1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
2Department of Surgery, Ajou University School of Medicine, Suwon, Korea
Copyright © 2025 by the Korean Cancer Association
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ethical Statement
This study included patients who underwent radical PG-DTR or TG for pathological stage I gastric cancer. Patients who underwent combined organ resection or lacked computed tomography (CT) scan data required for body composition analysis were excluded. This study received approval from the Institutional Review Board of Severance Hospital, Yonsei University Health System (4-2024-0081). The informed consent was waived as this was a retrospective study.
Author Contributions
Conceived and designed the analysis: Song JH, Kim HI.
Collected the data: Cho M, Kim YM, Hyung WJ, Kim HI.
Contributed data or analysis tools: Park SH, Kim HI.
Performed the analysis: Song JH, Kim HI.
Wrote the paper: Song JH, Kim HI.
Administrative, technical, or material support: Cho M, Hyung WJ.
Supervision: Kim HI.
Conflict of Interest
Conflict of interest relevant to this article was not reported.
PG-DTR (n=197) | TG (n=309) | p-value | |
---|---|---|---|
Age (yr) | 57.2±11.8 | 60.0±10.5 | 0.006 |
Sex | |||
Male | 122 (61.9) | 217 (70.2) | 0.053 |
Female | 75 (38.1) | 92 (29.8) | |
ASA | |||
1 | 44 (22.3) | 48 (15.5) | 0.066 |
2 | 117 (59.4) | 184 (59.5) | |
3 | 36 (18.3) | 77 (24.9) | |
Weight (kg) | 64.3±10.3 | 64.9±10.4 | 0.538 |
Height (cm) | 164.5±8.7 | 164.9±7.6 | 0.571 |
BMI | 23.7±2.9 | 23.8±3.1 | 0.687 |
Tumor size (mm) | 24.1±15.6 | 31.6±23.1 | < 0.001 |
Histology | |||
Differentiated | 81 (41.1) | 121 (39.2) | 0.661 |
Undifferentiated | 116 (58.9) | 288 (60.8) | |
Lymphovascular invasion | |||
No | 175 (88.8) | 264 (85.4) | 0.272 |
Yes | 22 (11.2) | 45 (14.6) | |
Perineural invasion | |||
No | 192 (97.5) | 293 (94.8) | 0.147 |
Yes | 5 (2.5) | 16 (5.2) | |
T category | |||
T1a | 82 (41.6) | 121 (39.2) | 0.039 |
T1b | 98 (49.7) | 137 (44.3) | |
T2 | 17 (8.6) | 51 (16.5) | |
N category | |||
N0 | 187 (94.9) | 282 (91.3) | 0.123 |
N1 | 10 (5.1) | 27 (8.7) | |
Stage | |||
Ia | 170 (86.3) | 231 (74.8) | 0.002 |
Ib | 27 (13.7) | 78 (25.2) |
PG-DTR (n=197) | TG (n=309) | p-value | |
---|---|---|---|
Operation method | |||
Open | 1 (0.5) | 113 (36.6) | < 0.001 |
Laparoscopic | 114 (57.9) | 149 (48.2) | |
Robotic | 82 (41.6) | 47 (15.2) | |
Omentectomy | |||
Partial | 189 (95.9) | 179 (57.9) | < 0.001 |
Total | 8 (4.1) | 130 (42.1) | |
Lymph node dissection | |||
D1+ | 196 (99.5) | 183 (59.2) | < 0.001 |
D2 | 1 (0.5) | 126 (40.8) | |
Retrieved lymph nodes | 41.1±15.6 | 56.1±21.5 | < 0.001 |
Operation time | 210.0±47.2 | 214.0±55.9 | 0.391 |
Blood loss | 76.6±70.2 | 157.3±151.7 | < 0.001 |
Transfusion | 0 | 3 (1.0) | 0.085 |
Hospital stay | 6.3±3.0 | 8.1±4.1 | < 0.001 |
Early complication | 113 (57.4) | 205 (66.3) | 0.041 |
Clavien-Dindo grade | |||
I | 59 (29.9) | 87 (28.2) | 0.089 |
II | 46 (23.4) | 93 (30.1) | |
IIIa | 8 (4.1) | 19 (6.1) | |
IIIb | 0 | 3 (1.0) | |
IVa | 0 | 3 (1.0) | |
V | 0 | 0 | |
Early major complication | 8 (4.1) | 25 (8.1) | 0.073 |
Long-term surgical complication | 5 (2.5) | 19 (6.1) | 0.062 |
Clavien-Dindo grade | |||
I | 1 (0.5) | 5 (1.6) | 0.439 |
II | 3 (1.5) | 6 (1.9) | |
IIIa | 1 (0.5) | 6 (1.9) | |
IIIb | 0 | 2 (0.6) | |
Long-term major surgical complication | 1 (0.5) | 8 (2.6) | 0.084 |
Anemia | 100 (50.8) | 211 (68.3) | < 0.001 |
Iron replacement | 50 (25.4) | 131 (42.4) | < 0.001 |
Vitamin B12 deficiency | 31 (15.7) | 99 (32.0) | < 0.001 |
Vitamin B12 replacement | 91 (46.2) | 278 (90.0) | < 0.001 |
Sarcopenia | |||
Preoperative | 35/196 (17.9) | 78/308 (25.3) | 0.050 |
At 6 months postoperatively | 44/192 (22.9) | 97/305 (31.8) | 0.032 |
At 12 months postoperatively | 55/189 (29.1) | 96/294 (32.7) | 0.411 |
At 60 months postoperatively | 75/180 (41.7) | 96/245 (39.2) | 0.606 |
Complications |
Major complications |
|||||
---|---|---|---|---|---|---|
Odds ratio | 95% CI | p-value | Odds ratio | 95% CI | p-value | |
Age | 1.043 | 1.003-1.085 | 0.035 | |||
Operation method | ||||||
Open | 1 | 0.006 | ||||
MIS | 0.344 | 0.162-0.733 | ||||
VF | 1.008 | 1.005-1.011 | < 0.001 | 1.009 | 1.003-1.015 | 0.003 |
SF | 0.988 | 0.978-0.997 | 0.013 |
Anemia |
Vitamin B12 deficiency |
|||||
---|---|---|---|---|---|---|
Odds ratio | 95% CI | p-value | Odds ratio | 95% CI | p-value | |
Sex | ||||||
Male | 1 | 0.024 | ||||
Female | 1.824 | 1.081-3.076 | ||||
ASA | ||||||
1 | 1 | |||||
2 | 1.294 | 0.768-2.181 | 0.333 | |||
3 | 2.158 | 1.139-4.091 | 0.018 | |||
BMI | 1.137 | 1.055-1.226 | 0.001 | |||
Preoperative hemoglobin | 0.541 | 0.463-0.632 | < 0.001 | |||
Preoperative vitamin B12 | 0.998 | 0.998-0.999 | < 0.001 | |||
Resection extent | ||||||
PG-DTR | 0.447 | 0.298-0.670 | < 0.001 | 0.494 | 0.303-0.806 | 0.005 |
TG | 1 | 1 |
Values are presented as mean±standard deviation or number (%). p-value of < 0.05 is considered significant. ASA, American Society of Anesthesiology scores; BMI, body mass index; PG-DTR, proximal gastrectomy with double-tract reconstruction; TG, total gastrectomy.
Values are presented as number (%) or mean±standard deviation. p-value of < 0.05 is considered significant. PG-DTR, proximal gastrectomy with double-tract reconstruction; TG, total gastrectomy.
p-value of < 0.05 is considered significant. CI, confidence interval; MIS, minimally-invasive surgery; SF, subcutaneous fat; VF, visceral fat.
p-value of < 0.05 is considered significant. ASA, American Society of Anesthesiology scores; BMI, body mass index; CI, confidence interval; PG-DTR, proximal gastrectomy with double-tract reconstruction; TG, total gastrectomy.