Total gastrectomy is not necessary for proximal gastric cancer Journal Article


Authors: Harrison, L. E.; Karpeh, M. S.; Brennan, M. F.
Article Title: Total gastrectomy is not necessary for proximal gastric cancer
Abstract: Background. Although there is an increasing incidence of proximal gastric cancers in the United States, the appropriate extent of resection for proximal gastric cancer is not known. This study addresses whether the type of operation (total gastrectomy [TG] vs proximal gastrectomy [PG]) affects outcome for proximal gastric adenocarcinoma. Methods. Review of the prospective gastric database at Memorial Sloan-Kettering Cancer Center from July 1985 to August 1995 identified 391 patients with proximal gastric cancer. Of those patients, 98 underwent curative TG or PG through an exclusively abdominal approach. Patients undergoing esophagogastrectomy (n = 293) were excluded from analysis. Data are expressed as medians and ranges. Results. The length of hospital stay was the same for patients undergoing resection for PG (16.5 days [range 8 to 55]) and for TG (18 days [range 8 to 48]). In addition, hospital mortality rates for PG (6.0%) were similar to those for TG (3.0%). There was no significant difference in tumor differentiation and overall stage between the groups that underwent TG and those that underwent PG. There was no significant difference in time to recurrence between the two operative groups (PG, 15.7 months, versus TG, 18 months). In addition, there was no association between first site of recurrence and type of procedure. The overall 5-year survival rate for proximal gastric cancer was 43% (median survival 46 months), whereas the 5- year survival rate for TG was 41% (median survival 51 months; difference not significant). Conclusions. The extent of resection for proximal gastric cancer does not affect long-term outcome. TG and PG have similar overall survival rates and time and rate of recurrence, and both procedures can be accomplished safely.
Keywords: adult; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; surgical technique; survival rate; major clinical study; mortality; cancer recurrence; prospective studies; adenocarcinoma; quality of life; neoplasm recurrence, local; length of stay; hospitalization; gastrectomy; stomach cancer; stomach adenocarcinoma; stomach neoplasms; unnecessary procedures; hospital mortality; total stomach resection; databases; humans; human; male; female; priority journal; article
Journal Title: Surgery
Volume: 123
Issue: 2
ISSN: 0039-6060
Publisher: Elsevier Inc.  
Date Published: 1998-02-01
Start Page: 127
End Page: 130
Language: English
DOI: 10.1016/s0039-6060(98)70248-x
PUBMED: 9481396
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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MSK Authors
  1. Murray F Brennan
    927 Brennan
  2. Martin S Karpeh
    98 Karpeh