Reasonable Excision Range for Upper Third and Middle Third Gastric Cancer Less than 4cm in Size

Abstract

Appropriate indications for proximal gastrectomy in cases with cancer in the upper third of the stomach and pylorus preserving gastrectomy (PPG) for those with middle third gastric cancer, i.e. without compromising curability, were examined. Study materials included 341 upper third and 1258 middle third gastric cancers less than 4 cm in size which were surgically resected at our hospital between 1946 and 1994. Localized, superficial lesions less than 30 mm in size, and other macroscopic types including differentiated and undifferentiated lesions with neither lymph node metastasis nor serosal involvement are indications for proximal gastrectomy provided that the lesion is less than 4cm in size and is an upper third gastric cancer. Polypoid, protruded, ulcerated and depressed types, less than 20mm in size, and differentiated types less than 18mm in size or undifferentiated types without serosal involvement, are indications for PPG if the lesion is less than 4cm in size and is a middle third gastric cancer.