title: [Impact of different gastrectomy and reconstruction methods on prognosis and quality of life in proximal gastric cancer].
abstract: OBJECTIVE
  To evaluate the impact of different gastrectomy and reconstruction method on prognosis and quality of life in proximal gastric cancer.
  
  
  METHODS
  The 265 cases of proximal gastric cancer received radical resection, according to gastrectomy or reconstruction method, were divided into proximal gastrectomy/gastroesophagostomy group (PG) (n = 63) and total gastrectomy/esophagojejunostomy group (TG) (n = 202). The clinical pathologic features, prognosis, postoperative quality of life in 2 groups were compared.
  
  
  RESULTS
  There had no significant differences in age, gender, CEA value between two groups (all P > 0.05). In PG and TG group, tumor size (cm), ratio of organic invasion, lymph nodes metastasis, distal metastasis, TNM IV stage, Borrmann typing, poor or undifferentiated carcinoma was 2.9 ± 1.9 vs. 4.8 ± 2.8, 9.5% vs. 32.2%, 64.7% vs. 70.6%, 0 vs. 8.4%, 6.9% vs. 31.8%, 44.4% vs. 69.2%, 31.7% vs. 53.7%, respectively, all with significant difference (t = -6.260, χ(2) = 29.473, 14.559, 5.665, 32.483, 12.588, 10.954, all P < 0.05). In PG and TG group, the ratio of D3 and D3(+) resection, multi-visceral resection, complications was 0 vs. 13.8%, 9.5% vs. 38.6%, 7.9% vs. 1.5% respectively, showed increasing range of resection and decreasing complications significantly in TG group (all P < 0.05). The median survival time (months) was 62.5 vs. 78.9 in TG and PG group respectively, without significant difference (P > 0.05). In 2 groups, the evaluation index of post-operative quality of life without significant differences (P > 0.05).
  
  
  CONCLUSIONS
  For proximal gastric cancer, although the cases received TG with worse clinicopathological features, which prognosis was similar to that received PG. The postoperative quality of life without significant difference between the cases received gastroesophagostomy and esophagojejunostomy.
authors.affiliation: Department of Gastrointestinal-Pancreatic Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wu
authors.forename: Yu-long
authors.initials: YL
authors.lastname: He
authors.forename: Jian-bo
authors.initials: JB
authors.lastname: Xu
authors.forename: Shi-rong
authors.initials: SR
authors.lastname: Cai
authors.forename: Jin-ping
authors.initials: JP
authors.lastname: Ma
authors.forename: Chuang-qi
authors.initials: CQ
authors.lastname: Chen
authors.forename: Xin-hua
authors.initials: XH
authors.lastname: Zhang
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Wen-hua
authors.initials: WH
authors.lastname: Zhan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*