J Gastric Cancer.  2014 Dec;14(4):246-251. 10.5230/jgc.2014.14.4.246.

Long-Term Outcomes of Proximal Gastrectomy versus Total Gastrectomy for Upper-Third Gastric Cancer

• Son MW
• Kim YJ
• Jeong GA
• Cho GS
• Lee MS

• KMID: 2183648
• DOI: http://doi.org/10.5230/jgc.2014.14.4.246

Abstract

PURPOSE
There are two surgical procedures for proximal early gastric cancer (EGC): total gastrectomy (TG) and proximal gastrectomy (PG). This study aimed to compare the long-term outcomes of PG with those of TG.
MATERIALS AND METHODS
Between January 2001 and December 2008, 170 patients were diagnosed with proximal EGC at Soonchunhyang University Cheonan Hospital, of which 64 patients underwent PG and 106 underwent TG. Clinicopathologic features, postoperative complications, blood chemistry data, changes in body weight, and oncological outcomes were analyzed and retrospectively compared between both groups.
RESULTS
Tumor size was smaller and the number of retrieved lymph nodes was lower in the PG group. The postoperative complication rate was 10.9% in the TG group and 16.9% in the PG group. The incidence of Los Angeles grade C and D reflux esophagitis was significantly higher in the TG group. Hemoglobin level was higher and body weight loss was greater in the TG group at 2, 3, and 5 years postoperatively. The albumin levels at 3 and 5 years were lower in the TG group. There was no significant difference in the 5-year overall survival rates between the two groups (P=0.789).
CONCLUSIONS
Postoperative complications and oncologic outcomes were observed to be similar between the two groups. The PG group showed better laboratory data and weight loss than did the TG group. Moreover, severe reflux esophagitis occurred less frequently in the PG group than in the TG group. PG can be considered as an effective surgical treatment for proximal EGC.

Keyword

Stomach neoplasms; Proximal gastrectomy; Total gastrectomy

MeSH Terms

Body Weight
Chemistry
Chungcheongnam-do
Esophagitis, Peptic
Gastrectomy*
Humans
Incidence
Lymph Nodes
Postoperative Complications
Retrospective Studies
Stomach Neoplasms*
Survival Rate
Weight Loss

Figure

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  Fig. 1 Schematic representation of proximal (A) and total (B) gastrectomy.

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  Fig. 2 Overall survival of patients in proximal gastrectomy (PG) and total gastrectomy (TG) groups. There were no significant differences in the overall survival rates of patients in PG and TG groups (5-year survival rates, 95.3% versus 95.6%, respectively; P=0.789).

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