BACKGROUND AND OBJECTIVES: To determine which optimal surgical procedure for middle-third advanced gastric cancer (AGC) based on comparative study of the long-term prognosis between total gastrectomy (TG) and distal gastrectomy (DG). METHODS: Between March 1993 and December 2005, 402 patients with middle-third AGC who underwent gastric resection were enrolled in this study. We analyzed the long-term prognosis according to the length of the proximal resection margin (PRM) and the extent of gastric resection, and determined independent prognostic factors. RESULTS: TG was performed in 244 patients (60.7%) and DG was performed in 158 patients (39.3%). There were no significant differences in the 5-year survival rates according to the length of PRM. The 5-year survival rates of patients who underwent DG were significantly higher than the rates of the patients who underwent TG in curative cases (67.8% vs. 58.4%, P = 0.037). Nevertheless, there was no significant difference in the stage-stratified survival rates according to the extent of gastric resection. Multivariate analysis revealed that surgical curability, extent of lymphadenectomy, and stage were independent prognostic factors. CONCLUSION: If curative resection can be performed, the long-term prognosis of patients with middle-third AGC was not affected by the length of PRM or the extent of gastric resection. (c) 2009 Wiley-Liss, Inc.
BACKGROUND AND OBJECTIVES: To determine which optimal surgical procedure for middle-third advanced gastric cancer (AGC) based on comparative study of the long-term prognosis between total gastrectomy (TG) and distal gastrectomy (DG). METHODS: Between March 1993 and December 2005, 402 patients with middle-third AGC who underwent gastric resection were enrolled in this study. We analyzed the long-term prognosis according to the length of the proximal resection margin (PRM) and the extent of gastric resection, and determined independent prognostic factors. RESULTS:TG was performed in 244 patients (60.7%) and DG was performed in 158 patients (39.3%). There were no significant differences in the 5-year survival rates according to the length of PRM. The 5-year survival rates of patients who underwent DG were significantly higher than the rates of the patients who underwent TG in curative cases (67.8% vs. 58.4%, P = 0.037). Nevertheless, there was no significant difference in the stage-stratified survival rates according to the extent of gastric resection. Multivariate analysis revealed that surgical curability, extent of lymphadenectomy, and stage were independent prognostic factors. CONCLUSION: If curative resection can be performed, the long-term prognosis of patients with middle-third AGC was not affected by the length of PRM or the extent of gastric resection. (c) 2009 Wiley-Liss, Inc.
Authors: Massimiliano Bissolati; Matteo Desio; Fausto Rosa; Stefano Rausei; Daniele Marrelli; Gian Luca Baiocchi; Giovanni De Manzoni; Damiano Chiari; Giovanni Guarneri; Fabio Pacelli; Lorenzo De Franco; Sarah Molfino; Chiara Cipollari; Elena Orsenigo Journal: Gastric Cancer Date: 2016-01-05 Impact factor: 7.370