Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2004 Feb;36(1):50-5.
doi: 10.4143/crt.2004.36.1.50. Epub 2004 Feb 29.

Long-term results of proximal and total gastrectomy for adenocarcinoma of the upper third of the stomach

Chang Hak Yoo  1 , Byung Ho Sohn, Won Kon Han, Won Kil Pae
Affiliations

Long-term results of proximal and total gastrectomy for adenocarcinoma of the upper third of the stomach

Chang Hak Yoo et al. Cancer Res Treat. 2004 Feb.

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.

Keywords: Prognosis; Recurrence; Stomach neoplasm; Surgical treatment.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Cumulative survival of patients treated by proximal and total gastrectomy. p=0.378 (log-rank test).
Fig. 2
Fig. 2
Cumulative survival of patients treated by proximal and total gastrectomy according to UICC TNM A: stage I (p=0.141), B: stage II (p=0.926), C: stage III (p=0.138), D: stage IV (p=0.253).
See this image and copyright information in PMC

References

    1. Borch K, Jnsson B, Tarpila E, Franzen T, Berglund J, Kullman E, Franzen L. Changing pattern of histological type, location, stage and outcome of surgical treatment of gastric carcinoma. Br J Surg. 2000;87:618–626. - PubMed
    1. de Calan L, Portier G, Ozoux JP, Rivallain B, Perrier M, Brizon J. Carinoma of the cardia and proximal third of the stomach. Am J Surg. 1988;155:481–485. - PubMed
    1. Kaibara N, Nishimura O, Nishidoi H. Proximal gastrectomy as the surgical procedure of choice for upper gastric carcinoma. J Surg Oncol. 1987;36:110–112. - PubMed
    1. Kitamura K, Yamaguchi T, Okamoto K, Taniguchi H, Hagiwara A, Sawai K, Takahashi T. Total gastrectomy for early gastric cancer. J Surg Oncol. 1995;60:83–88. - PubMed
    1. Japanese Gastric Cancer Association. The new Japanese Classification of Gastric Carcinoma, 2nd English ed. Gastric Cancer. 1998;1:1–15.

LinkOut - more resources