Analysis of Local Recurrence Following Proximal Gastrectomy in Patients with Upper Third Gastric Cancer.

PURPOSE Little is known about local recurrence following proximal gastrectomy in patients with upper third gastric cancer. We performed this study to evaluate the long-term results of a proximal gastrectomy, and to analyze the risk factors of local recurrence affecting survival in these patients. MATERIALS AND METHODS We undertook a retrospective study of 63 patients who underwent potentially curative proximal gastrectomy between 1990 and 1999, with special reference to local recurrence. RESULTS During a median follow-up period of 37 months, 25 of the 63 patients (39.7%) developed a recurrence of cancer, with local recurrence in 15 patients (23.8%), the majority of these occurring at the remnant stomach or anastomosis. The median time to local recurrence was 38 months (8~78 months). Univariate analysis of risk factors for local recurrence revealed an infiltrative or diffuse gross type, with a tumor sizes>5 cm, a distal resection margin <or=3 cm and serosal invasion. Reoperation for cure was possible in only 4 patients and most died within the first year following diagnosis of recurrence. CONCLUSION When performing a proximal gastrectomy for upper third gastric cancer, even after curative resection, all risk factors should be considered to reduce rates of local recurrence.