RT Journal Article
SR Electronic
T1 Limited Oncological Benefits of Laparoscopic Total Gastrectomy With Splenectomy for Patients With Type 4 or Large Type 3 Gastric Cancer
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 5937
OP 5944
DO 10.21873/anticanres.16103
VO 42
IS 12
A1 MASAZUMI SAKAGUCHI
A1 HISAHIRO HOSOGI
A1 SHIGEO HISAMORI
A1 YOSUKE KINJO
A1 SEIICHIRO KANAYA
A1 KAZUTAKA OBAMA
YR 2022
UL http://ar.iiarjournals.org/content/42/12/5937.abstract
AB Background/Aim: Total gastrectomy with splenectomy (TGS) is routinely performed in patients with type 4 or large type 3 gastric cancer (GC), which sometimes metastasize to splenic hilar lymph nodes (LNs). However, the indication for and significance of TGS remain controversial. This multicenter retrospective study aimed to evaluate the oncological feasibility of laparoscopic TGS (LTGS) in patients with advanced proximal GC. Patients and Methods: We retrospectively studied patients with type 4 or large type 3 GC who underwent LTGS at three Institutes between January 2010 and December 2018. Results: We identified 26 consecutive eligible patients for analysis. Large type 3/type 4 were observed in 10 (38.5%)/16 (61.5%) cases. Involvement of the greater curvature was observed in 19 cases (73.1%), and GC spread to the whole stomach was observed in 12 cases (46.2%). R0 resection was achieved in 23 cases (88.5%). The median number of retrieved splenic hilar LNs was 4.0 (1-15), and the number of cases with splenic hilar LN metastasis was 3 (11.5%). Postoperative grade II intra-abdominal abscess was observed in 1 case (3.8%), and pancreatic fistula was not observed in any patient. Recurrence was observed in 18 cases (69.2%), of which 16 (88.9%) presented peritoneal recurrence. The median overall survival (OS) was 40.6 months, and the 5-year OS rate was 30.3%. The 5-year survival rate of patients with splenic hilar LN metastasis was 33.3% and the therapeutic value of splenectomy was 3.83. Conclusion: LTGS was performed safely, but the oncological benefit of the procedure for type 4 or large type 3 GC was very limited.