Surgical treatment of gastric adenocarcinoma: impact on survival and quality of life. A prospective ten year study

The objective of this prospective study was to compare the results of total (TG) versus subtotal (SG) gastrectomy in patients with adenocarcinoma of the lower two-thirds of the stomach. Two hundred and twenty-seven patients underwent curative operation. Preoperative nutritional assessment, postopera...

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Bibliographic Details
Published inHepato-gastroenterology Vol. 43; no. 7; p. 187
Main Authors Braga, M, Molinari, M, Zuliani, W, Foppa, L, Gianotti, L, Radaelli, G, Cristallo, M, Di Carlo, V
Format Journal Article
LanguageEnglish
Published Greece 01.01.1996
Subjects
Adenocarcinoma - mortality
Adenocarcinoma - rehabilitation
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Female
Gastrectomy
Humans
Male
Middle Aged
Nutritional Physiological Phenomena
Prospective Studies
Quality of Life
Stomach Neoplasms - mortality
Stomach Neoplasms - rehabilitation
Stomach Neoplasms - surgery
Survival Rate
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Summary:The objective of this prospective study was to compare the results of total (TG) versus subtotal (SG) gastrectomy in patients with adenocarcinoma of the lower two-thirds of the stomach. Two hundred and twenty-seven patients underwent curative operation. Preoperative nutritional assessment, postoperative tumor stage, postoperative morbidity/mortality, five-year survival, postgastrectomy dietary intake and nutritional sequelae were recorded in all patients. Postoperative mortality rate was 2.8% in the TG group and 1.1% in the SG group. The number of reoperations, anastomotic dehiscence rate and the length of postoperative stay were higher in the TG group. Five-year survival was closely related to lymph node involvement and gastric wall invasion. The extent of gastric resection did not influence survival when patients were matched for cancer stage. In the SG group, no recurrence in the gastric stump was observed. SG group showed a higher dietary energy intake than the TG group (p < 0.01). This might explain the ability of the SG group to increase body weight more than the TG group (p < 0.01). Only the TG group needed a monthly parenteral vitamin B12 supplements starting 36 months after surgery. The results suggest that SG should be considered the treatment of choice of the gastric adenocarcinoma when a cancer-free proximal resection margin can be guaranteed.
ISSN:0172-6390