Analysis of Local Recurrence Following Proximal Gastrectomy in Patients with Upper Third Gastric Cancer

Abstract

Purpose: Little is known about local recurrence following proximal gastrectomy in patients with upper third gastric cancer. We performed this study to evaluate the long-term results of a proximal gastrectomy, and to analyze the risk factors of local recurrence affecting survival in these patients.

Materials and methods: We undertook a retrospective study of 63 patients who underwent potentially curative proximal gastrectomy between 1990 and 1999, with special reference to local recurrence.

Results: During a median follow-up period of 37 months, 25 of the 63 patients (39.7%) developed a recurrence of cancer, with local recurrence in 15 patients (23.8%), the majority of these occurring at the remnant stomach or anastomosis. The median time to local recurrence was 38 months (8~78 months). Univariate analysis of risk factors for local recurrence revealed an infiltrative or diffuse gross type, with a tumor sizes>5 cm, a distal resection margin <or=3 cm and serosal invasion. Reoperation for cure was possible in only 4 patients and most died within the first year following diagnosis of recurrence.

Conclusion: When performing a proximal gastrectomy for upper third gastric cancer, even after curative resection, all risk factors should be considered to reduce rates of local recurrence.

Keywords: Local recurrence; Prognosis; Proximal gastrectomy; Stomach neoplasm.