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Treatment
Surgery is the treatment of choice for stomach cancer, as long as adequate margins (5-6 cm) around the tumor can be obtained and regional lymph nodes are removed. Total gastrectomy does not improve survival, compared to subtotal or partial gastrectomy.
Key:
X = complete
* = partial
o = optional
• = see note under procedure
| Types of Surgery | Lesion | Stomach (Upper) |
Stomach (Lower) |
Lymph Nodes | Other Organs |
|---|---|---|---|---|---|
| Local surgical excision Includes excision of ulcer, other lesions or stomach tissue wit evidence of tumor |
X | ||||
| Polypectomy |
X | ||||
| Partial/subtotal/hemigastrectomy—upper (proximal) portion Includes sleeve resection of stomach • may include part of esophagus |
* | X | • | ||
| Antrectomy | X | X | |||
| Partial/subtotal/hemigastrectomy—lower (distal) portion. Includes sleeve resection of stomach • may include part of duodenum |
X | X | • | ||
| Gastropylorectomy |
X | X | |||
| Billroth I • includes part of duodenum |
X | X | • | ||
| Billroth II • includes duodenum |
X | X | • | ||
| Partial/subtotal/hemigastrectomy, not otherwise specified Includes sleeve resection of stomach, resection of portion of stomach, NOS |
*/° | */° | ° | ° | |
| Total/near total gastrectomy (more than 80%) Includes resection with pouch left for anastomosis, total gastrectomy following previous partial resection for other reason | X | X | X | ° | |
| Hofmeister-Finsterer operation | X | X | X | ||
| Gastrectomy, not otherwise specified | */X | */X | X | ° | |
| Gastrectomy (partial/total/radical) with partial/total removal of other organs | */X | */X | X | * | |
| Surgery of regional/distant sites/nodes only | */X | */X |