Prognosis of Patients With Gastric Cancer Who Underwent Proximal Gastrectomy

Abstract

Proximal gastrectomy (PG) has been introduced for patients who are preoperatively diagnosed with early gastric cancer located in the upper third of the stomach. In the present study, we compared the prognosis of patients who underwent PG with that of patients who underwent total gastrectomy (TG). Between 1997 and 2006, 51 patients were diagnosed with early gastric cancer located in the upper third of the stomach and underwent PG. In the same period, 35 patients were diagnosed with early gastric cancer and underwent TG. Of these, in 24 patients, the cancer was localized in the middle to upper part of the stomach, and 11 patients had multiple cancers. We compared the clinicopathologic differences and prognoses between the two groups. Significantly fewer lymph nodes were dissected in the PG group (mean, 18.2) than in the TG group (mean, 36.6;P < 0.001). Complications were detected in 17.6% of patients in the PG group and in 14.3% of patients in the TG group, which was not significant (P = 0.678). The overall and disease-specific 5-year survival rates in the 51 patients who underwent PG (88.7% and 97.1%, respectively) were not different from those in the 35 patients who underwent TG (87.6% and 93.4%; P = 0.971 and P = 0.553; respectively). These findings indicate that PG can be performed safely and may have various advantages compared with TG in terms of patients' daily lives.

A novel method of delta-shaped intracorporeal double-tract reconstruction in totally laparoscopic proximal gastrectomy

“…While there is still lack of agreement that PG-JI or PG-DT can replace TG-RY, PG-JI and PG-DT, as function-preserving surgery, do have several advantages over TG-RY [3,[6][7][8][12][13][14][15][16][17]. First, the remnant stomach offers significantly increased food intake volume and better QOL for patients.…”

Proximal gastrectomy with exclusion of no. 3b lesser curvature lymph node dissection could be indicated for patients with advanced upper-third gastric cancer

“…Among the 3921 individuals comprising the base population, 204 of 300 patients with T1 upper-third gastric cancer underwent proximal gastrectomy. Although LNs lying along the right gastric and right gastroepiploic vessels are not dissected, survival outcome after proximal gastrectomy performed for early upper-third gastric cancer is known to be comparable with that after total gastrectomy [17,18]. Several reports have demonstrated that the occurrence of metastasis from upper-third gastric cancer to LNs at the no.…”

Long-term clinicopathological prognosis on 609 cases after gastrectomy: A 10-year follow up single-institutional retrospective analysis

“…Studies have reported inconsistent results about relationship between age and prognosis [4][5], which may result from the absence of unified criterion of age groups. The elderly are identified as old people who are more than 65 years old by World Health Organization (WHO).…”