Chongqing University FuLing Hospital, Chongqing, China.
The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Am Surg. 2024 Nov;90(11):3015-3023. doi: 10.1177/00031348241260273. Epub 2024 Jun 12.
Proximal gastrectomy (PG) is one of function-preserving gastrectomy (FPG). In this study, we compared the long-term results of proximal gastric cancer (PGC) patients undergoing proximal gastrectomy and total gastrectomy (TG).
Patients diagnosed with PGC and receiving PG or TG between 2004 and 2020 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was applied to minimize confounding factors. Kaplan-Meier analysis and log-rank test were used to compare overall survival (OS) and cancer-specific survival (CSS) between the PG and TG groups. Univariate and multivariate Cox regression analyses were performed to identify independent risk factors affecting OS.
A total of 3916 patients were recruited according to the inclusion and exclusion criteria, with 2614 undergoing PG and 1302 undergoing TG. After 1:1 PSM matching, 912 pairs of data were included for analysis. Before PSM matching, PG group tended to have better OS and CSS outcomes. However, after PSM matching, both surgical approaches showed similar long-term results.
PG for PGC yields comparable long-term outcomes to TG and demonstrates safety in terms of oncologic outcomes.
近端胃切除术（PG）是一种保留功能的胃切除术（FPG）。本研究比较了接受近端胃切除术和全胃切除术（TG）的近端胃癌（PGC）患者的长期结果。
从监测、流行病学和最终结果（SEER）数据库中选择 2004 年至 2020 年间诊断为 PGC 并接受 PG 或 TG 的患者。应用倾向评分匹配（PSM）以最小化混杂因素。采用 Kaplan-Meier 分析和对数秩检验比较 PG 组和 TG 组的总生存期（OS）和癌症特异性生存期（CSS）。采用单因素和多因素 Cox 回归分析确定影响 OS 的独立危险因素。
根据纳入和排除标准共招募了 3916 例患者，其中 2614 例行 PG，1302 例行 TG。经过 1:1 PSM 匹配后，纳入 912 对数据进行分析。在 PSM 匹配前，PG 组的 OS 和 CSS 结果较好。但在 PSM 匹配后，两种手术方式的长期结果相似。
PG 治疗 PGC 的长期疗效与 TG 相当，在肿瘤学结果方面具有安全性。
