Total gastrectomy for gastric carcinoma

Area of Science:

• Surgical Oncology
• Gastroenterology
• Clinical Research

Background:

• Gastric cancer is a prevalent malignancy worldwide, necessitating surgical intervention.
• Total gastrectomy is the primary surgical option for proximal gastric cancer.
• This procedure carries significant mortality and morbidity risks, particularly in elderly patients.

Purpose of the Study:

• To evaluate the outcomes of total gastrectomy in gastric cancer patients.
• To assess the safety, morbidity, mortality, and survival rates associated with the procedure.
• To identify factors influencing survival in patients undergoing total gastrectomy.

Main Methods:

• A retrospective analysis of 38 gastric cancer patients who underwent total gastrectomy between 1996 and 2001.
• Data collected included patient demographics, tumor characteristics (location, histology, TNM stage), surgical details, and postoperative outcomes.
• Outcomes assessed were operation time, blood transfusions, hospital stay, morbidity, mortality, and survival rates.

Main Results:

• The study included patients with a mean age of 59.5 years, predominantly with adenocarcinoma (97.4%).
• Most patients presented with advanced disease (Stage III: 81.6%, Stage IV: 7.9%).
• Postoperative morbidity was 21%, hospital mortality was 20%, with anastomotic leak and cardiac complications being significant causes of death. Average survival was 10.5 months.

Conclusions:

• Total gastrectomy is a safe procedure for gastric cancer, with acceptable mortality rates when performed with curative or palliative intent.
• The high proportion of advanced-stage tumors (Stage III/IV) resulted in low survival rates.
• Improved survival outcomes are achievable in patients diagnosed with earlier stages of gastric cancer.