title: DO PROXIMAL AND DISTAL GASTRIC TUMOURS BEHAVE DIFFERENTLY?
abstract: Although the incidence of gastric (adenocarcinoma) cancer has been decreasing over time, it is still one of the most common malignancies worldwide, and proximal tumours tend to have a worse prognosis.
  
  
  
  To compare surgical outcomes and prognosis between proximal - excluding tumours of the cardia - and distal gastric cancer.
  
  
  
  Out of 293 cases reviewed - 209 with distal and 69 with proximal gastric cancer - were compared for clinical and pathological features, stage, surgical outcome, mortality and survival.
  
  
  
  Statistically, there was no significant difference between patients in both groups regarding mortality (p=0.661), adjuvant chemotherapy (p 0.661), and radiation (p=1.000). However, there was significant difference in the degree of lymph node dissection employed (p=0.002) and the number of positive lymph nodes resected (p=0.038) between the two groups. The odds of death at five years for patients who had a D0 dissection was three times greater (odds ratio 2.78; (95%CI 1.33-5.82) than that for patients who had a D2 dissection, while for patients who had a D1 dissection the odds ratio was only 1.41 (95%CI 0.71-2.83) compared to D2-dissected patients.
  
  
  
  Although no significant differences were found between proximal and distal gastric cancer, the increased risk of death in D0- and D1-dissected patients clearly suggests an important role of radical D2 lymph node dissection in survival.
authors.affiliation: Postgraduate Program in Medicine, Surgical Sciences, Universidade Federal do Rio Grande do Sul; RS, Brazil.
authors.forename: Laurence Bedin da
authors.initials: LB
authors.lastname: Costa
authors.affiliation: Department of Surgery, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul; RS, Brazil.
authors.forename: Marcelo Garcia
authors.initials: MG
authors.lastname: Toneto
authors.affiliation: Department of Surgery, Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brazil.
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: Moreira
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate