Our Summary

This research paper discusses the increase in upper third gastric cancer and the rise in a certain type of surgery, called endoscopic submucosal dissection (ESD), for treating it. If ESD is not a viable option or is not able to completely treat the cancer, then more invasive surgery may be necessary. For cancer in the lower part of the stomach, it’s possible to save the upper part. However, for cancer in the upper part of the stomach, a total removal of the stomach is usually the standard treatment, regardless of the cancer stage. This is due to complications that can arise after a surgery that only removes a part of the stomach, like acid reflux, rather than issues related to the cancer itself.

Recently, a new surgical method called double tract reconstruction after a partial stomach removal surgery has been introduced for treating early stage upper stomach cancer. But, there’s not enough research comparing its effectiveness to total stomach removal. Therefore, a new study (KLASS-05) that compares the two is currently being conducted. The results of this study are expected to be very important for determining future treatment options for early stage upper stomach cancer.

FAQs

  1. What is the standard treatment option for upper third gastric cancer?
  2. What is the double tract reconstruction method after proximal gastrectomy?
  3. What is the purpose of the KLASS-05 trial comparing laparoscopic proximal gastrectomy with double tract reconstruction and laparoscopic total gastrectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastrectomy is to follow a careful diet plan after the surgery. This may include eating smaller, more frequent meals and avoiding certain foods that may cause discomfort or complications. It is important to work closely with a dietitian to ensure you are getting the necessary nutrients and vitamins to support your recovery and overall health.

Suitable For

Patients who are typically recommended for gastrectomy include those with upper third gastric cancer that is not amenable to endoscopic submucosal dissection (ESD) or is non-curable, as well as those with lower third gastric cancer where preservation of the upper part of the stomach is not possible. Total gastrectomy is often recommended for upper third gastric cancer, regardless of the stage, due to the complications associated with this type of cancer. In some cases, double tract reconstruction after proximal gastrectomy may be considered for upper third early gastric cancer. It is important for patients to discuss their treatment options with their healthcare provider to determine the best course of action for their specific situation.

Timeline

Before gastrectomy:

  1. Patient is diagnosed with upper third gastric cancer.
  2. Endoscopic submucosal dissection (ESD) may be performed if indicated.
  3. If ESD is not curative, surgical treatment may be recommended.
  4. Total gastrectomy is often the standard treatment option for upper third gastric cancer.
  5. Patient undergoes pre-operative evaluations and preparations.

After gastrectomy:

  1. Patient undergoes surgery to remove all or part of the stomach.
  2. Recovery period in the hospital post-surgery.
  3. Patient may experience changes in diet and eating habits.
  4. Follow-up appointments with healthcare providers for monitoring and treatment.
  5. Rehabilitation and adjustment to life after gastrectomy, including potential changes in digestion and nutritional needs.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a gastrectomy for my upper third gastric cancer?
  2. Are there any alternative treatment options available for my condition?
  3. What is the expected recovery time after the gastrectomy procedure?
  4. What kind of dietary changes will I need to make after the gastrectomy?
  5. Will I need any additional treatments, such as chemotherapy or radiation therapy, after the gastrectomy?
  6. What are the potential long-term effects of having a gastrectomy?
  7. How often will I need to follow up with you after the gastrectomy procedure?
  8. Will I need any special tests or monitoring after the gastrectomy to check for recurrence or complications?
  9. Can you explain the different types of gastrectomy procedures available and why you recommend a specific type for me?
  10. Are there any clinical trials or research studies that I may be eligible for related to gastrectomy for upper third gastric cancer?

Reference

Authors: Park DJ, Park YS, Ahn SH, Kim HH. Journal: Korean J Gastroenterol. 2017 Sep 25;70(3):134-140. doi: 10.4166/kjg.2017.70.3.134. PMID: 28934829