Aoyama Ryuhei, Tsunoda Shigeru, Okamura Ryosuke, Yamashita Yoshito, Hata Hiroaki, Kinjo Yosuke, Miki Akira, Kanaya Seiichiro, Yamamoto Michihiro, Matsuo Koichi, Manaka Dai, Tanaka Eiji, Kawada Hironori, Kondo Masato, Itami Atsushi, Kan Takatsugu, Kadokawa Yoshio, Ito Tetsuo, Hirai Kenjiro, Hosogi Hisahiro, Nishigori Tatsuto, Hisamori Shigeo, Hoshino Nobuaki, Obama Kazutaka
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Kyoto Esophageal and Gastric Surgery Study Group, Kyoto, Japan.
World J Surg. 2025 Jul;49(7):1891-1898. doi: 10.1002/wjs.12638. Epub 2025 May 21.
Subtotal gastrectomy (SG) is a surgical option for early remnant gastric cancer (RGC). However, reports evaluating the feasibility and oncological safety of SG for RGC are limited. Here, we aimed to evaluate the short- and long-term outcomes of SG for RGC.
We conducted a multi-institutional retrospective cohort study and compared the outcomes between SG and completion gastrectomy (CG) of patients with clinical stage I RGC. The short- and long-term outcomes, body weight change, and serum albumin level at 1 year postoperatively were evaluated.
Twenty-two and 202 patients in the SG and CG groups, respectively, were included in the analysis. The risk ratios (95% confidence interval [CI]) were 0.90 (0.27, 2.22) and 0.51 (0.33, 2.47) for the overall and severe complications, respectively. No anastomotic leakage was observed in the SG group, while 6.4% of the CG group had anastomotic leakage (p = 0.62). The 3-year relapse-free survival rates were 79.8% and 78.8% in the SG and CG groups, respectively (hazard ratio [95% CI], 0.87 [0.31, 2.40]; p = 0.80). The median body weight changes at 1 year postoperatively from the preoperative level were significantly less in the SG group (96.4% and 90.4% in the SG and CG groups, respectively; p = 0.021), and the median serum albumin changes at 1 year postoperatively were + 0.01 and -0.04 g/dL, respectively (p = 0.551).
SG might be one of the potential options for clinical stage I RGC, if the proximal margin is secured.
胃次全切除术（SG）是早期残胃癌（RGC）的一种手术选择。然而，评估SG治疗RGC的可行性和肿瘤学安全性的报告有限。在此，我们旨在评估SG治疗RGC的短期和长期结果。
我们进行了一项多机构回顾性队列研究，并比较了临床I期RGC患者SG和根治性胃切除术（CG）的结果。评估了术后1年的短期和长期结果、体重变化以及血清白蛋白水平。
分析纳入了SG组的22例患者和CG组的202例患者。总体并发症和严重并发症的风险比（95%置信区间[CI]）分别为0.90（0.27，2.22）和0.51（0.33，2.47）。SG组未观察到吻合口漏，而CG组有6.4%发生吻合口漏（p = 0.62）。SG组和CG组的3年无复发生存率分别为79.8%和78.8%（风险比[95%CI]，0.87[0.31，2.40]；p = 0.80）。SG组术后1年相对于术前水平的体重中位数变化明显更小（SG组和CG组分别为96.4%和90.4%；p = 0.021），术后1年血清白蛋白的中位数变化分别为+0.01和-0.04 g/dL（p = 0.551）。
如果近端切缘安全，SG可能是临床I期RGC的潜在选择之一。
