A new analysis combined results from several studies to compare two types of surgery for advanced stomach cancer near the top of the stomach. The surgeries were proximal gastrectomy (PG), which removes only the upper part of the stomach, and total gastrectomy (TG), which removes the whole stomach. All patients had received chemotherapy before surgery.
The study looked at 284 patients who had PG and 305 who had TG. It found that PG took about 21 minutes less time in the operating room. However, PG led to slightly more blood loss (about 9 mL more) and removed about 4 fewer lymph nodes. The number of cancer-positive lymph nodes was similar between the two groups.
Importantly, there was no significant difference in 5-year overall survival or recurrence-free survival between PG and TG. Rates of serious complications were also similar. The study suggests that for carefully selected patients, keeping part of the stomach may be a reasonable option without harming long-term outcomes.
However, the study noted that PG removed fewer lymph nodes, which could affect staging. The authors emphasize that patient selection is key. More research is needed to confirm these findings in different patient groups.