Subtotal Gastrectomy for Clinical Stage I Remnant Gastric Cancer.

IF 2.3 3区医学 Q2 SURGERY

World Journal of Surgery Pub Date : 2025-05-21 DOI:10.1002/wjs.12638

Ryuhei Aoyama, Shigeru Tsunoda, Ryosuke Okamura, Yoshito Yamashita, Hiroaki Hata, Yosuke Kinjo, Akira Miki, Seiichiro Kanaya, Michihiro Yamamoto, Koichi Matsuo, Dai Manaka, Eiji Tanaka, Hironori Kawada, Masato Kondo, Atsushi Itami, Takatsugu Kan, Yoshio Kadokawa, Tetsuo Ito, Kenjiro Hirai, Hisahiro Hosogi, Tatsuto Nishigori, Shigeo Hisamori, Nobuaki Hoshino, Kazutaka Obama

{"title":"Subtotal Gastrectomy for Clinical Stage I Remnant Gastric Cancer.","authors":"Ryuhei Aoyama, Shigeru Tsunoda, Ryosuke Okamura, Yoshito Yamashita, Hiroaki Hata, Yosuke Kinjo, Akira Miki, Seiichiro Kanaya, Michihiro Yamamoto, Koichi Matsuo, Dai Manaka, Eiji Tanaka, Hironori Kawada, Masato Kondo, Atsushi Itami, Takatsugu Kan, Yoshio Kadokawa, Tetsuo Ito, Kenjiro Hirai, Hisahiro Hosogi, Tatsuto Nishigori, Shigeo Hisamori, Nobuaki Hoshino, Kazutaka Obama","doi":"10.1002/wjs.12638","DOIUrl":null,"url":null,"abstract":"Background: Subtotal gastrectomy (SG) is a surgical option for early remnant gastric cancer (RGC). However, reports evaluating the feasibility and oncological safety of SG for RGC are limited. Here, we aimed to evaluate the short- and long-term outcomes of SG for RGC.Methods: We conducted a multi-institutional retrospective cohort study and compared the outcomes between SG and completion gastrectomy (CG) of patients with clinical stage I RGC. The short- and long-term outcomes, body weight change, and serum albumin level at 1 year postoperatively were evaluated.Results: Twenty-two and 202 patients in the SG and CG groups, respectively, were included in the analysis. The risk ratios (95% confidence interval [CI]) were 0.90 (0.27, 2.22) and 0.51 (0.33, 2.47) for the overall and severe complications, respectively. No anastomotic leakage was observed in the SG group, while 6.4% of the CG group had anastomotic leakage (p = 0.62). The 3-year relapse-free survival rates were 79.8% and 78.8% in the SG and CG groups, respectively (hazard ratio [95% CI], 0.87 [0.31, 2.40]; p = 0.80). The median body weight changes at 1 year postoperatively from the preoperative level were significantly less in the SG group (96.4% and 90.4% in the SG and CG groups, respectively; p = 0.021), and the median serum albumin changes at 1 year postoperatively were + 0.01 and -0.04 g/dL, respectively (p = 0.551).Conclusion: SG might be one of the potential options for clinical stage I RGC, if the proximal margin is secured.","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/wjs.12638","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Subtotal gastrectomy (SG) is a surgical option for early remnant gastric cancer (RGC). However, reports evaluating the feasibility and oncological safety of SG for RGC are limited. Here, we aimed to evaluate the short- and long-term outcomes of SG for RGC.

Methods: We conducted a multi-institutional retrospective cohort study and compared the outcomes between SG and completion gastrectomy (CG) of patients with clinical stage I RGC. The short- and long-term outcomes, body weight change, and serum albumin level at 1 year postoperatively were evaluated.

Results: Twenty-two and 202 patients in the SG and CG groups, respectively, were included in the analysis. The risk ratios (95% confidence interval [CI]) were 0.90 (0.27, 2.22) and 0.51 (0.33, 2.47) for the overall and severe complications, respectively. No anastomotic leakage was observed in the SG group, while 6.4% of the CG group had anastomotic leakage (p = 0.62). The 3-year relapse-free survival rates were 79.8% and 78.8% in the SG and CG groups, respectively (hazard ratio [95% CI], 0.87 [0.31, 2.40]; p = 0.80). The median body weight changes at 1 year postoperatively from the preoperative level were significantly less in the SG group (96.4% and 90.4% in the SG and CG groups, respectively; p = 0.021), and the median serum albumin changes at 1 year postoperatively were + 0.01 and -0.04 g/dL, respectively (p = 0.551).

Conclusion: SG might be one of the potential options for clinical stage I RGC, if the proximal margin is secured.

查看原文本刊更多论文

胃大部切除术治疗临床I期残胃癌。

背景：胃大部切除术（SG）是早期残余胃癌（RGC）的一种手术选择。然而，评估SG用于RGC的可行性和肿瘤安全性的报告有限。在这里，我们的目的是评估SG为RGC的短期和长期结果。方法：我们进行了一项多机构回顾性队列研究，比较了临床I期RGC患者SG和完全胃切除术（CG）的结果。评估两组患者术后1年的短期和长期预后、体重变化和血清白蛋白水平。结果：SG组和CG组分别纳入22例和202例患者。总体并发症和严重并发症的风险比（95%可信区间[CI]）分别为0.90（0.27,2.22）和0.51（0.33,2.47）。SG组无吻合口瘘，而CG组吻合口瘘发生率为6.4% （p = 0.62）。SG组和CG组3年无复发生存率分别为79.8%和78.8%(风险比[95% CI]， 0.87 [0.31, 2.40]；p = 0.80)。SG组术后1年的中位体重变化较术前水平明显减少(SG组和CG组分别为96.4%和90.4%；p = 0.021)，术后1年血清白蛋白变化中位数分别为+ 0.01和-0.04 g/dL （p = 0.551）。结论：如果近端缘得到保护，SG可能是临床I期RGC的潜在选择之一。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

World Journal of Surgery 医学-外科

CiteScore

5.10

自引率

3.80%

发文量

460

审稿时长

3 months

期刊介绍： World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.