Prognostic Impact Of The Extent Of Gastric Resection On Gastric Cancer In The Middle One-third Of The Stomach

Objective To analyze the prognostic impact of the extent of gastricresection on gastric cancer in the middle one-third of the stomach.Methods From January1998to December2005,222patients with middle-thirdgastric cancer underwent D2radical resection. Among them,66underwentdistal gastrectomy (DG group), while156underwent total gastrectomy (TGgroup). The5-year survival rates were compared between distalgastrectomy and total gastrectomy groups. The prognostic factors wereevaluated by univariate and multivariate analyses.Results The5-year survival rates of distal gastrectomy group and totalgastrectomy group were63.9%and49.8%respectively, with significantdifference (P<0.05). Nevertheless, there were no significant differencesin the TNM classification, according to the extent of gastric resection.There were no significant differences in the5-year survival ratesaccording to the length of the proximal resection margin. Tumor size, theextent of gastric resection，the way of digestive reconstruction，depthof inviasion, lymph node metastasis, TNM classification were predictivefactors of survival. Depth of inviasion, lymph node metastasis, TNMclassification were independent prognostic factor. However, multivariateanalysis revealed that the extent of gastric resection was not independentprognostic factor.Conclusions On the basis of radical surgery, the long-term prognosis ofpatients with middle-third gastric cancer was not affected by the lengthof the proximal resection margin. If completely resection can be performed,distal gastrectomy is feasible to patients with middle-third gastriccancer.