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. 1980 Dec;192(6):730–737. doi: 10.1097/00000658-198012000-00007

Selection of operative procedure for adenocarcinoma of the midstomach. Twenty years' experience with implications for future treatment strategy.

M H Shiu, D N Papacristou, C Kosloff, G Eliopoulos
PMCID: PMC1344972  PMID: 7447526

Abstract

Pathoanatomic studies of the regional spread of adenocarcinoma of the middle one-third of the stomach suggested the need for extensive gastric and lymphatic resection. To seek evidence of improved results, a retrospective study was made of 213 patients curatively treated by three commonly used procedures: 1) radical high subtotal gastrectomy (SG, n = 39), 2) radical total gastrectomy (TG, n = 48), and 3) extended total gastrectomy (ETG, n = 126). The overall five-year survival rates were SG:10%, TG:16%, and ETG:19%. Advanced stage tumors (N2, N3, or M1) were highly lethal, irrespective of the type of resection. However, patients with early stage tumors (T1-4, N0 or N1) showed higher survival rates after more extensive resections (ETG:42% and TG: six of eight patients, versus SG:17%). The highest survival rate (93%) was observed in a subset of patients with early stage tumors electively treated by ETG; this was achieved despite the presence of metastasis to the juxtagastric (N1) lymph nodes or direct invasion of an adjacent organ in most of these patients. These observations confirm the merit of extensive resection for carcinoma of the midstomach.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Buchholtz T. W., Welch C. E., Malt R. A. Clinical correlates of resectability and survival in gastric carcinoma. Ann Surg. 1978 Dec;188(6):711–715. doi: 10.1097/00000658-197812000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cady B., Ramsden D. A., Choe D. S. Treatment of gastric cancer. Surg Clin North Am. 1976 Jun;56(3):599–605. doi: 10.1016/s0039-6109(16)40935-7. [DOI] [PubMed] [Google Scholar]
  3. Cady B., Ramsden D. A., Stein A., Haggitt R. C. Gastric cancer. Contemporary aspects. Am J Surg. 1977 Apr;133(4):423–429. doi: 10.1016/0002-9610(77)90126-x. [DOI] [PubMed] [Google Scholar]
  4. Cassell P., Robinson J. O. Cancer of the stomach: a review of 854 patients. Br J Surg. 1976 Aug;63(8):603–607. doi: 10.1002/bjs.1800630811. [DOI] [PubMed] [Google Scholar]
  5. Dupont J. B., Jr, Lee J. R., Burton G. R., Cohn I., Jr Adenocarcinoma of the stomach: review of 1,497 cases. Cancer. 1978 Mar;41(3):941–947. doi: 10.1002/1097-0142(197803)41:3<941::aid-cncr2820410323>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  6. Fujimaki M., Soga J., Wada K., Tani H., Aizawa O. Total gastrectomy for gastric cancer. Clinical considerations on 431 cases. Cancer. 1972 Sep;30(3):660–664. doi: 10.1002/1097-0142(197209)30:3<660::aid-cncr2820300313>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
  7. Hawley P. R., Westerholm P., Morson B. C. Pathology and prognosis of carcinoma of the stomach. Br J Surg. 1970 Dec;57(12):877–883. doi: 10.1002/bjs.1800571202. [DOI] [PubMed] [Google Scholar]
  8. Majima S., Etani S., Fujita Y., Takahashi T. Evaluation of extended lymph node dissection for gastric cancer. Jpn J Surg. 1972 Mar;2(1):1–6. doi: 10.1007/BF02468900. [DOI] [PubMed] [Google Scholar]
  9. McNEER G., SUNDERLAND D. A., McINNES G., VANDENBERG H. J., Jr, LAWRENCE W., Jr A more thorough operation for gastric cancer; anatomical basis and description of technique. Cancer. 1951 Sep;4(5):957–967. doi: 10.1002/1097-0142(195109)4:5<957::aid-cncr2820040509>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  10. McNeer G., Bowden L., Booner R. J., McPeak C. J. Elective total gastrectomy for cancer of the stomach: end results. Ann Surg. 1974 Aug;180(2):252–256. doi: 10.1097/00000658-197408000-00022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Papachristou D. N., Fortner J. G. Adenocarcinoma of the gastric cardia. The choice of gastrectomy. Ann Surg. 1980 Jul;192(1):58–64. doi: 10.1097/00000658-198007000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Peto R., Pike M. C. Conservatism of the approximation sigma (O-E)2-E in the logrank test for survival data or tumor incidence data. Biometrics. 1973 Sep;29(3):579–584. [PubMed] [Google Scholar]
  13. SUNDERLAND D. A., McNEER G., ORTEGA L. G., PEARCE L. S. The lymphatic spread of gastric cancer. Cancer. 1953 Sep;6(5):987–996. doi: 10.1002/1097-0142(195309)6:5<987::aid-cncr2820060518>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]

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