Pattern of surgical treatment for early gastric cancers in upper third of the stomach

Shuji Takiguchi, Toru Masuzawa, Motohiro Hirao, Hiroshi Imamura, Yutaka Kimura, Junya Fujita, Shigeyuki Tamura, Yoshiyuki Fujiwara, Masaki Mori, Yuichiro Doki

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Abstract

Background/Aims: Various surgical treatments are indicated for early gastric cancers in upper third of the stomach (U-EGC) because of its anatomical property and favorable prognosis. Methodology: Five hundred and eighty six cases of U-EGCs were collected for 9 years from 19 hospitals in Japan. Surgical procedures were classified as total (TG) and proximal gastrectomy (PG), and the latter was subclassified as esophagogastrostomy (PG-EG) and jejunal interposition (PG-JI) reconstruction. Results: TG was more frequent than PG (76.3% vs. 21.8%, p<.0001). PG was more frequently performed in high volume hospitals than in low volume hospitals (26.8% vs. 10.2%, p<.0001), however there were still large difference in frequency of PG even among high volume hospitals, ranging from 5.0% to 72.0%. For reconstruction after PG, PG-EG and PG-JI were representatively performed in 50 (39.1%) and 35 (27.3%) patients. Each institute tended to preferentially employ either PG-EG or PG-JI. Tumor size was significantly larger in TG than in PG (38.8mm vs. 22.3mm, p<.0001) and diffuse type tended to be more frequent in TG as well. Conclusions: There is a huge variety of surgical treatment for U-ECG in general hospitals in our country. A multi-institutional large cohort randomized trial might be urgent to establish the standard surgical procedure of this infrequent disease.

Original languageEnglish
Pages (from-to)1823-1827
Number of pages5
JournalHepato-gastroenterology
Volume58
Issue number110-111
DOIs
Publication statusPublished - 2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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    Takiguchi, S., Masuzawa, T., Hirao, M., Imamura, H., Kimura, Y., Fujita, J., Tamura, S., Fujiwara, Y., Mori, M., & Doki, Y. (2011). Pattern of surgical treatment for early gastric cancers in upper third of the stomach. Hepato-gastroenterology, 58(110-111), 1823-1827. https://doi.org/10.5754/hge11161