COMPARATIVE ANALYSIS OF SURGICAL OUTCOMES AND OVERALL SURVIVAL BETWEEN TOTAL AND PARTIAL GASTRECTOMY IN GASTRIC CANCER: 396 CASES IN A SINGLE INSTITUTION

Summary Objective: To compare clinical characteristics and indicators related to the surgical treatment of gastric cancer between patients submitted to Total Gastrectomy and those submitted to Partial Gastrectomy. Method: Retrospective descriptive comparative study. For patients with stomach cancer who underwent lymphadenectomy with D2 lymphadenectomy during the period from jan-2005 to jul-2015 at Hospital Erasto Gaertner, Curitiba-PR. Patients were allocated to the groups Total Gastrectomy and Partial Gastrectomy. And the statistical analyses always took place in a comparative manner between the groups. The data were submitted to several statistical analyses, being p<0.05 considered statistically significant. Results: Of the total of 396 patients, 123 (31%) underwent Total Gastrectomy, 273 (69%) Partial Gastrectomy. When age, gender, BMI, Performance Status, Anesthetic Risk (ASA), and laboratory tests were analyzed, there was no statistically significant difference between the groups. The most frequent histological type was adenocarcinoma. And the staging data were similar between the groups. The surgical time was significantly longer in the total gastrectomies 240 minutes, against 180 minutes in the partial ones. Postoperative complications occurred in 23 (18.7%) patients of the Total Gastrectomy group versus 35 (12.8%) patients of the Partial Gastrectomy group, not reaching statistical relevance. On the other hand, the need for reoperation was significantly greater in the Total Gastrectomy group, 19 (15.4%) patients versus 22 (8.1%) in the Partial Gastrectomy group. Death within 30 days was higher in Total Gastrectomy 3.8% versus 2.5% in Partial Gastrectomy. The mean length of stay, as well as the daily stays in the ICU were longer for Total Gastrectomy. The number of lymph nodes dissected showed no difference between the groups. The mean overall survival was 7.14 years (5.90-8.38) in patients submitted to total and 9.31 years (8.47-10.15) in the partial, with a significant statistical difference (p=0.01). Compared to 5 years, the overall survival was significantly higher for Partial Gastrectomy, 74% versus 56%. Conclusions: Patients submitted to total gastrectomy have worse results in relation to partial gastrectomy. Primary tumor size, lymph node involvement, surgical time and severe postoperative complications requiring reoperation are the main factors influencing the overall survival of patients.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019