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Which is the optimal extent of resection in middle third gastric cancer between total gastrectomy and subtotal gastrectomy?

Title
Which is the optimal extent of resection in middle third gastric cancer between total gastrectomy and subtotal gastrectomy?
Authors
Lee J.H.Kim Y.I.
Ewha Authors
김용일
SCOPUS Author ID
김용일scopus
Issue Date
2010
Journal Title
Journal of Gastric Cancer
ISSN
2093-582XJCR Link
Citation
vol. 10, no. 4, pp. 226 - 233
Indexed
SCOPUS scopus
Abstract
Purpose: In resectable gastric cancer, choice regarding the extent of resection depends on tumor size, location, and distance from resection margin. However, there remains controversy for choice of resection for tumors in the middle third of the stomach. This study investigated patients who underwent gastrectomy in order to analyze the differences between total gastrectomy (TG) and subtotal gastrectomy (STG). Materials and Methods: From 2000 to 2006, 125 patients with a tumor in the middle third of the stomach underwent radical gastric resection at EUMC. We retrospectively conducted comparative analysis for the differences in clinicopathological characteristics and prognosis between TG and STG. Results: The average tumor size was 6.7 cm for TG, and 4.1 cm for STG. The number of metastatic lymph nodes were 13.3 for TG, and 3.7 for STG. Patients with more advanced cancer were more likely to receive TG. The 5-year survival rate for TG was lower (38.1%) than STG (69.0%). However, if tumor stages were stratified, there was no significant difference in the survival rate. Histologically, for the undifferentiated type of cancer (Stage 1, 2), the 5-year survival rate of STG was higher (88.1%) than TG (75.0%). Conclusions: Comparing patients with tumors in the middle third of the stomach who underwent TG and STG, there was no statistically significant difference in the 5-year survival rate. If stages were stratified, the clinicopathological characteristic becomes a key factor in deciding the prognosis, rather than the choice of resection. Thus if the radical resection margin can be obtained for a tumor in the middle third of the stomach, STG is considered instead of TG. © 2010 by The Korean Gastric Cancer Association.
DOI
10.5230/jgc.2010.10.4.226
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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