Comparison between Proximal Gastric Cancer and Distal Gastric Cancer

Yoon, Ki Young; Lee, Sang Ho; Choi, Kyung Hyun

Abstract

BACKGROUND/AIMS: Proximal gastric cancer (PGC) has been known to have a poor prognosis compared to distal gastric cancer (DGC), but the reasons have not been fully explained yet. We compared the clinical characteristics, prognosis, and outcome of PGC and DGC.
METHODS
The 1187 cases were divided into the PGC group and the DGC group based on the location of primary tumor. We reviewed reterospectively the medical records of the patients who underwent gastrectomy at Kosin Medical Center between 1989 and 1998. The PGC group included 156 patients and the DGC group included 1,031 patients.
RESULTS
The PGC group showed more advanced tumor T stages (p<0.05), and more lymph-node metastasis (p<0.05). The resectability was 83.5% in PGC group and 88.4% in DGC group, but these were not statistically different (p>0.05). In the tumor stage I, II, IV, the two groups showed no statistical difference in 5-year survival rates. However, in stage III, the overall 5-year survival rate was higher in the DGC group.
CONCLUSIONS
In survival of PGC group and DGC group, there was no statistical difference between tumor stage I, II, and IV. Patients with PGC were diagnosed at more advanced stage, which might be the reason for the poor prognosis. Therefore, if early diagnosis can be made and adequate therapy is performed, the prognosis of PGC will be improved.