Abstract
Background: We aimed to assess long-term survival between locally advanced proximal gastric cancer (LAPGC) patients who underwent proximal gastrectomy (PG) and those who underwent total gastrectomy (TG) to evaluate the optimal extent of resection and adjuvant therapy.Materials and Methods: Patients diagnosed with locally advanced proximal gastric adenocarcinoma were selected from the National Cancer Data Base (2004–2015) in America. Survival analysis was performed via Kaplan-Meier and Cox proportional hazards models.Results: A total of 4,381 eligible patients were identified, 1,243 underwent PG and 3,138 underwent TG. Patients in TG group had a poor prognosis (hazard ratio [HR] = 1.13, 95% confidence interval [CI]: 1.03–1.25) compared with those in PG group. Moreover, postoperative chemoradiation therapy was associated with improved overall survival compared to surgery alone (HR = 0.71, 95% CI: 0.53–0.97) in LAPGC patients who had PG, while preoperative chemotherapy (HR = 0.74, 95% CI: 0.59–0.92) was associated with improved survival among patients who had TG.Conclusions: Our study suggested that LAPGC patients underwent PG experienced better long-term outcomes than those underwent TG. It also suggested that multimodality treatment of LAPGC, including preoperative chemotherapy followed by TG or postoperative chemotherapy followed by PG, should be considered to achieve better long-term outcomes.
Highlights
Gastric cancer (GC) is the fifth most common malignancy and the third leading cause of cancer-related mortality worldwide [1]
Some studies even found that the prognosis of locally advanced PGC (LAPGC) patients undergoing Proximal gastrectomy (PG) was significantly better than those undergoing total gastrectomy (TG) [9, 26]
Eligible patients were LAPGC according to the International Classification of Diseases for Oncology codes and underwent definitive gastrectomy
Summary
Gastric cancer (GC) is the fifth most common malignancy and the third leading cause of cancer-related mortality worldwide [1]. The newly published “Japanese Gastric Cancer Treatment Guidelines 2018” recommends that PG is suitable for early stage diseases [6]. Some studies even found that the prognosis of LAPGC patients undergoing PG was significantly better than those undergoing TG [9, 26]. These published studies generally included limited number of patients ranging from 45 to 423. We aimed to assess long-term survival between locally advanced proximal gastric cancer (LAPGC) patients who underwent proximal gastrectomy (PG) and those who underwent total gastrectomy (TG) to evaluate the optimal extent of resection and adjuvant therapy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
