Comparison of Proximal Gastrectomy With Double-Tract Reconstruction and Total Gastrectomy for Stage II-III Upper Gastric Cancer: A Dual-Institutional Propensity Score-Matched Analysis.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Comparison of Proximal Gastrectomy With Double-Tract Reconstruction and Total Gastrectomy for Stage II-III Upper Gastric Cancer: A Dual-Institutional Propensity Score-Matched Analysis.
Συγγραφείς:	Song JH; Department of Surgery, Ajou University School of Medicine, Suwon, Korea.; Department of Surgery, Yonsei University College of Medicine, Seoul, Korea., Wi S; Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea., Boo Y; Department of Surgery, Ajou University School of Medicine, Suwon, Korea., Park SH; Department of Surgery, Yonsei University College of Medicine, Seoul, Korea., Cho M; Department of Surgery, Yonsei University College of Medicine, Seoul, Korea., Kim YM; Department of Surgery, Yonsei University College of Medicine, Seoul, Korea., Son SY; Department of Surgery, Ajou University School of Medicine, Suwon, Korea., Kim J; CAE Group, Hardware Solution Team, Health and Medical Equipment Business, Samsung Electronics Co. Ltd., Seoul, Korea., Park JC; Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea., Hur H; Department of Surgery, Ajou University School of Medicine, Suwon, Korea., Hyung WJ; Department of Surgery, Yonsei University College of Medicine, Seoul, Korea., Han SU; Department of Surgery, Ajou University School of Medicine, Suwon, Korea., Kim HI; Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. cairus@yuhs.ac.
Πηγή:	Journal of gastric cancer [J Gastric Cancer] 2026 Oct; Vol. 26 (4), pp. 534-551.
Τύπος έκδοσης:	Journal Article; Comparative Study
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Korean Gastric Cancer Association Country of Publication: Korea (South) NLM ID: 101559430 Publication Model: Print Cited Medium: Internet ISSN: 2093-5641 (Electronic) Linking ISSN: 15981320 NLM ISO Abbreviation: J Gastric Cancer Subsets: MEDLINE
Imprint Name(s):	Original Publication: Seoul : Korean Gastric Cancer Association
Ιατρικοί όροι (MeSH):	Stomach Neoplasms/surgery , Stomach Neoplasms/pathology , Stomach Neoplasms/mortality , Gastrectomy/methods , Gastrectomy/adverse effects , Plastic Surgery Procedures/methods , Postoperative Complications/epidemiology , Postoperative Complications/etiology, Humans ; Female ; Propensity Score ; Retrospective Studies ; Male ; Aged ; Middle Aged ; Neoplasm Staging
Περίληψη:	Purpose: Total gastrectomy (TG) is the standard treatment for stage II-III upper gastric cancer, whereas proximal gastrectomy is primarily used for early-stage disease. This study compared the oncologic and nutritional consequences, including anemia, vitamin B12 deficiency, and body composition changes, between proximal gastrectomy with double-tract reconstruction (PG-DTR) and TG. Materials and Methods: We retrospectively analyzed a prospectively maintained dual-institutional database of patients who underwent curative-intent PG-DTR or TG for stage II-III gastric cancer between 2015 and 2022. Machine learning-based propensity score matching balanced the clinicopathological variables. Perioperative outcomes, hematologic and nutritional parameters, computed tomography-based body composition, and survival were compared. Results: After matching, 62 patient pairs were included. Complication rates were comparable between the groups. Five-year cumulative incidences of anemia (86.2% vs. 88.7%, P=0.507), iron replacement (48.7% vs. 58.3%, P=0.595), and vitamin B12 deficiency (8.9% vs. 22.3%, P=0.139) were similar. However, the 5-year cumulative incidence of vitamin B12 replacement was significantly lower after PG-DTR than after TG (46.4% vs. 95.4%, P<0.001). Longitudinal changes in body composition, body weight, hemoglobin level, albumin level, and prognostic nutritional index were similar between the groups. Five-year overall survival rates were 78.9% and 81.1% (P=0.801), and the 5-year recurrence-free survival rates were 73.0% and 78.2% (P=0.690) in the PG-DTR and TG groups, respectively. Conclusions: PG-DTR showed no statistically significant differences in perioperative, nutritional, and oncologic outcomes compared with TG in this cohort. These findings should be interpreted cautiously because of the limited statistical power, and larger prospective studies are warranted. (Copyright © 2026. Korean Gastric Cancer Association.)
Competing Interests:	No potential conflict of interest relevant to this article was reported.
References:	Cancer Res Treat. 2025 Jan;57(1):174-185. (PMID: 38965924) Cancer Res Treat. 2004 Feb;36(1):50-5. (PMID: 20396565) Blood. 2019 Jan 3;133(1):40-50. (PMID: 30401705) Front Nutr. 2019 Nov 12;6:169. (PMID: 31781571) JAMA Netw Open. 2023 Feb 1;6(2):e2256004. (PMID: 36790808) N Engl J Med. 1972 Aug 31;287(9):425-9. (PMID: 5044916) Eur J Surg Oncol. 2018 Dec;44(12):1963-1970. (PMID: 30197164) Gastric Cancer. 2018 Sep;21(5):845-852. (PMID: 29423892) Ann Surg. 2013 Dec;258(6):970-5. (PMID: 24096753) J Clin Epidemiol. 2022 Dec;152:176-184. (PMID: 36126791) Gastric Cancer. 2023 Jan;26(1):1-25. (PMID: 36342574) Lancet. 1959 Jan 3;1(7062):18-21. (PMID: 13612234) J Clin Invest. 2004 May;113(9):1251-3. (PMID: 15124013) J Hepatol. 2015 Jul;63(1):131-40. (PMID: 25724366) Surg Endosc. 2019 Jun;33(6):1757-1768. (PMID: 30203207) N Engl J Med. 2007 Nov 1;357(18):1810-20. (PMID: 17978289) N Engl J Med. 2005 Mar 10;352(10):1011-23. (PMID: 15758012) Ann Surg Oncol. 2017 Sep;24(9):2712-2719. (PMID: 28477088) Ann Surg Oncol. 2011 Dec;18(13):3711-7. (PMID: 21556950) World Health Organ Tech Rep Ser. 1968;405:5-37. (PMID: 4975372) Ann Surg. 2004 Aug;240(2):205-13. (PMID: 15273542) Multivariate Behav Res. 2011 May;46(3):399-424. (PMID: 21818162) J Am Coll Surg. 2016 May;222(5):e39-45. (PMID: 26968319) Asian J Surg. 2022 Oct;45(10):1823-1831. (PMID: 34642056) Surgery. 2023 Apr;173(4):957-967. (PMID: 36543733) J Clin Epidemiol. 2010 Aug;63(8):826-33. (PMID: 20630332) J Gastric Cancer. 2023 Jan;23(1):3-106. (PMID: 36750993) Crit Rev Oncol Hematol. 2025 Sep;213:104788. (PMID: 40466818) Transl Gastroenterol Hepatol. 2020 Apr 05;5:22. (PMID: 32258526) Gastric Cancer. 2017 Sep;20(5):913-918. (PMID: 28032232) Lancet. 2012 Jan 28;379(9813):315-21. (PMID: 22226517) Am J Clin Nutr. 2000 May;71(5):1147-60. (PMID: 10799377) Langenbecks Arch Surg. 2016 Aug;401(5):687-97. (PMID: 27143021) Stat Med. 2010 Feb 10;29(3):337-46. (PMID: 19960510) Ann Surg Open. 2021 Nov 24;2(4):e107. (PMID: 37637877) Front Oncol. 2024 Apr 02;14:1380358. (PMID: 38628673)
Grant Information:	RS-2026-25517509 Korea MOHW Ministry of Health and Welfare
Contributed Indexing:	Keywords: Anemia; Gastrectomy; Stomach neoplasms; Vitamin B12 deficiency
Entry Date(s):	Date Created: 20261008 Date Completed: 20261008 Latest Revision: 20261014
Update Code:	20261014
PubMed Central ID:	PMC13655703
DOI:	10.5230/jgc.2026.26.e44
PMID:	42845255
Βάση Δεδομένων:	MEDLINE

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ISSN:	2093-5641
DOI:	10.5230/jgc.2026.26.e44