Objective To study the clinical significance of total gastrectomy in treatment for gastric cardia cancer.
Methods The clinical data of 118 patients with gastric cardia cancer underwent operation from May 1997 to October 2012 in the Department of General Surgery of Baiyin Hospital, Affiliated to Lanzhou University were analyzed retrospe-
ctively. Among these 118 patients, there were 65 patients treated by total gastrectomy (total gastrectomy group) and 53
patients treated by proximal gastrectomy (proximal gastrectomy group). The postoperative complications, survival rate,
quality of life, and nutrition indexes were compared after operation between the total gastrectomy group and the prox-
imal gastrectomy group.
Results ① The incidence of postoperative complications was 7.7% (5/65) and 13.2% (7/53) in the total gastrectomy group and the proximal gastrectomy group, respectively, the difference was not statistically signi-
ficant (χ2=0.972, P=0.248). ② 1-, 3-, and 5-year survival rate after operation were 63.1%, 46.2%, and 30.8% in the
total gastrectomy group;which were 66.0%, 36.9%, and 18.5% in the proximal gastrectomy group. The difference of 1-year survival rate after operation was not statistically significant in two groups (χ2=0.193, P=0.402), the 3- and the 5-year survival rates of the total gastrectong group were significantly higher than those of the proximal gastrectony group (χ2=4.508, P=0.022;χ2=30.271, P=0.000). ③ The Spitzer quality of life score had no difference at the different time
after operation in two groups (P>0.05). Compared with the proximal gastrectomy group, the points of heartburn, swallo-
wing problem, appetite, and food intake on 12 months after operation in the total gastrectomy group were higher (P<
0.05), the points of the other indexes had no significant differences (P>0.05). ④ The nutrition indexes after operation
had no differences at the different time after operation in two groups (P>0.05).
Conclusions Total gastrectomy in treatment for gastric cardia cancer would not increase complications, also can improve 5-year survival for patients with
Ⅰ-Ⅲ stage, and survival condition after operation is also much better than that of proximal gastrectomy.
Citation: WANG Yun,PU Changchun,WU Jingzhang,CHEN Yan,.. Comparative Analysis on Survival Condition after Total Gastrectomy and Proximal Gastrectomy for Gastric Cardia Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(11): 1272-1278. doi: Copy