Objective: To study the best range of radical resection in the treatment of cancer of the cardia and fundus of stomach.
Methods: 418 patients with cancer of the cardia and fundus of stomach underwent radical resection. Of them 192 were treated by extended radical resection (extended group), and 226 by radical resection (radical group). The 5-year and 10-year survival rates were followed up and compared in the two groups.
Results: Analysis failed to demonstrate significant difference between the two operations for TNM stage I and II (P > 0.05). For stage III, however, the 5-year and 10-year survival rates in the extended group increased by 14.2% and 15.9% as compared with those in the radical group (P < 0.05). The two groups survival rates were similar for stage IV (P > 0.05).
Conclusions: To completely clean the lymph nodes of splenic hilus and artery and improve long-term survival rate, extended radical resection including spleen and body and tail of the pancreas should be recommended for stage III patients with cancer of the cardia and fundus of stomach when their serosa was involved or lymph node metastasis took place.