The reasonable surgery for gastric body cancer and prognostic analysis

Objective To discuss the reasonable surgery for gastric body cancer. Methods From January 2001 to December 2006, the clinicopathological data of 145 patients with a tumor in the middle third of the stomach underwent radical gastric resection were analyzed retrospectively. We conducted comparative analysis for the differences in clinicopathological characteristics and prognosis between total gastrectomy (TG) and subtotal gastrectomy (STG). Results The 98 patients underwent TG, 47 received STG. There were significant differences in aspects of tumor size, depth of tumor, nodal status and TNM stage between the 2 groups. Patients with more advanced cancer were more likely to receive TG. The 5-year survival rate for TG was lower (25.5%) than STG (63.8%)(χ2=11.707, P=0.000). However, if tumor stages were stratified, there was no significant difference in the 5-year survival rate. TNM stage (P=0.044) and histologic type (HR=1.834, 95%CI: 1.073-3.135, P=0.027) were independent prognostic factors. Conclusions The overall survival rate of STG for gastric cancer in the middle third of the stomach is better than that of TG. If the radical resection margin can be obtained for gastric body carcinoma, STG is considered instead of TG.