title: Surgical outcomes for early gastric cancer in the upper third of the stomach.
abstract: BACKGROUND
  Although outcomes of operations for advanced gastric cancer in the upper third of the stomach are said to be poorer, outcomes of operations for early gastric cancer in the upper third of the stomach have been less well studied. The aim of this study is to analyze and establish a therapeutic strategy for early tumors in the upper third of the stomach.
  
  
  METHODS
  Patients (n = 673; 79 patients were located in the upper third of the stomach and 594 in more distal sites) with early gastric cancer who underwent curative gastrectomy were included in this study. Clinicopathologic characteristics and results of operations for early tumors were compared between the two groups. Prognostic factors were evaluated with uni- and multivariate analyses.
  
  
  RESULTS
  Tumors in the upper third of the stomach were more often protruded, differentiated, submucosa invasive, and located at the posterior wall, and more often involved venous invasion and adjacent metastatic lymph nodes. Lymph node metastasis, but not tumor location, was an independent prognostic factor in all registered patients. Results of operations were not different between the two groups.
  
  
  CONCLUSIONS
  Early proximal tumors show distinct features, but prognosis after curative operation is as good as that of distal two-third tumors.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0024, Japan.
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Masato
authors.initials: M
authors.lastname: Nomura
authors.forename: Goro
authors.initials: G
authors.lastname: Matsuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Ono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D013270:Stomach / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome