Proximal Versus Total Gastrectomy For Proximal Gastric Cancer: A Surveillance, Epidemiology, And End Results Program Database Analysis

Lay abstractThe choice of surgical strategy for patients with proximal gastric cancer (PGC) remains controversial. This study analyzed a large number of PGC patients to addresses whether surgical procedure (proximal gastrectomy [PG] vs total gastrectomy [TG]) influences survival outcomes for PGC. The results shown that although TG achieves a longer distal margin, no differences were detected in the survival time. TG and PG have similar survival time after surgery. TG was not necessary for PGC patients, and PG may be considered an ideal surgery approach.Aims: To addresses whether surgical procedure (proximal gastrectomy [PG] vs total gastrectomy [TG]) influences survival outcomes. Methods: Patients were selected from Surveillance, Epidemiology and End Results Program (SEER) database. Survival curve was used to evaluate the differences in overall survival (OS) and cancer-specific survival (CSS). Results: No significant difference was detected in OS and CSS time between PG and TG groups. Also, no significant differences were observed in OS and CSS times between the two groups with respect to clinical stage, tumor stage, node stage, age, gender and tumor differentiation. Tumor differentiation, tumor size, tumor stage, node stage and age were independent prognostic factors in patients with proximal gastric cancer. Conclusions: TG was not necessary for proximal gastric cancer patients, and PG may be considered as an ideal surgery approach.