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 [glossary term:] 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
[glossary term:] Polypectomy
X
Partial/subtotal/[glossary term:] hemigastrectomy—upper (proximal) portion
Includes sleeve resection of stomach
• may include part of esophagus
* X
[glossary term:] Antrectomy X X
Partial/subtotal/hemigastrectomy—lower (distal) portion.
Includes sleeve resection of stomach
• may include part of duodenum
X X
[glossary term:] Gastropylorectomy
X X
[glossary term:] Billroth I
• includes part of duodenum
X X
[glossary term:] 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 [glossary term:] anastomosis, total gastrectomy following previous partial resection for other reason X X X °
[glossary term:] 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