La gastrectomia totale vs subtotale nel trattamento radicale del carcinoma gastrico

Summary. Background: This work proposes to review and assess selective principles for a radicai treatment of gastric carcinoma with respect to resection type as well as thè role of lymphadenectomy. Patients and methods: From 1994 to 1999, we operated 222 patients affected by gastric adenocarcinoma at thè I Surgical Clinic Insti-tute in Padua. Out of thè whole group, 138 patients (62.1%) underwent radicai surgical treatment (75 pa¬tients with total gastrectomy, extended in 30 cases, and 63 patients by means of gastric resection). Resuìts: The overall survival rate at a median follow-up of 4 years was 58% for thè patients treated with total gastrectomy, and 77% in case of distai gastric resection. The 97% of patients with early gastric cancer are alive at a median follow-up of three years. Conc/usions: whenever it is feasible. subtotal gastrectomy could ensure a radicai treatment of gastric carcinoma with low morbidity and mortality rate. The survival rate of such patients was 77%. Prognosis of early gastric cancer is excellent. Pa¬tients with IV stage tumors surgically treated had a poor outcome. and they should be susceptible of a multidisci-plinary palliative approach.