Journal article
Tammy Ju, Lisbi Rivas, Kyle Kurland, Sheena W. Chen, A. Sparks, P. Lin, K. Vaziri
American Journal of Surgery, 2018
American Journal of Surgery, 2018
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APA
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Ju, T., Rivas, L., Kurland, K., Chen, S. W., Sparks, A., Lin, P., & Vaziri, K. (2018). National trends in total vs subtotal gastrectomy for middle and distal third gastric cancer. American Journal of Surgery.
Chicago/Turabian
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Ju, Tammy, Lisbi Rivas, Kyle Kurland, Sheena W. Chen, A. Sparks, P. Lin, and K. Vaziri. “National Trends in Total vs Subtotal Gastrectomy for Middle and Distal Third Gastric Cancer.” American Journal of Surgery (2018).
MLA
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Ju, Tammy, et al. “National Trends in Total vs Subtotal Gastrectomy for Middle and Distal Third Gastric Cancer.” American Journal of Surgery, 2018.
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@article{tammy2018a,
title = {National trends in total vs subtotal gastrectomy for middle and distal third gastric cancer.},
year = {2018},
journal = {American Journal of Surgery},
author = {Ju, Tammy and Rivas, Lisbi and Kurland, Kyle and Chen, Sheena W. and Sparks, A. and Lin, P. and Vaziri, K.}
}
Abstract
BACKGROUND To identify trends in total and subtotal gastrectomy for middle and distal third gastric adenocarcinoma in the U.S.
METHODS NCDB was queried for patients with stage 0-III middle or distal gastric adenocarcinoma treated with total or subtotal gastrectomy. Statistical analysis including cox proportional hazards model was performed to examine overall survival by stage.
RESULTS 1,628 (85%) underwent subtotal gastrectomy and 283 (15%) underwent total. 1113 patients (58%) had distal tumors and 798 (42%) had middle tumors. Total gastrectomy patients more often had poor tumor grade (60% vs 50%,p < 0.01), larger size (46.3 mm vs 37.8 mm,p < 0.0001), had positive nodes (3.6 ± 5.9 vs 2.2 ± 4.1,p < 0.0001), underwent chemoradiation (13% vs 6%,p < 0.0001), and were higher clinical stage (p < 0.05). An overall survival curve showed an adjusted HR of 2.7 for total vs subtotal gastrectomy at clinical stage 3 (p < 0.05).
CONCLUSIONS Total gastrectomy is performed for larger, more aggressive tumors with higher stage. Subtotal gastrectomy may have a survival benefit for stage III gastric cancers.