The role of subtotal and total gastrectomy in the treatment of gastric cancer

The optimal procedure for the lower third gastric adenocarcinoma is still an open question. We performed an analysis of the long-term survival of patients after subtotal (SG) or total gastrectomy (TG) on 164 enrolled patients. Bivariate and multivariable analyses were performed in order to identify characteristics associated with long-term survival. Survival was significantly affected by the number of positive lymph nodes (LN). Patients who have undergone TG had a higher number of total removed LN. the adjusted hazard ratio for the TG group suggests a partial superiority of TG over Sc; for patients with curative intent. Our data support the importance of extended LN dissection.

Automated summary

The study analyzed the long-term survival of patients with lower third gastric adenocarcinoma after subtotal or total gastrectomy, finding that the number of positive lymph nodes significantly affected patient survival rates. Patients who underwent total gastrectomy had a higher number of total removed lymph nodes, with adjusted hazard ratio suggesting partial superiority of total gastrectomy over subtotal gastrectomy for patients with curative intent. The data support the importance of extended lymph node dissection.