The Indication of Proximal Gastrectomy and Splenectomy for Proximal Gastric Cancer by the Relationship between the Depth of Cancer Invasion and the Pattern of Lymph Node Metastases

One hundred and twenty-five cases of proximal gastric cancer out of 842 cases of primary gastric cancer seen between 1976 and 1985 were investigated. The incidence of proximal gastric cancer and the incidence of stages I and I have been increasing. Investigation of survival rates indicates the necessity of curative resection of proximal gastric cancer. Proximal gastrectomy could achieve the aim of radical, i. e. , curative treatment, if it is performed in appropriate cases of proximal gastric cancer, that is : 1) carcinoma arising in the proximal third of the stomach without cancer expansion to the middle third of the stomach, 2) superficial cancer limited to submucosa invasion, and 3) no metastasis into lymph nodes along distal portion of stomach. Splenectomy was thought to be unnecessary for curative surgery in patients with superficial cancer.