Department of Surgery, Kangbuk Samsung Hospital,Sungkyunkwan University School of Medicine, Seoul, Korea.
Published online: August 31, 2002.
ABSTRACT
PURPOSE: Little is known about local recurrence following proximal gastrectomy in patients with upper third gastric cancer. We performed this study to evaluate the long-term results of a proximal gastrectomy, and to analyze the risk factors of local recurrence affecting survival in these patients.
MATERIALS AND METHODS: We undertook a retrospective study of 63 patients who underwent potentially curative proximal gastrectomy between 1990 and 1999, with special reference to local recurrence.
RESULTS: During a median follow-up period of 37 months, 25 of the 63 patients (39.7%) developed a recurrence of cancer, with local recurrence in 15 patients (23.8%), the majority of these occurring at the remnant stomach or anastomosis.
The median time to local recurrence was 38 months (8~78 months). Univariate analysis of risk factors for local recurrence revealed an infiltrative or diffuse gross type, with a tumor sizes>5 cm, a distal resection margin <or=3 cm and serosal invasion. Reoperation for cure was possible in only 4 patients and most died within the first year following diagnosis of recurrence.
CONCLUSION: When performing a proximal gastrectomy for upper third gastric cancer, even after curative resection, all risk factors should be considered to reduce rates of local recurrence.
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