{"title":"胃大部切除术治疗临床I期残胃癌。","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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>SG might be one of the potential options for clinical stage I RGC, if the proximal margin is secured.</p>","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":"{\"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\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>SG might be one of the potential options for clinical stage I RGC, if the proximal margin is secured.</p>\",\"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}","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}
Subtotal Gastrectomy for Clinical Stage I Remnant Gastric Cancer.
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.
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.
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