The comparison of long-term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancer
Abstract Background Conventional methods for treating patients with proximal gastric cancer (PGC) include proximal gastrectomy (PG) and total gastrectomy (TG) and such methods have become challenging due to double tract reconstruction (DTR). However, the clinical outcomes remain unclear. This study...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-02985-z |
| _version_ | 1827979473709957120 |
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| author | Keming Ying Weisong Bai Guiru Yan Ziseng Xu Shenheng Du Chengxue Dang |
| author_facet | Keming Ying Weisong Bai Guiru Yan Ziseng Xu Shenheng Du Chengxue Dang |
| author_sort | Keming Ying |
| collection | DOAJ |
| description | Abstract Background Conventional methods for treating patients with proximal gastric cancer (PGC) include proximal gastrectomy (PG) and total gastrectomy (TG) and such methods have become challenging due to double tract reconstruction (DTR). However, the clinical outcomes remain unclear. This study was performed with the aim of verifying that PG-DTR was beneficial in terms of reducing the incidence of postoperative complications and improving the prognosis. Methods The PGC patient cohort was retrospectively grouped into the PG-DTR and TG groups. Clinicopathological features, complications, and survival data were compared between the two groups. Results A total of 388 patients were included in the analyses. Patients who were subjected to TG tended to have more severe gastroesophageal reflux (GR) (P = 0.041), anemia (P = 0.007), and hypoalbuminemia (P < 0.001). Overall survival rates, regardless of clinical stage, were significantly different between the PG-DTR and TG groups (all P < 0.05). The multivariate Cox regression analysis confirmed that surgical procedure, tumor size, infiltration depth, lymph node metastasis, differentiation, and age were independent risk factors. The patients were likely to benefit from PG-DTR (all HR > 1 and P < 0.05). However, no significant differences were observed in the risks of GR, anemia, and hypoalbuminemia (all P > 0.05). Moreover, the nomogram derived from significant parameters showed great calibration and discrimination ability and significant clinical benefit. Conclusions The patients who underwent PG-DTR had a favorable prognosis. The risk of postoperative complications, such as severe GR, anemia, and hypoalbuminemia, was lower in PG-DTR than in TG. Thus, PG-DTR is more beneficial for patients with PGC and may be a valuable and promising surgical procedure. |
| first_indexed | 2024-04-09T21:38:25Z |
| format | Article |
| id | doaj.art-d3f0928dccc54b2baf57d5cbdbd712d0 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-09T21:38:25Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-d3f0928dccc54b2baf57d5cbdbd712d02023-03-26T11:12:28ZengBMCWorld Journal of Surgical Oncology1477-78192023-03-0121111410.1186/s12957-023-02985-zThe comparison of long-term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancerKeming Ying0Weisong Bai1Guiru Yan2Ziseng Xu3Shenheng Du4Chengxue Dang5Department of Surgical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Surgical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Surgical Oncology, The Central Hospital of HanzhongDepartment of Surgical Oncology, The Central Hospital of HanzhongDepartment of Surgical Oncology, The Central Hospital of HanzhongDepartment of Surgical Oncology, The First Affiliated Hospital of Xi’an Jiaotong UniversityAbstract Background Conventional methods for treating patients with proximal gastric cancer (PGC) include proximal gastrectomy (PG) and total gastrectomy (TG) and such methods have become challenging due to double tract reconstruction (DTR). However, the clinical outcomes remain unclear. This study was performed with the aim of verifying that PG-DTR was beneficial in terms of reducing the incidence of postoperative complications and improving the prognosis. Methods The PGC patient cohort was retrospectively grouped into the PG-DTR and TG groups. Clinicopathological features, complications, and survival data were compared between the two groups. Results A total of 388 patients were included in the analyses. Patients who were subjected to TG tended to have more severe gastroesophageal reflux (GR) (P = 0.041), anemia (P = 0.007), and hypoalbuminemia (P < 0.001). Overall survival rates, regardless of clinical stage, were significantly different between the PG-DTR and TG groups (all P < 0.05). The multivariate Cox regression analysis confirmed that surgical procedure, tumor size, infiltration depth, lymph node metastasis, differentiation, and age were independent risk factors. The patients were likely to benefit from PG-DTR (all HR > 1 and P < 0.05). However, no significant differences were observed in the risks of GR, anemia, and hypoalbuminemia (all P > 0.05). Moreover, the nomogram derived from significant parameters showed great calibration and discrimination ability and significant clinical benefit. Conclusions The patients who underwent PG-DTR had a favorable prognosis. The risk of postoperative complications, such as severe GR, anemia, and hypoalbuminemia, was lower in PG-DTR than in TG. Thus, PG-DTR is more beneficial for patients with PGC and may be a valuable and promising surgical procedure.https://doi.org/10.1186/s12957-023-02985-zProximal gastrectomy; Double tract reconstruction; Total gastrectomy; Survival; Postoperative complications |
| spellingShingle | Keming Ying Weisong Bai Guiru Yan Ziseng Xu Shenheng Du Chengxue Dang The comparison of long-term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancer World Journal of Surgical Oncology Proximal gastrectomy; Double tract reconstruction; Total gastrectomy; Survival; Postoperative complications |
| title | The comparison of long-term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancer |
| title_full | The comparison of long-term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancer |
| title_fullStr | The comparison of long-term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancer |
| title_full_unstemmed | The comparison of long-term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancer |
| title_short | The comparison of long-term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancer |
| title_sort | comparison of long term oncological outcomes and complications after proximal gastrectomy with double tract reconstruction versus total gastrectomy for proximal gastric cancer |
| topic | Proximal gastrectomy; Double tract reconstruction; Total gastrectomy; Survival; Postoperative complications |
| url | https://doi.org/10.1186/s12957-023-02985-z |
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