Feasibility and long-term survival of proximal gastrectomy after neoadjuvant therapy for locally advanced proximal gastric cancer: A propensity-score-matched analysis.
10.1097/CM9.0000000000003232
- Author:
Tingfei GU
1
;
Yinkui WANG
2
;
Zhouqiao WU
3
;
Ning HE
1
;
Yingai LI
1
;
Fei SHAN
1
;
Ziyu LI
1
;
Jiafu JI
3
Author Information
1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China.
2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Translational Research, Peking University Cancer Hospital & Institute, Beijing 100142, China.
3. State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China.
- Publication Type:Journal Article
- Keywords:
Function preserving gastrectomy;
Gastric cancer;
Neoadjuvant therapy;
Proximal gastrectomy;
Total gastrectomy
- MeSH:
Humans;
Stomach Neoplasms/drug therapy*;
Gastrectomy/methods*;
Neoadjuvant Therapy/methods*;
Male;
Female;
Middle Aged;
Propensity Score;
Aged;
Adult;
Retrospective Studies
- From:
Chinese Medical Journal
2025;138(16):1984-1990
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Neoadjuvant therapy enhances the possibility of achieving radical resection and improves the prognosis for locally advanced gastric cancer (GC). However, there is a lack of evidence regarding the optimal extent of resection for locally advanced proximal GC after neoadjuvant therapy.
METHODS:In this study, 330 patients underwent resection in Peking University Cancer Hospital, with curative intent after neoadjuvant therapy for histologically confirmed proximal GC from January 2009 to December 2022.
RESULTS:In this study, 45 patients underwent proximal gastrectomy (PG), while 285 underwent total gastrectomy (TG). After propensity-score matching, 110 patients (71 TG and 39 PG) were included in the analysis. No significant differences between PG and TG regarding short-term outcomes and long-term prognosis were found. Specifically, PG demonstrated comparable overall survival to TG ( P = 0.47). Subgroup analysis revealed that although not statistically significant, PG showed a potential advantage over TG in overall survival for patients with tumor-long diameters less than 4 cm ( P = 0.31). However, for those with a long diameter larger than 4 cm, TG had a better survival probability ( P = 0.81). No substantial differences were observed in baseline characteristics, surgical safety, postoperative recovery, and postoperative complications.
CONCLUSION:For locally advanced proximal GC with objective response to neoadjuvant therapy (long diameter <4 cm), PG is an alternative surgical procedure.
