title: Long term outcome following surgical treatment for distal gastric cancer.
abstract: BACKGROUND. At the current time, the belief that total gastrectomy (TG) offers a better survival benefit compared with distal gastrectomy (DG) in distal gastric cancer still persists among many surgeons. The aim of the study was to determine whether TG in patients with distal stomach cancer offers a benefit in long term survival compared with DG. METHODS. Data on 180 consecutive patients with adenocarcinoma of the distal stomach that underwent surgery during the period 2000-2003 were analyzed. Distal gastrectomy was performed on 91 patients (50.5%), and 89 patients (49.5%) underwent TG. RESULTS. The postoperative morbidity (anastomotic leakage, intraperitoneal hemorrhage and pulmonary complications) was significantly higher in the TG group than in the DG group. The TG group had a significantly higher rate of 30-day postoperative mortality than DG group, and a longer mean postoperative hospital stay. The 5-year survival rate was significantly higher for the DG group than for the TG group. The number of lymph node metastases and TNM stages are significant predictors of poor survival. CONCLUSIONS. Compared with patients undergoing TG, a better long-term survival time, lower postoperative morbidity and mortality rates and a lower hospitalization stay was obtained in patients that underwent DG for distal gastric cancer. This observation justifies the use of this procedure for the surgical therapy of the cancer of distal stomach.
authors.affiliation: Regional Institute of Gastroenterology and Hepatology 3rd Surgical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. teodora_mocan@yahoo.com
authors.forename: Lucian
authors.initials: L
authors.lastname: Mocan
authors.forename: Claudiu
authors.initials: C
authors.lastname: Tomus
authors.forename: Dana
authors.initials: D
authors.lastname: Bartos
authors.forename: Florin
authors.initials: F
authors.lastname: Zaharie
authors.forename: Ilie
authors.initials: I
authors.lastname: Ioana
authors.forename: Adrian
authors.initials: A
authors.lastname: Bartos
authors.forename: Cosmin
authors.initials: C
authors.lastname: Puia
authors.forename: Alexandru
authors.initials: A
authors.lastname: Necula
authors.forename: Teodora
authors.initials: T
authors.lastname: Mocan
authors.forename: Cornel
authors.initials: C
authors.lastname: Iancu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome