抄録
A consecutive series of 570 patients with middle gastric cancer were evaluated in order to assess their prognosis, focusing on the relationship among the extent of gastric resection, consequent duodenal passage reconstruction, and postoperative adjuvant therapy.
These patients underwent total, subtotal (distal or proximal) gastrectomy between Aug. 1974 and May 1997. Patients receiving subtotal gastrectomy had significantly better survival than those receiving total gastrectomy in stage 1A and 3A gastric cancer. On the other hand, patients with duodenal food passage (DFP) reconstruction had better survival than those without DFP reconstruction, though the difference between these groups was not significant.
Multivariate analysis revealed that the duodenal food passage and the extent of the gastric resection were independent prognostic variables; in patients who underwent only gastrectomy, the extent of resection and DFP were independent prognostic variables, whereas in patients who underwent gastrectomy with postoperative adjuvant therapy, these two factors were not independent prognostic variables. Though the actual mechanism behind this difference is unclear, our findings indicate that gastric surgeons must carefully consider among the surgical resection procedures when treating adenocarcinoma of the middle gastric cancer.
