local recurrence following total or subtotal gastrectomy for adenocarcinoma of the antrum

aim :  this study aimed to compare the recurrence rate, mortality, and morbidity of curative resection of distal adenocarcinoma of the stomach between total gastrectomy (tg) and subtotal gastrectomy (stg). background : the choice between tg and stg for adenocarcinoma of the lower third of the stomach is still a matter of debate and controversy among surgeons. patients and methods : hospital records of 66 patients with distal adenocarcinoma of stomach, which had undergone even-total or subtotal gastrectomy between october 2001 and february 2006 in taleghani hospital, iran were reviewed retrospectively. demographic data and clinicopathological factors were recorded. post-operative outcomes including mortality, morbidity and tumor recurrence were assessed. univariate analyses using fisher's exact test, the student t-test, and the pearson ? 2 test were used. p values less than 0.05 were considered statistically significant. results : recurrence rate was higher in stg than tg (61% vs. 23%, rr=2.68, 95% ci=1.37-5.24, p =0.002). the mean time interval between gastrectomy and tumor recurrence was not different between tg and stg (19.75±5.1 vs. 18.0±7.8 months, p =0.507). tumor size >5 cm ( p =0.004), diffuse type ( p =0.034), poor differentiation ( p =0.001) and serosal invasion ( p =0.012) were found to be significantly related to tumor recurrence in patients who had undergone gastrectomy. conclusion : subtotal and total gastrectomy techniques have similar surgical outcome and postoperative complication rate; however, stg is associated with a more than twofold increase in local recurrence risk.