Is Proximal Gastrectomy Superior to Total Gastrectomy for Proximal Gastric Carcinoma?

1992 ◽  
Vol 9 (1) ◽  
pp. 13-18
Author(s):  
Shunichi Tsujitani ◽  
Yoshihiro Kakeji ◽  
Akihiro Watanabe ◽  
Yoshihiko Maehara ◽  
Motonosuke Furusawa ◽  
...  
Keyword(s):  
Gastric Carcinoma ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Proximal Gastric Carcinoma

Randomized Controlled Trial to Evaluate Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma

2017 ◽  
Vol 265 (2) ◽  
pp. 277-283 ◽  
Author(s):  
Takeshi Sano ◽  
Mitsuru Sasako ◽  
Junki Mizusawa ◽  
Seiichiro Yamamoto ◽  
Hitoshi Katai ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Gastric Carcinoma ◽  
Total Gastrectomy ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Proximal Gastric Carcinoma

Prognostic impact of splenic hilar lymph node metastasis in proximal gastric carcinoma: A retrospective analysis of 665 patients treated with D2 total gastrectomy.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 11-11
Author(s):  
Oh Jeong ◽  
Young-Kyu Park ◽  
Seong Yeob Ryu
Keyword(s):  
Lymph Node ◽  
Gastric Carcinoma ◽  
Total Gastrectomy ◽  
Poor Prognosis ◽  
Stage Iii ◽  
Prognostic Impact ◽  
Hilar Lymph Node ◽  
Node Metastasis ◽  
Undifferentiated Histology ◽  
Proximal Gastric Carcinoma

11 Background: Standard D2 lymph node (LN) dissection for proximal gastric carcinoma includes removing splenic hilar LNs. However, patients with splenic hilar LN metastasis often show a poor prognosis even after curative surgery. This study aimed to investigate the prognostic impact of splenic hilar LN metastasis in proximal gastric carcinoma. Methods: We reviewed prospectively constructed data of 665 patients who underwent total gastrectomy with D2 LN dissection for proximal gastric carcinoma. Clinicopathological features and survivals were compared between patients with and without splenic hilar LN metastasis. The prognostic value of splenic hilar LN metastasis was examined using a multivariate Cox prognostic model. Results: Of 665 patients, 63 (9.5%) with stage III or IV disease had splenic hilar LN metastasis. Splenic hilar LN metastasis was associated with a larger tumor size, B4 gross type, undifferentiated histology, and lymphovascular invasion. The 5-year survival of patients with splenic hilar LN metastasis was significantly worse at each tumor stage (stage III = 45% vs. 66%, p = 0.044, stage IV = 12% vs. 32%, p = 0.017). The 5-year survival of patients with splenic hilar LN metastasis did not significantly differ from that of the distant metastasis group (26% vs. 31%, p = 0.484). Multivariate analysis revealed that splenic hilar LN metastasis is an independent poor prognostic factor when adjusting for tumor node metastasis stage and other prognostic factors. Conclusions: Patients with splenic hilar LN metastasis show a poor prognosis after surgery. More intensive adjuvant treatment and postoperative surveillance will be required for patients with splenic hilar LN metastasis.

scholarly journals Proximal Gastrectomy versus Total Gastrectomy for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Comprehensive Analysis of Data from the SEER Registry

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Kaixuan Zhu ◽  
Yingying Xu ◽  
Jiaxin Fu ◽  
Farah Abdidahir Mohamud ◽  
Zongkui Duan ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Surgical Approach ◽  
Esophagogastric Junction ◽  
Proximal Gastrectomy ◽  
Locally Advanced ◽  
Cox Proportional Hazards Model ◽  
Type Ii ◽  
Siewert Type ◽  
Siewert Type Ii ◽  
Significant Difference

Background. To determine the ideal surgical approach (total gastrectomy (TG) vs. proximal gastrectomy (PG)) for Siewert type II adenocarcinoma of the esophagogastric junction (AEG), we searched and analyzed the Surveillance, Epidemiology, and End Results (SEER) data. Methods. Patients with Siewert type II AEG treated by TG or PG were identified from the 2004–2014 SEER dataset. We obtained the patients’ overall survival (OS) and cancer-specific survival (CSS) and stratified the patients by surgical approach. We performed a propensity score 1 : 1 matching (PSM) analysis and a univariate and multivariate Cox proportional hazards model. Results. A total of 2,217 patients with 6th AJCC stage IA–IIIB Siewert type II AEG was examined: 1,584 patients (71.4%) underwent PG, and 633 patients (28.6%) underwent TG. The follow-up time was 1–131 months. OS favored total gastrectomy before the PSM analysis (χ2=3.952, p=0.047), but after this analysis, there was no significant difference between TG and PG (χ2=2.227, p=0.136). The univariate and multivariate analyses identified age as an independent factor, and an X-tail analysis revealed 70 years as a cut-off point. The patients aged≥70 years obtained a significant long-term OS benefit from PG compared to TG (χ2=8.245, p=0.004), and those aged<70 years showed no difference between TG and PG (χ2=0.167, p=0.682). Conclusions. PG showed an equivalent survival benefit to TG in both the early and locally advanced stages of Siewert type II AEG. For elderly patients, PG is strongly recommended because of its clearer OS benefit compared to TG.

scholarly journals Differential Diagnosis between Bone Metastasis and Osteomalacia to the Patient Undergone Total Gastrectomy for Gastric Carcinoma

2003 ◽  
Vol 36 (5) ◽  
pp. 363-368 ◽  
Author(s):  
Noboru Nakagawa ◽  
Tetsuro Yamane ◽  
Yasushi Takeda ◽  
Shouzou Kitai ◽  
Shinji Okano ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Bone Metastasis ◽  
Gastric Carcinoma ◽  
Total Gastrectomy
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