Total gastrectomy for gastric carcinoma

We retrospectively analyzed experience with total gastrectomy (TG) for gastric carcinoma in 23 patients. The TNM stage was I in one patient, II in one patient, III in eight patients, and IV in 13. Linitis plastica was found in ten patients. The operation was considered curative in only eight patients (35%). There were 13 complications in eight patients. There were no operative deaths. The survival ranged from three to 36 months. The survival for curative TG was a mean of 21.2 months +/- 3.3 SEM; for palliative TG, mean survival was 10.1 months +/- 1.1 SEM (P less than .001). These results suggest that gastric carcinoma that extensively involves the fundus and/or the corpus continues to be highly lethal, even when these tumors can be resected with a TG. Furthermore, even when the operation is considered "curative" and can be done with little or no operative mortality, the average survival was at best 21 months.