45. 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 gastric resection on gastric cancer in the middle one-third of the stomach.
Methods: From January 1998 to December 2005, 222 patients with middle-third gastric cancer underwent D2 radical resection. Among them, 66 underwent distal gastrectomy (DG group), while 156 underwent total gastrectomy (TG group). The 5-year survival rates were compared between distal gastrectomy and total gastrectomy groups. The 171 prognostic factors were evaluated by univariate and multivariate analyses.
Results: The 5-year survival rates of distal gastrectomy group and total gastrectomy group were 63.9% and 49.8% respectively, with significant difference (P<0.05). Nevertheless, there were no significant differences in the TNM classification, according to the extent of gastric resection. there were no significant differences in the 5-year survival rates according to the length of the proximal resection margin. Tumor size, the extent of gastric resection, depth of invation, lymph node metastasis, TNM classification were predictive factors of survival. But, multivariate analysis revealed that the extent of gastric resection was not independent prognostic factor.
Conclusions: If curative resection can be performed, the longterm prognosis of patients with middle-third gastric cancer was not affected by the extent of gastric resection, distal gastrectomy is feasible.