Long-term Results of Proximal and Total Gastrectomy for Adenocarcinoma of the Upper Third of the Stomach.
- Author:
Chang Hak YOO
1
;
Byung Ho SOHN
;
Won Kon HAN
;
Won Kil PAE
Author Information
1. Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Stomach neoplasm;
Surgical treatment;
Recurrence;
Prognosis
- MeSH:
Adenocarcinoma*;
Constriction, Pathologic;
Esophagitis, Peptic;
Gastrectomy*;
Humans;
Incidence;
Mortality;
Multivariate Analysis;
Prognosis;
Recurrence;
Retrospective Studies;
Stomach Neoplasms;
Stomach*
- From:Cancer Research and Treatment
2004;36(1):50-55
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The choice of surgical strategy for patients with adenocarcinoma of the upper one third of the stomach is controversial. This study was performed to analyze the surgical results of a 11-year experience with these lesions. MATERIALS AND METHODS: From January 1990 to December 2000, 259 patients with upper third gastric cancer underwent proximal gastrectomy (n=74) or total gastrectomy (n=185) through an abdominal approach. Morbidity, mortality, recurrence patterns, and survival were compared between these two groups retrospectively. RESULTS: There were no significant differences in general complication and mortality rates between the two groups. However, the incidences of reflux esophagitis (16.2%) and anastomotic stricture (35.1%) were more common in the proximal gastrectomy group compared with the total gastrectomy group (0.5 and 8.1%). Regarding the main patterns of recurrence, local recurrence was dominant in the proximal gastrectomy group, whereas distant recurrence was dominant in the total gastrectomy group. Five-year overall survival (54.8 versus 47.8%) and survival according to tumor stage were no different between the groups. Multivariate analysis showed that the extent of resection was not an independent prognostic factor. CONCLUSION: The extent of resection for upper third gastric cancer did not appear to affect long-term outcome. However, proximal gastrectomy is associated with an increased risk of reflux esophagitis, anastomotic stricture, and local recurrence.
