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

Tissues Removed
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