Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objective: To suggest the possible indication of proximal gastrectomy for advanced gastric cancer located at the upper third of the stomach.
Background: Proximal gastrectomy has been an alternative surgical procedure for early proximal gastric cancer due to its benefits for quality of life while maintaining oncological outcomes. However, the oncological safety of proximal gastrectomy for advanced tumors remains unclear.
Methods: We retrospectively reviewed data from 878 patients who underwent radical total gastrectomy from 2003 to 2018 for pathologic T2-T4 gastric cancer in the upper third of the stomach. We identified risk factors for lymph node metastasis at the distal part of the stomach, which was not dissected in proximal gastrectomy. Subsequently, we evaluated the metastasis rate and therapeutic value index of lymph nodes at the distal part of the stomach in patients with none of these risk factors.
Results: Multivariable analysis revealed that esophagogastric junction (EGJ)-tumor epicenter distance >30 mm, tumor size >70 mm, macroscopic type IV tumor, and serosal invasion were risk factors for lymph node metastasis at the distal stomach. In patients without risk factors, the therapeutic value index for any lymph nodes at the distal stomach was 0.8, suggesting that lymph node dissection could be omitted in these patients.
Conclusions: EGJ-tumor epicenter distance ≤ 30 mm, tumor size ≤ 70 mm, not a macroscopic type IV tumor, and no serosal invasion could be an indication of proximal gastrectomy for advanced gastric cancer located at the upper third of the stomach.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455053 | PMC |
| http://dx.doi.org/10.1097/AS9.0000000000000107 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Relationship Between Kyphosis and Postoperative Gastroesophageal Reflux After Proximal Gastrectomy.
Ann Gastroenterol Surg
September 2025
First Department of Surgery, Faculty of Medicine University of Yamanashi Chuo Yamanashi Japan.
Aim: The prevalence of kyphosis is increasing with increasing life expectancy. One of the most notable gastrointestinal complications is gastroesophageal reflux disease (GERD) in patients with kyphosis. In this study, we investigated the association between kyphosis and the incidence of postoperative GERD in patients who underwent proximal gastrectomy (PG), a procedure with a particularly high risk of GERD.
View Article and Find Full Text PDFAim: This study explores the evolving landscape of gastrectomy procedures in Japan, based on nationwide surveys conducted in 2014 and 2021. It highlights changes in surgical approaches, including a growing focus on minimally invasive and function-preserving procedures, as well as the increasing consideration of postoperative quality of life (QOL).
Methods: Two nationwide questionnaire surveys were conducted in 2014 and 2021, targeting members of the Japanese Society for Gastro-surgical Pathophysiology.
A novel insertion/deletion in APC promotor 1B is associated with both gastric and colon polyposis.
Fam Cancer
September 2025
Ambry Genetics, 1 Enterprise, Aliso Viejo, CA, 92656, USA.
Pathogenic variants in the APC gene are classically associated with autosomal dominant familial adenomatous polyposis (FAP), characterized by tens-to-thousands of colonic adenomatous polyps and a high-penetrance predisposition to colorectal cancer. More recently, specific PVs in the YY1 binding motif of APC promoter 1B have been associated with autosomal dominant gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS), characterized by tens-to-thousands of fundic gland polyps and a predisposition to gastric cancer but which are only rarely associated with features consistent with FAP. Although management guidelines currently treat FAP and GAPPS as mutually exclusive conditions, the extent of phenotypic overlap is not well-characterized.
View Article and Find Full Text PDFLetter to editor about "Prospective multicenter validation of a machine learning model for predicting anastomotic leakage in patients with gastric adenocarcinoma undergoing total or proximal gastrectomy".
Int J Surg
September 2025
Department of Anesthesiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Anastomotic Leakage and Gastroparesis Syndrome Following Laparoscopic Radical Gastrectomy: A Retrospective Cohort Study Involving 3779 Patients.
Surg Laparosc Endosc Percutan Tech
September 2025
Department of General Surgery, The First Medical Center, Chinese PLA General Hospital.
Background And Objectives: The occurrence of anastomotic leakage (AL) and gastroparesis syndrome (GS), common and severe complications after laparoscopic radical gastrectomy, significantly impacts the prognosis of patients. The objective of this study was to investigate the risk factors associated with AL after laparoscopic radical gastrectomy and GS after laparoscopic distal gastrectomy.
Methods: In this retrospective cohort study, 3779 patients who underwent laparoscopic radical gastrectomy and met the inclusion criteria were included.