医学
胃切除术
外科肿瘤学
内科学
癌症
胃肠病学
比例危险模型
肝病学
危险系数
倾向得分匹配
淋巴结
食管切除术
胃弯曲度
外科
胃
食管癌
置信区间
作者
Seung‐Ho Lee,Yoon Soo Chae,Won‐Gun Yun,Jane Chungyoon Kim,Jae Kyun Park,Min Gyu Kim,Jeesun Kim,Yo-Seok Cho,Seong‐Ho Kong,Do Joong Park,Hyuk‐Joon Lee,Han‐Kwang Yang
标识
DOI:10.1245/s10434-024-15048-8
摘要
Abstract Background This study aimed to investigate the oncologic long-term safety of proximal gastrectomy for upper-third advanced gastric cancer (AGC) and Siewert type II esophagogastric junction (EGJ) cancer. Methods The study enrolled patients who underwent proximal gastrectomy (PG) or total gastrectomy (TG) with standard lymph node (LN) dissection for pathologically proven upper-third AGC and EGJ cancers between January 2007 and December 2018. Propensity score-matching with a 1:1 ratio was performed to reduce the influence of confounding variables such as age, sex, tumor size, T stage, N stage, and tumor-node-metastasis (TNM) stage. Kaplan-Meier survival analysis was performed to analyze oncologic outcome. The prognostic factors of recurrence-free survival (RFS) were analyzed using the Cox proportional hazard analysis. Results Of the 713 enrolled patients in this study, 60 received PG and 653 received TG. Propensity score-matching yielded 60 patients for each group. The overall survival rates were 61.7 % in the PG group and 68.3 % in the TG group ( p = 0.676). The RFS was 86.7 % in the PG group and 83.3 % in the TG group ( p = 0.634). The PG group showed eight recurrences (1 anastomosis site, 1 paraaortic LN, 1 liver, 1 spleen, 1 lung, 1 splenic hilar LN, and 2 remnant stomachs). In the multivariate analysis, the operation method was not identified as a prognostic factor of tumor recurrence. Conclusion The patients who underwent PG had a long-term oncologic outcome similar to that for the patients who underwent TG for upper-third AGC and EGJ cancer.
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