Report of 87 cases of advanced proximal gastric cancer combined with splenectomy

Objective To investigate the rational surgical precedures for advanced proximal gastric cancer by studying lymph node metastasis and relative factors.Methods The data of 87 patients with proximal gastric cancer undergoing radical total gastrectomy combined with splenectomy in our hospital from 1995 to 2000 were retrospectively analyzed to determine the indications for the combined splenectomy.Results The lymph node metastasis rate of the No. 10 to 11 in advanced proximal gastric cancer of lesser curvature of stomach was 7.2% (2/28), while that in greater curvature of stomach ( 43.6% , 7/39) and fundus of stomach ( 45% , 9/20) was significantly increased ( P 0.01 ).Conclusion For advanced proximal gastric cancers in lesser curvature of stomach, radical total gastrectomy combined with splenectomy was used in terms of tumor size, the depth of invasion and the lymph node metastasis. For those in greater curvature and fundus of stomach, when the tumor can be radically resected, rational surgical procedure is radical total gastrectomy combined with splenectomy.