Surgical outcomes for early gastric cancer in the upper third of the stomach

BACKGROUND: Although outcomes of operations for advanced gastric cancer in the upper third of the stomach are said to be poorer, outcomes of operations for early gastric cancer in the upper third of the stomach have been less well studied. The aim of this study is to analyze and establish a therapeutic strategy for early tumors in the upper third of the stomach. STUDY DESIGN: Patients (n = 673; 79 patients were located in the upper third of the stomach and 594 in more distal sites) with early gastric cancer who underwent Curative gastrectomy were included in this study. Clinicopathologic characteristics and results of operations for early tumors were compared between the two groups. Prognostic factors were evaluated with uni- and multivariate analyses. RESULTS: Tumors in the upper third of the stomach were more often protruded. differentiated, submucosa invasive, and located at the posterior wall, and more often involved venous invasion and adjacent metastatic lymph nodes. Lymph node metastasis. but not tumor location, was an independent prognostic factor in all registered patients. Results of operations were not different between the two groups. CONCLUSIONS: Early proximal tumors show distinct features, bur prognosis after curative operation is as good as that of distal two-third tumors. (C) 2005 by the American College of Surgeons.