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.
6 affiliations
- 1Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
- 2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
- 3Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea.
- 4CAE Group, Hardware Solution Team, Health and Medical Equipment Business, Samsung Electronics Co. Ltd., Seoul, Korea.
- 5Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
- 6Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. [email protected].
Abstract
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.
Related
- Exploring alternative techniques for laparoscopic sleeve gastrectomy with stapling first: the in situ method in a propensity score-matched retrospective study.
- Lower‐Limb‐Predominant Axonal Sensorimotor Polyneuropathy With Severe Proximal Weakness and Possible Myopathic Involvement After Sleeve Gastrectomy: A Case Report of Delayed Recognition
- Short-term surgical outcomes of robotic versus laparoscopic radical gastrectomy for gastric cancer: a propensity score-matched retrospective cohort study.
- Survival and treatment selection in NUT carcinoma: a population-based study and propensity score-matched comparison with poorly differentiated head and neck squamous cell carcinoma
- Accelerometry-based comparison of functional outcomes across total and partial knee and hip arthroplasty : a propensity-matched UK Biobank Study
BibTeX
@article{song2026comparison,
title = {{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.}},
author = {Jeong Ho Song and SeoYeon Wi and Yeojin Boo and Sung Hyun Park and Minah Cho and Yoo Min Kim and Sang-Yong Son and Jaehyuk Kim and Jun Chul Park and Hoon Hur and Woo Jin Hyung and Sang-Uk Han and Hyoung-Il Kim},
journal = {Journal of gastric cancer},
year = {2026},
month = oct,
doi = {10.5230/jgc.2026.26.e44},
url = {https://europepmc.org/article/MED/42845255},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - 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.
AU - Jeong Ho Song
AU - SeoYeon Wi
AU - Yeojin Boo
AU - Sung Hyun Park
AU - Minah Cho
AU - Yoo Min Kim
AU - Sang-Yong Son
AU - Jaehyuk Kim
AU - Jun Chul Park
AU - Hoon Hur
AU - Woo Jin Hyung
AU - Sang-Uk Han
AU - Hyoung-Il Kim
PY - 2026
DA - 2026/10/01
JO - Journal of gastric cancer
DO - 10.5230/jgc.2026.26.e44
UR - https://europepmc.org/article/MED/42845255
AB - 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.
SN - 2093-582X
SN - 2093-5641
ER -