title: Clinicopathological Features of Upper Third Gastric Cancer during a 21-Year Period (Single Center Analysis).
abstract: OBJECTIVE
  The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease.
  
  
  METHODS
  The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated.
  
  
  RESULTS
  The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006).
  
  
  CONCLUSIONS
  The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Je-Ho
authors.initials: JH
authors.lastname: Jang
authors.forename: Reinaldo Isaacs
authors.initials: RI
authors.lastname: Beron
authors.forename: Hye Seong
authors.initials: HS
authors.lastname: Ahn
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Kong
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
authors.forename: Woo-Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Kuhn Uk
authors.initials: KU
authors.lastname: Lee
authors.forename: Han-Kwang
authors.initials: HK
authors.lastname: Yang
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