Oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomach
Background: The oncological relevance of proximal gastrectomy in advanced gastric cancer remains unclear. We aimed to examine the frequency of lymph node metastasis in advanced gastric cancer to determine the oncological validity of proximal gastrectomy selection. Materials and methods: This study i...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Surgery Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845024000046 |
| _version_ | 1827295824109895680 |
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| author | Yoshiro Imai Ryo Tanaka Kentaro Matsuo Mitsuhiro Asakuma Sang-Woong Lee |
| author_facet | Yoshiro Imai Ryo Tanaka Kentaro Matsuo Mitsuhiro Asakuma Sang-Woong Lee |
| author_sort | Yoshiro Imai |
| collection | DOAJ |
| description | Background: The oncological relevance of proximal gastrectomy in advanced gastric cancer remains unclear. We aimed to examine the frequency of lymph node metastasis in advanced gastric cancer to determine the oncological validity of proximal gastrectomy selection. Materials and methods: This study included consecutive 71 patients with locally advanced gastric cancer in the upper third of the stomach who underwent total gastrectomy at our institution between 2001 and 2017. Lymph node metastasis and its therapeutic value index were examined to identify candidates for proximal gastrectomy. Metastatic and 3-year overall survival rates of numbers 3a and 3b lymph nodes were examined from 2010 to 2019. Results: The metastatic rate and therapeutic value index of numbers 4d, 5, 6, and 12a lymph nodes were zero or low. The number 3 lymph node had a metastatic rate and therapeutic value index of 36.6 % and 31.1, respectively. The metastatic and 3-year overall survival rates of the number 3a lymph node were 32.7 % and 89 %, respectively, whereas those of the number 3b lymph node were 3.8 % and 100 %, respectively. All patients with positive metastasis to the number 3b lymph node received adjuvant chemotherapy. Histopathological findings of positive metastasis to the number 3b lymph node were located in the lesser curvature, and the tumor diameter exceeded 40 mm. Conclusion: For advanced gastric cancer of the upper third of the stomach, the indications of localization to the lesser curvature and a tumor diameter of >40 mm should be considered cautiously. |
| first_indexed | 2024-03-08T11:53:17Z |
| format | Article |
| id | doaj.art-657de0160eef496a97a401f242e4e51d |
| institution | Directory Open Access Journal |
| issn | 2589-8450 |
| language | English |
| last_indexed | 2024-04-24T14:27:55Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj.art-657de0160eef496a97a401f242e4e51d2024-04-03T04:27:15ZengElsevierSurgery Open Science2589-84502024-03-01182327Oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomachYoshiro Imai0Ryo Tanaka1Kentaro Matsuo2Mitsuhiro Asakuma3Sang-Woong Lee4Corresponding author at: Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.; Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, JapanDepartment of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, JapanDepartment of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, JapanDepartment of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, JapanDepartment of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, JapanBackground: The oncological relevance of proximal gastrectomy in advanced gastric cancer remains unclear. We aimed to examine the frequency of lymph node metastasis in advanced gastric cancer to determine the oncological validity of proximal gastrectomy selection. Materials and methods: This study included consecutive 71 patients with locally advanced gastric cancer in the upper third of the stomach who underwent total gastrectomy at our institution between 2001 and 2017. Lymph node metastasis and its therapeutic value index were examined to identify candidates for proximal gastrectomy. Metastatic and 3-year overall survival rates of numbers 3a and 3b lymph nodes were examined from 2010 to 2019. Results: The metastatic rate and therapeutic value index of numbers 4d, 5, 6, and 12a lymph nodes were zero or low. The number 3 lymph node had a metastatic rate and therapeutic value index of 36.6 % and 31.1, respectively. The metastatic and 3-year overall survival rates of the number 3a lymph node were 32.7 % and 89 %, respectively, whereas those of the number 3b lymph node were 3.8 % and 100 %, respectively. All patients with positive metastasis to the number 3b lymph node received adjuvant chemotherapy. Histopathological findings of positive metastasis to the number 3b lymph node were located in the lesser curvature, and the tumor diameter exceeded 40 mm. Conclusion: For advanced gastric cancer of the upper third of the stomach, the indications of localization to the lesser curvature and a tumor diameter of >40 mm should be considered cautiously.http://www.sciencedirect.com/science/article/pii/S2589845024000046Advanced gastric cancerUpper third of the stomachProximal gastrectomyTherapeutic value |
| spellingShingle | Yoshiro Imai Ryo Tanaka Kentaro Matsuo Mitsuhiro Asakuma Sang-Woong Lee Oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomach Surgery Open Science Advanced gastric cancer Upper third of the stomach Proximal gastrectomy Therapeutic value |
| title | Oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomach |
| title_full | Oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomach |
| title_fullStr | Oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomach |
| title_full_unstemmed | Oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomach |
| title_short | Oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomach |
| title_sort | oncological relevance of proximal gastrectomy in advanced gastric cancer of upper third of the stomach |
| topic | Advanced gastric cancer Upper third of the stomach Proximal gastrectomy Therapeutic value |
| url | http://www.sciencedirect.com/science/article/pii/S2589845024000046 |
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