doentes apresentavam, sob a classificação de obstrução gástrica de GOOSS, graus 0 ou 1. A duração operatória média foi de 169 minutos. No pós-operatório, sob a classificação de complicações de Clavien-Dindo, houve 4 pacientes em grau II e 2 em grau V (dois óbitos, correspondendo a uma mortalidade operatória de 6,9%). O tempo médio para se atingir GOOSS 2 foi de 5 dias e, ao longo do seguimento, 96,15% da população atingiu GOOSS 2 ou 3. A sobrevida média foi de 213 dias. Considerando os resultados satisfatórios obtidos, a técnica de partição gástrica é efetiva e segura, proporcionando sobrevida, manutenção de dieta via oral e qualidade de vida para os pacientes.

Surgical treatment of gastric cancer: a 10-year experience in a high-volume university hospital

OBJECTIVES: Surgery remains the cornerstone treatment modality for gastric cancer, the fifth most common type of tumor in Brazil. The aim of this study was to analyze the surgical treatment outcomes of patients with gastric cancer who were referred to a high-volume university hospital. METHODS: We reviewed all consecutive patients who underwent any surgical procedure due to gastric cancer from a prospectively collected database. Clinicopathological characteristics, surgical and survival outcomes were evaluated, with emphasis on patients treated with curative intent. RESULTS: From 2008 to 2017, 934 patients with gastric tumors underwent surgical procedures in our center. Gastric adenocarcinoma accounted for the majority of cases. Of the 875 patients with gastric adenocarcinoma, resection with curative intent was performed in 63.5%, and palliative treatment was performed in 22.4%. The postoperative surgical mortality rate for resected cases was 5.3% and was related to D1 lymphadenectomy and the presence of comorbidities. Analysis of patients treated with curative intent showed that resection extent, pT category, pN category and final pTNM stage were related to disease-free survival (DFS) and overall survival (OS). The DFS rates for D1 and D2 lymphadenectomy were similar, but D2 lymphadenectomy significantly improved the OS rate. Additionally, clinical factors and the presence of comorbidities had influence on the OS. CONCLUSIONS: TNM stage and the type of lymphadenectomy were independent factors related to prognosis. Early diagnosis should be sought to offer the optimal surgical approach in patients with less-advanced disease

Validation of classic and expanded criteria for endoscopic submucosal dissection of early gastric cancer: 7 years of experience in a Western tertiary cancer center

OBJECTIVE: Our aim was to evaluate the Japan Gastroenterological Endoscopy Society criteria for endoscopic submucosal resection of early gastric cancer (EGC) based on the experience in a Brazilian cancer center. METHODS: We included all patients who underwent endoscopic submucosal resection for gastric lesions between February 2009 and October 2016. Demographic data and information regarding the endoscopic resection, pathological report and follow-up were obtained. Statistical calculations were performed with Fisher’s exact test and chi-square tests, with 95% confidence intervals. RESULTS: In total, 76% of the 51 lesions were adenocarcinomas, 16% were adenomas, and 8% had other diagnoses. The average size was 19.9 mm (±11.7). The average procedure length was 113.9 minutes (±71.4). The complication rate was 21.3%, with only one patient who needed surgical treatment (transmural perforation). Among the adenocarcinomas, 39.5% met the classic criteria for curability, 31.6% met the expanded criteria and 28.9% met the criteria for noncurative resection. Analysis of the indication criteria and curability revealed differences among cases with ‘‘only-by-size’’ expanded criteria (64.28%), other expanded criteria (40%) and classic criteria (89.47%), with a p-value of 0.049. During follow-up (15.8 months; ±14.3), 86.1% of the EGC patients had no recurrence. When well-differentiated and poorly differentiated lesions or lesions included in the classic and expanded criteria were compared, there were no differences in recurrence. The noncurative group presented a higher recurrence rate than the classic group (p=0.014). CONCLUSION: These results suggest that the Japanese endoscopic submucosal resection criteria might be useful for endoscopic treatment of EGC in Western countries

II Consenso Brasileiro de Câncer Gástrico realizado pela Associação Brasileira de Câncer Gástrico

Background: Since the publication of the first Brazilian Consensus on Gastric Cancer (GC) in 2012 carried out by the Brazilian Gastric Cancer Association, new concepts on diagnosis, staging, treatment and follow-up have been incorporated. Aim: This new consensus is to promote an update to professionals working in the fight against GC and to provide guidelines for the management of patients with this condition. Methods: Fiftynine experts answered 67 statements regarding the diagnosis, staging, treatment and prognosis of GC with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree A consensus was adopted when at least 80% of the sum of the answers “fully agree” and “partially agree” was reached. This article presents only the responses of the participating experts. Comments on each statement, as well as a literature review, will be presented in future publications. Results: Of the 67 statements, there was consensus in 50 (74%). In 10 declarations, there was 100% agreement. Conclusion: The gastric cancer treatment has evolved considerably in recent years. This consensus gathers consolidated principles in the last decades, new knowledge acquired recently, as well as promising perspectives on the management of this disease.Racional: Desde a publicação do primeiro Consenso Brasileiro sobre Câncer Gástrico em 2012 realizado pela Associação Brasileira de Câncer Gástrico (ABCG), novos conceitos sobre o diagnóstico, estadiamento, tratamento e seguimento foram incorporados. Objetivo: Promover uma atualização aos profissionais que atuam no combate ao câncer gástrico (CG) e fornecer diretrizes quanto ao manejo dos pacientes portadores desta afecção. Métodos: Cinquenta e nove especialistas responderam 67 declarações sobre o diagnóstico, estadiamento, tratamento e prognóstico do CG com cinco alternativas possíveis: 1) concordo plenamente; 2) concordo parcialmente; 3) indeciso; 4) discordo e 5) discordo fortemente. Foi considerado consenso a concordância de pelo menos 80% da soma das respostas “concordo plenamente” e “concordo parcialmente”. Este artigo apresenta apenas as respostas dos especialistas participantes. Os comentários sobre cada declaração, assim como uma revisão da literatura serão apresentados em publicações futuras. Resultados: Das 67 declarações, houve consenso em 50 (74%). Em 10 declarações, houve concordância de 100%. Conclusão: O tratamento do câncer gástrico evoluiu consideravelmente nos últimos anos. Este consenso reúne princípios consolidados nas últimas décadas, novos conhecimentos adquiridos recentemente, assim como perspectivas promissoras sobre o manejo desta doença

INTRAPERITONEAL CHEMOTHERAPY FOR GASTRIC CANCER WITH PERITONEAL CARCINOMATOSIS: STUDY PROTOCOL OF A PHASE II TRIAL

ABSTRACT BACKGROUND: Peritoneal carcinomatosis in gastric cancer is considered a fatal disease, without expectation of definitive cure. As systemic chemotherapy is not sufficient to contain the disease, a multimodal approach associating intraperitoneal chemotherapy with surgery may represent an alternative for these cases. AIMS: The aim of this study was to investigate the role of intraperitoneal chemotherapy in stage IV gastric cancer patients with peritoneal metastasis. METHODS: This study is a single institutional single-arm prospective clinical trial phase II (NCT05541146). Patients with the following inclusion criteria undergo implantation of a peritoneal catheter for intraperitoneal chemotherapy: Stage IV gastric adenocarcinoma; age 18–75 years; Peritoneal carcinomatosis with peritoneal cancer index<12; Eastern Cooperative Oncology Group 0/1; good clinical status; and lab exams within normal limits. The study protocol consists of four cycles of intraperitoneal chemotherapy with paclitaxel associated with systemic chemotherapy. After treatment, patients with peritoneal response assessed by staging laparoscopy undergo conversion gastrectomy. RESULTS: The primary outcome is the rate of complete peritoneal response. Progression-free and overall survivals are other outcomes evaluated. The study started in July 2022, and patients will be screened for inclusion until 30 are enrolled. CONCLUSIONS: Therapies for advanced gastric cancer patients have been evaluated in clinical trials but without success in patients with peritoneal metastasis. The treatment proposed in this trial can be promising, with easy catheter implantation and ambulatory intraperitoneal chemotherapy regime. Verifying the efficacy and safety of paclitaxel with systemic chemotherapy is an important progress that this study intends to investigate

Characterization of the molecular subtypes of gastric cancer by gene and protein expression

INTRODUÇÃO: Recentemente, a classificação molecular do câncer gástrico (CG) emergiu como opção promissora para definir subgrupos prognósticos, distinguir o comportamento biológico, além de permitir a identificação de potenciais alvos terapêuticos para drogas específicas. Por meio de técnicas moleculares, o CG foi dividido em 4 subtipos: instabilidade de microssatélites (MSI), vírus Epstein-Barr (EBV)-positivo, genomicamente estável (GS) e instabilidade cromossômica (CIN). Os custos associados à complexidade técnica das metodologias moleculares são ainda um obstáculo para sua implantação na prática de rotina. OBJETIVOS: Determinar os grupos da classificação molecular por meio da expressão proteica de marcadores associados a cada subtipo. Comparar as diferentes classificações moleculares existentes e propor um novo modelo. MÉTODOS: Foram avaliados, retrospectivamente, 287 pacientes com CG submetidos à gastrectomia-D2 curativa, por meio da construção de tissue microarray. A expressão das proteínas de reparo do DNA, E-caderina e p53 foram avaliadas por imuno-histoquímica (IH), determinando os grupos MSI, GS e CIN, respectivamente. O EBV foi detectado por hibridização in situ (ISH). RESULTADOS: Após avaliação histopatológica, 179 (62,4%) pacientes foram classificados como CIN, 58 (20,2%) MSI, 30 (10,5%) EBV e 20 (7%) como GS. Os subtipos associaram-se com características distintas, tais como: gênero masculino (EBV, p=0.101); idade avançada (MSI, p=0,017), menor relação neutrófilo-linfócito (CIN, p=0,029), gastrectomia total (EBV, p < 0,001), localização distal (MSI, p=0,004), Laurén difuso (GS, p < 0,001), e estádio avançado (GS, p=0,014). O subtipo MSI apresentou melhor sobrevida livre de doença (SLD) (82,8%), seguido pelo EBV e CIN (ambos com 70%) e GS (50%) (p=0.005). A sobrevida global (SG) foi maior nos tumores MSI (75,9%), seguido pelo EBV (73,3%), CIN (65.4%) e GS (45%, mediana de 25 meses) (p=0.007). Em análise multivariada, gastrectomia total, pT, pN e os subtipos tumorais foram fatores significativos associados à SLD (MSI p=0,012; EBV p=0,037; CIN p=0,018; GS referência). Do mesmo modo, o tipo de cirurgia, pT, e os subtipos tumorais foram fatores independentes associados a SG (MSI p=0,010; EBV p=0,006; CIN p=0,025; GS referência). Com base no risco de recidiva dos pacientes do estudo, nova classificação, que inclui 5 subtipos, foi proposta. Evidenciou-se que a classificação por risco e cluster tiveram melhor acurácia para identificar recidivas e óbitos respectivamente. CONCLUSÃO: A análise IH/ISH foi capaz de determinar subtipos de CG com características clinicopatológicas e prognósticos distintos, reproduzindo os subtipos obtidos pela classificação molecularBACKGROUND: Recently, the molecular classification of gastric cancer (CG) emerged as a promising option to define prognostic subgroups, to distinguish biological behavior, and to identify potential therapeutic targets for specific drugs. Through molecular techniques, GC was divided into 4 subtypes: microsatellite instability (MSI), Epstein-Barr virus (EBV) positive, genomically stable (GS) and chromosomal instability (CIN). The costs associated with the technical complexity of the molecular methodologies are still an obstacle to its implementation in routine practice. OBJECTIVES: To determine molecular classification groups by means of protein expression of markers associated with each subtype. To compare the different existing molecular classifications and propose a new model. METHODS: We retrospectively evaluated 287 CG patients submitted to curative D2-gastrectomy through the construction of tissue microarray. Expression of the DNA repair proteins, E-cadherin and p53 were evaluated by immunohistochemistry (IH), determining the MSI, GS and CIN subtypes, respectively. EBV was detected by in situ hybridization (ISH). RESULTS: After the histopathological evaluation, 179 (62.4%) patients were classified as CIN, 58 (20.2%) MSI, 30 (10.5%) EBV and 20 GS (7%) as GS. The subtypes presented associations with distinct characteristics, such as: male gender (EBV, p=0.101); advanced age (MSI, p=0.017), Laurén diffuse type (GS, p < 0.001), lower neutrophil-lymphocyte ratio (CIN, p=0.029), total gastrectomy (EBV, p < 0.001), distal location (MSI, p=0.004), and advanced stage (GS, p=0.014). The MSI subtype presented better disease-free survival (DFS) (82.8%), followed by the EBV and CIN subtypes (both with 70%) and GS (50%) (p=0.005). Overall survival (OS) was higher in MSI tumors (75.9%), followed by EBV (73.3%), CIN (65.4%) and GS (45%, median of 25 months) (p=0.007). In multivariate analysis, total gastrectomy, tumor invasion, lymph node metastasis, and tumor subtypes were significant factors associated with SLD (MSI p=0.012, EBV p=0.037, CIN p=0.018, GS reference). Likewise, type of surgery, pT, and tumor subtypes were independent factors associated with OS (p=0.010, p=0.010, EBV p=0.006, CIN p=0.025, GS reference). Based on the risk of recurrence, a new classification including 5 subtypes was proposed. It was evidenced that the risk classification and cluster had better accuracy to identify recurrences and deaths respectively. CONCLUSION: The IH / ISH analysis was able to determine CG groups with clinicopathological characteristics and distinct prognoses, reproducing the subtypes obtained by the molecular classificatio

Risk factors associated with the development of gastric adenocarcinoma: case-control study

INTRODUÇÃO: O câncer vem apresentando um impacto cada vez maior nas populações em todo o mundo. Apesar de recente queda global na sua incidência, o câncer gástrico ainda é o quinto tipo mais comum. Sua patogênese é multifatorial, envolvendo a interação de fatores genéticos, ambientais e infecciosos. OBJETIVO: Avaliar a associação de tabagismo, consumo de álcool e nível de escolaridade com o desenvolvimento de câncer gástrico. MÉTODOS: Trata-se de um estudo caso-controle de base hospitalar em que foram incluídos pacientes com diagnóstico de adenocarcinoma de estômago confirmado por exame histopatológico sem tratamento prévio para a neoplasia. Posteriormente, os casos foram divididos em subtipos de acordo com a histologia (intestinal e difuso) e localização da lesão (proximal, distal e outras). Os indivíduos do grupo controle foram selecionados entre pacientes admitidos no mesmo hospital, sem história ou suspeita de câncer de estômago, emparelhados por frequência aos casos segundo sexo e idade. Tabagismo foi classificado em maços-ano e consumo de álcool em gramas-ano. RESULTADOS: Foram analisados 240 casos e 499 controles recrutados no período de junho de 2001 a dezembro de 2007. Não frequentaram a escola ou apresentavam ensino fundamental incompleto 94 indivíduos (39,2%) no grupo dos casos e 187 (37,5%) no grupo de controles. Ensino universitário foi atingido por 12 indivíduos (5%) no grupo de casos e por 45 indivíduos (9%) do grupo de controles. Não houve associação de nível de escolaridade com risco de desenvolvimento de câncer de estômago. Tabagismo esteve associado ao risco de câncer gástrico com odds ratio (OR) de 2,25 (IC95%: 1,53-3,31) para ex-tabagistas e de 2,67 (IC95%: 1,72-4,13) para tabagistas atuais. Com relação à localização e tipo histológico, tabagismo foi associado com todos os subtipos de tumores gástricos analisados, com destaque para os tumores proximais que apresentaram OR de 5,38 (IC95%: 2,15-13,45) para consumo superior a 38 maços-ano. Consumo de álcool também esteve associado a risco de desenvolvimento de câncer gástrico em todos os subtipos analisados. Entretanto, esta associação apresentou características distintas do tabagismo. Ex-consumidores de álcool apresentaram risco mais elevado (OR=3,81; IC95%: 2,45-5,91) que consumidores atuais (OR=2,06; IC95%: 1,31-3,26). A análise da interação mostrou que o efeito conjunto de tabagismo e consumo de álcool encontrado foi maior que o esperado, evidenciando interação positiva [?=1,51 (IC 95%: 1,05 - 1,96)]. CONCLUSÕES: Tabagismo e consumo de álcool apresentaram associação com o risco de desenvolvimento de câncer gástrico, com destaque para tabagistas atuais e maior consumo de maços-ano. O consumo associado do tabaco e do álcool aumenta esse riscoBACKGROUND: Cancer has an increasing impact on populations around the world. Despite a recent overall decline in incidence, gastric cancer stills the fifth most common type. Its pathogenesis is multifactorial involving the interaction of genetic, environmental and infectious factors. OBJECTIVES: To evaluate the association of smoking, alcohol consumption and education level with the development of gastric cancer. METHODS: This is a hospital-based case-control study that included patients with gastric adenocarcinoma confirmed by histopathological examination without prior treatment. Subsequently, patients were divided into subtypes according to histology (intestinal and diffuse) and location of the lesion (proximal, distal and others). Control subjects were selected among patients admitted to the same hospital with no history of gastric câncer, and were frequency-matched to cases for age and sex. Smoking was classified in pack-years and alcohol consumption in grams per year. RESULTS: We analyzed 240 cases and 499 controls recruited from June 2001 to December 2007. Not attended school or had incomplete elementary school 94 subjects (39.2%) in the group of cases and 187 (37.5%) in the control group. University education was achieved by 12 subjects (5%) in the case group and 45 subjects (9%) in the control group. There was no association of education level with increased risk of stomach cancer. Smoking was associated with increased risk of gastric cancer with an odds ratio (OR) of 2.25 (95%CI: 1.53-3.31) for former smokers and 2.67 (95%CI: 1.72-4.13) for current smokers. With respect to location and histological type, smoking was associated with all subtypes of gastric tumors analyzed with emphasis on the proximal tumors that had OR of 5.38 (95%CI: 2.15-13.45) for consumption over 38 packs-years. Alcohol consumption was also associated with increases risk of gastric cancer development in all analyzed subtypes. However, this association showed distinct characteristics of smoking. Former drinkers had higher risk (OR=3.81; 95%CI: 2.45-5.91) than current users (OR=2.06; 95%CI: 1.31-3.26). The analysis of the interaction showed that the combined effect of smoking and alcohol consumption was higher than expected, thus showing up a positive interaction [?= 1.51 (95%CI: 1.05-1.96)]. CONCLUSIONS: Smoking and alcohol consumption were associated with the risk of gastric cancer development, especially for current smokers and higher consumption of pack-years. Association of tobacco and alcohol consumption increases this ris

Exclusão Duodenal na Regulação da Glicemia em Diabéticos Tipo 2 Submetidos a Gastrectomia com Y-de-Roux por Câncer Gástrico: Estudo de Coorte

Background: The effect of the duodenal exclusion in glycemic regulation has yet to be&nbsp;defined. Individuals with type 2 Diabetes Mellitus (T2DM) operated for other reasons than&nbsp;obesity, represent an adequate model to analyze clinical outcomes of duodenal exclusion.&nbsp;&nbsp; Objective: To analyze the changes in glycemia and pharmacotherapy for T2DM in patients undergoing gastrectomy with Roux-in-Y derivation for gastric cancer.&nbsp; Methods: An observational study was conducted in 2018 on patients who were submitted to surgery from 2001 to 2016. Medical records of 129 patients’ cohort operated in two public hospitals were analyzed retrospectively before the surgery (T0) and one year after (T1). The research&nbsp;protocol was approved by the ethics committee. The final sample was mainly represented by&nbsp;women (50.5%) with a mean age of 65.5 years, and a mean body mass index of 26.5 kg/m2 SD 4.30.&nbsp;&nbsp; Results: One year later, mean glucose levels of the entire sample decreased (p=0.046), but 70% of patients with glycemia&gt; 100 at T0, remained with the same value in T1. Glycated hemoglobin had no significant change (p=0.988). Regarding the pharmacotherapy for T2DM,&nbsp;60.7% of the sample had no change. However, 6.7% had discontinuation of the medication with the improvement of T2DM. The multivariate model by classification and decision tree method (CART) found as predictors of change in&nbsp;DM2 medication, age (&lt;62.5 years) and a body mass index (&gt; 30.2 kg/m2) with a predictive value of&nbsp;71.4%.&nbsp; Conclusion: There was no improvement of glycemia and pharmacotherapy in patients with&nbsp;T2DM who underwent gastrectomy with Roux-en-Y reconstruction, with a body mass index below 30&nbsp;kg/m2Antecedentes: Aún no se ha definido el efecto de la exclusión duodenal en la regulación glucémica. Individuos con Diabetes Mellitus tipo 2 (DM2) operados por otras razones distintas a la obesidad, representan un modelo adecuado para analizar los resultados clínicos de la exclusión duodenal. Objetivo: Analizar los cambios en la glucemia y la farmacoterapia para la DM2 en pacientes sometidos a gastrectomía con derivación en Y de Roux por cáncer gástrico. Métodos: se realizó un estudio observacional en 2018 en pacientes que fueron sometidos a cirugía entre 2001 y 2016. Se analizaron retrospectivamente las historias clínicas de una cohorte de 129 pacientes operados en dos hospitales públicos antes de la cirugía (T0) y un año después (T1). El protocolo de investigación fue aprobado por el comité de ética. La muestra final estuvo representada mayoritariamente por mujeres (50,5 %) con una edad media de 65,5 años y un índice de masa corporal medio de 26,5 kg/m2 SD 4,30. Resultados: Un año después, los niveles medios de glucosa de toda la muestra disminuyeron (p=0,046), pero el 70% de los pacientes con glucemia &gt; 100 en T0, permanecieron con el mismo valor en T1. La hemoglobina glicosilada no tuvo cambios significativos (p=0,988). En cuanto a la farmacoterapia para la DM2, el 60,7% de la muestra no presentó cambios. Sin embargo, el 6,7% tuvo suspensión de la medicación con la mejoría de la DM2. El modelo multivariante por método de clasificación y árbol de decisión (CART) encontró como predictores de cambio de medicación en DM2 la edad (&lt; 62,5 años) y el índice de masa corporal (&gt; 30,2 kg/m2) con un valor predictivo del 71,4%. Conclusión: No hubo mejoría de la glucemia y la farmacoterapia en pacientes con DM2 que se sometieron a gastrectomía con reconstrucción en Y de Roux, con un índice de masa corporal por debajo de 30 kg/m2Contexto: O efeito da exclusão duodenal na regulação glicêmica ainda não foi definido. Indivíduos com Diabetes Mellitus tipo 2 (T2DM) operados por outros motivos que não obesidade, representam um modelo adequado para analisar os resultados clínicos da exclusão duodenal. Objetivo: Analisar as alterações da glicemia e da farmacoterapia para DM2 em pacientes submetidos à gastrectomia com derivação em Y de Roux para câncer gástrico. Métodos: Foi realizado um estudo observacional em 2018 em pacientes operados de 2001 a 2016. Os prontuários de uma coorte de 129 pacientes operados em dois hospitais públicos foram analisados ​​retrospectivamente antes da cirurgia (T0) e um ano após (T1). O protocolo de pesquisa foi aprovado pelo comitê de ética. A amostra final foi representada principalmente por mulheres (50,5%) com idade média de 65,5 anos e índice de massa corporal médio de 26,5 kg/m2 SD 4,30. Resultados: Um ano depois, os níveis médios de glicose de toda a amostra diminuíram (p=0,046), mas 70% dos pacientes com glicemia &gt; 100 em T0, permaneceram com o mesmo valor em T1. A hemoglobina glicada não apresentou alteração significativa (p=0,988). Em relação à farmacoterapia para DM2, 60,7% da amostra não apresentou alteração. No entanto, 6,7% tiveram descontinuação da medicação com melhora do DM2. O modelo multivariado pelo método de classificação e árvore de decisão (CART) encontrou como preditores de mudança na medicação para DM2, idade (&lt;62,5 anos) e índice de massa corporal (&gt; 30,2 kg/m2) com valor preditivo de 71,4%. Conclusão: Não houve melhora da glicemia e farmacoterapia em pacientes com DM2 submetidos à gastrectomia com reconstrução em Y de Roux, com índice de massa corporal abaixo de 30 kg/m