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Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1980 Jan;62(1):25–30.

Gastric carcinoma: is radical gastrectomy worth while?

William P Longmire
PMCID: PMC2492281  PMID: 7362184

Abstract

Total gastrectomy as the treatment of choice for gastric carcinoma was evaluated by a number of centres during the decade 1945-55. The operative mortality was found to be higher, the 5-year survival rate was lower, and the undesirable digestive side effects were greater than those following subtotal resection. The very radical subtotal resections with miniature gastric remnants were also found to result in postgastrectomy symptoms quite similar to those of total gastrectomy. Technical refinements of oesophagojejunal anastomoses and the use of nutritional supplements and antianaemic therapy have reduced but have not eliminated the sequelae of radical gastrectomy.

A review of 15 reports of gastric cancer treatment from 8 countries suggests that in recent years total gastrectomy has been utilised in 25.4% of resections, with an average operative mortality of 21.7% and a 5-year survival of 12.3%. Radical resection or total gastrectomy is recommended for certain specific conditions, but for the usual antral gastric cancer subtotal resection distal to the vasa brevia with preservation of the gastric fundus and spleen is recommended

Keywords: STOMACH NEOPLASMS, CARCINOMA, GASTRECTOMY

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Selected References

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

  1. Adashek K., Sanger J., Longmire W. P., Jr Cancer of the stomach. Review of consecutive ten year intervals. Ann Surg. 1979 Jan;189(1):6–10. doi: 10.1097/00000658-197901000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bittner R., Beger H. G., Kraas E., Gögler H. Magencarcinomchirurgie auch bei über 70 jährigen? Langenbecks Arch Chir. 1978 Apr 7;344(4):293–307. doi: 10.1007/BF01261267. [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. Cartia Q., Quaranta L., Lucarini L., Galgano E. Analisi dei risultati del trattamento chirurgico di 592 casi di cancro dello stomaco. Minerva Med. 1977 May 5;68(22):1495–1502. [PubMed] [Google Scholar]
  5. Costello B. C., Taylor T. V., Torrance B. Personal experience in the surgical management of carcinoma of the stomach. Br J Surg. 1977 Jan;64(1):47–51. doi: 10.1002/bjs.1800640112. [DOI] [PubMed] [Google Scholar]
  6. Desmond A. M. Radical surgery in treatment of carcinoma of stomach. Proc R Soc Med. 1976 Nov;69(11):867–869. [PMC free article] [PubMed] [Google Scholar]
  7. Gilbertsen V. A. Results of treatment of stomach cancer. An appraisal of efforts for more extensive surgery and a rort of 1,983 cases. Cancer. 1969 Jun;23(6):1305–1308. doi: 10.1002/1097-0142(196906)23:6<1305::aid-cncr2820230610>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  8. Imanaga H., Nakazato H. Rseults of surgery for gastric cancer and effect of adjuvant mitomycin C on cancer recurrence. World J Surg. 1977 Mar;2(1):213–221. doi: 10.1007/BF01665086. [DOI] [PubMed] [Google Scholar]
  9. Longmire W. P., Jr Gewandelte Aspekte des Magenkarzinoms. MMW Munch Med Wochenschr. 1977 May 6;119(18):613–616. [PubMed] [Google Scholar]
  10. Longmire W. P., Jr, Kuzma J. W., Dixon W. J. The use of triethylenethiophosphoramide as an adjuvant to the surgical treatment of gastric carcinoma. Ann Surg. 1968 Mar;167(3):293–312. doi: 10.1097/00000658-196803000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lortat-Jacob J., Giuli R., Estenne B., Clot P. Intérêt de la gastrectomie totale pour le traitement des cancers de l'estomac. Etude de 482 interventions radicales. Chirurgie. 1975 Jan 15;101(1):59–67. [PubMed] [Google Scholar]
  12. Lundh G., Burn J. I., Kolig G., Richard C. A., Thomson J. W., van Elk P. J., Oszacki J. A co-operative international study of gastric cancer (under the auspices of the International Federation of Surgical Colleges). Ann R Coll Surg Engl. 1974 May;54(5):219–228. [PMC free article] [PubMed] [Google Scholar]
  13. MARSHALL S. F. Total versus radical partial resection for cancer of the stomach. Surg Gynecol Obstet. 1957 Apr;104(4):497–498. [PubMed] [Google Scholar]
  14. Mine M., Majima S., Harada M., Etani S. End results of gastrectomy for gastric cancer: effect of extensive lymph node dissection. Surgery. 1970 Nov;68(5):753–758. [PubMed] [Google Scholar]
  15. Moritz E., Wense G. Ergebnisse der chirurgischen Behandlung des Magenkarzinoms. Munch Med Wochenschr. 1973 Sep 7;115(36):1518–passim. [PubMed] [Google Scholar]
  16. RUSH B. F., Jr, BROWN M. W., RAVITCH M. M. Total gastrectomy: an evaluation of its use in the treatment of gastric cancer. Cancer. 1960 May-Jun;13:643–648. doi: 10.1002/1097-0142(196005/06)13:3<643::aid-cncr2820130329>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  17. SCOTT H. W., Jr, LONGMIRE W. P., Jr Total gastrectomy; report of 63 cases. Surgery. 1949 Sep;26(3):488–498. [PubMed] [Google Scholar]
  18. Schrock T. R., Way L. W. Total gastrectomy. Am J Surg. 1978 Mar;135(3):348–355. doi: 10.1016/0002-9610(78)90064-8. [DOI] [PubMed] [Google Scholar]
  19. Wolff H., Otto G. Zur Chirurgie des Magenkarzinoms--eigene Ergebnisse. Arch Geschwulstforsch. 1976;46(5):350–359. [PubMed] [Google Scholar]
  20. ZINNINGER M. M. Extension of gastric cancer in the intramural lymphatics and its relation to gastrectomy. Am Surg. 1954 Sep;20(9):920–927. [PubMed] [Google Scholar]

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