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KMID : 0939920040360010050
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대한암학회지
2004 Volume.36 No. 1 p.50 ~ p.55
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Long-term Results of Proximal and Total Gastrectomy for Adenocarcinoma of the Upper Third of the Stomach
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Yoo Chang-Hak
Sohn Byung-Ho
Han Won-Kon
Pae Won-Kil
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Abstract
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PURPOSE: The choice of surgical strategy for patients with adenocarcinoma of the upper one third of the stomach is controversial. This study was performed to analyze the surgical results of a 11-year experience with these lesions.
MATERIALS AND METHODS: From January 1990 to December 2000, 259 patients with upper third gastric cancer underwent proximal gastrectomy (n=74) or total gastrectomy (n=185) through an abdominal approach. Morbidity, mortality, recurrence patterns, and survival were compared between these two groups retrospectively.
RESULTS: There were no significant differences in general complication and mortality rates between the two groups. However, the incidences of reflux esophagitis (16.2%) and anastomotic stricture (35.1%) were more common in the proximal gastrectomy group compared with the total gastrectomy group (0.5 and 8.1%). Regar-ding the main patterns of recurrence, local recurrence was dominant in the proximal gastrectomy group, whereas distant recurrence was dominant in the total gastrectomy group. Five-year overall survival (54.8 versus 47.8%) and survival according to tumor stage were no different between the groups. Multivariate analysis showed that the extent of resection was not an independent prognostic factor.
CONCLUSION: The extent of resection for upper third gastric cancer did not appear to affect long-term outcome. However, proximal gastrectomy is associated with an increased risk of reflux esophagitis, anastomotic stricture, and local recurrence. (Cancer Research and Treatment 2004;36:50-55)
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KEYWORD
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Stomach neoplasm, Surgical treatment, Recurrence, Prognosis
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