Clinical significance of gastric outlet obstruction on the oncologic and surgical outcomes of radical surgery for carcinoma of the distal stomach.
OBJECTIVE
To determine the significance of gastric outlet obstruction (GOO) on the outcomes of radical surgery for distal gastric cancer.


METHODS
Three hundred seventy-one patients who underwent radical surgery for advanced gastric cancer arising at the distal stomach were categorized into two groups according to the presence of GOO, that is, 59 patients with GOO and 312 patients without. Clinicopathologic variables, postoperative morbidity and mortality, recurrence pattern, and survival outcomes of the two groups were compared.


RESULTS
Distal gastric carcinoma with GOO was usually diagnosed at a more advanced stage with aggressive pathologic features. GOO adversely affected overall survival after radical surgery with an odds ratio of 2.068 (P < 0.001). In patients with recurrent diseases, patients with GOO had higher rate of locoregional recurrence after radical surgery (P = 0.021). High-grade postoperative complications occurred at similar rates in both groups (P = 0.539).


CONCLUSIONS
The presence of GOO is an independent prognostic factor after radical surgery for advanced distal gastric cancer and provide additional information for identifying patients at higher risk of recurrence and pattern of recurrence during follow-up. Radical surgery in patients with GOO can be performed with acceptable morbidity and mortality.
Park
Seong-Heum
SH
Department of Surgery, Korea University College of Medicine, Seoul 136-701, Korea.
Mok
Young-Jae
YJ
Kim
Jong-Han
JH
Park
Sung-Soo
SS
Kim
Seung-Joo
SJ
Kim
Chong-Suk
CS
D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D017219:Gastric Outlet Obstruction / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D010525:Peripheral Nerves / Q000473:pathology; D011183:Postoperative Complications; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis
D012709:Serum Albumin