title: Clinicopathological characteristics of patients with proximal third gastric carcinoma.
abstract: OBJECTIVE
  Epidemiological studies show a continuing rise in the prevalence of proximal third gastric carcinoma (PGC), and the prognosis of patients with this carcinoma is poorer than that of patients with more distally located gastric carcinomas. We compared the clinicopathological features and prognosis of PGC patients with those of patients with middle/distal gastric carcinoma (MGC/DGC).
  
  
  METHODS
  Of the 2696 patients diagnosed with gastric carcinoma who underwent surgery in our hospital in a 15-year period, 271 patients (10.1%) were diagnosed with PGC and retrospectively reviewed.
  
  
  RESULTS
  T1-category tumours were less common in patients with PGC than in patients with MGC/DGC (p < 0.001). Lymph node invasion was more common in patients with PGC than in patients with MGC/DGC (p < 0.05). Tumour stage (stage I) and T category (T1) significantly influenced the 5-year survival rates of patients whose tumours were resected with curative intent. The 5-year survival rate of patients whose PGC were resected with curative intent was higher than that of patients whose PGC were resected with palliative intent (57.4 vs. 12.6%, p < 0.001). The 5-year survival rate was 49.3% for patients with PGC and 57.3% for patients with MGC/DGC (p = 0.0273). Multivariate analysis showed that tumour size, lymph node status, and resection with curative intent were significant prognostic factors for survival in patients with PGC.
  
  
  CONCLUSIONS
  The poor prognosis of PGC is mainly due to its more advanced stage at diagnosis compared with that of more distally located gastric carcinoma. Early detection is important for improving the prognosis of patients with proximal third gastric carcinoma.
authors.affiliation: Department of Surgery, Chonnam National University Medical School, Gwangju, Korea. dockim@chonnam.ac.kr
authors.forename: Dong Yi
authors.initials: DY
authors.lastname: Kim
authors.forename: Jae Kyoon
authors.initials: JK
authors.lastname: Joo
authors.forename: Seong Yeob
authors.initials: SY
authors.lastname: Ryu
authors.forename: Young Kyu
authors.initials: YK
authors.lastname: Park
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Shin Kon
authors.initials: SK
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome