Cancer of the proximal section of the stomach: the standards of surgical treatment based on 30 years of experience
Davydov, M.I.; Ter-Ovanesov, M.D.; Stilidi, I.S.; Germanov, A.B.; Efimov, O.N.; Abdikhakimov, A.N.; Marchuk, V.A.
Vestnik Rossiiskoi akademii meditsinskikh nauk 2002(1): 25-29
2002
ISSN/ISBN: 0869-6047 PMID: 11882966 Document Number: 543224
Cancer of the GE-junction is a highly malignant tumor with early lymphatic metastasis to the lymph nodes both in the abdomen and mediastenum. At surgery, lymph nodal metastasis is revealed in nearly 80% of cases. At present, surgical treatment with extended lymph node dissection is the "golden standard". Over 30-year experience in surgically treating GE-junction tumors in 1209 patients at the Thoracoabdominal Department, Russian Cancer Research Center, Russian Academy of Medical Sciences, support the view that extended procedures are superior to standard procedures. Radical procedures were made in 956 of the 1209 patients. These included subtotal proximal gastrectomies in 54.2% of cases, transpleural gastrectomies with esophageal resection in 42.4%, and Ivor-Lewis type procedures in 3.4%. In cases with extended lymph nodal dissection, five-year survival was superior to the results of standard procedures: 32.8 +/- 6.0 and 22.6 +/- 2.8%, respectively (t = 1.8). These figures obviously testify that extended and combined procedures with extended lymph nodal dissection make it possible to stage of a primary tumor and to improve long-term survival.