Surgical treatment of gastric adenocarcinoma: impact on survival and quality of life. A prospective ten year study

Background/Aims: The objective of this prospective study was to compare the results of total (TG) versus subtotal (SG) gastrectomy in patients with adenocarcinoma of the lower true-thirds of the stomach. Patients and Methods: Two hundred and twenty-seven patients underwent curative operation. Preoperative nutritional assessment, postoperative tumor stage, postoperative morbidity/mortality, five-year survival, postgastrectomy dietary intake and nutritional sequelae were recorded in all patients. Results: Postoperative mortality rate was 2.8% in the TG group and 1.1% in the SG group. The number of reoperations, anastomotic dehiscence rate and the length of postoperative stay were higher in the TG group. Five-year survival was closely related to lymph node involvement and gastric wall invasion. The extent of gastric resection did not influence survival when patients were matched for cancer stage. In the SG group, no recurrence in the gastric stump was observed. SG group showed a higher di...