Why do a total gastrectomy rather than partial for a cancerous tumor?

The initial diagnosis of gastric carcinoma often is delayed because up to 80 percent of patients are asymptomatic during the early stages of stomach cancer. Unfortunately, in the United States, many cases of gastric cancer are discovered only after local invasion has advanced. These factors may not always be accurately assessed by the preoperative staging work-up before resection. If the tumor is classified as T2, then partial gastrectomy may be warranted. Traditional surgical approaches attempt to maintain a 5-cm margin proximally and distally to the primary lesion. If there is perforation of the visceral peritoneum covering the gastric ligaments or the omentum, the tumor should be classified T3. Patients who have undergone subtotal gastrectomy have an increased risk of gastric cancer recurrence, requiring the use of more aggressive surgical approaches to attempt to remove involved lymph nodes. The most common postoperative complication is tumor recurrence. Five-year survival rates for postresection early gastric cancer have been reported to be as high as 90 percent. Total gastrectomy is recommended if the biopsy shows "diffuse-type" carcinoma. Middle-third gastric cancer always requires total gastrectomy. Current operative mortality rates are reported to be as low as 1 to 3 percent.

First answer by Jadeacres. Last edit by Jadeacres. Contributor trust: 175 [recommend contributor]. Question popularity: 2 [recommend question]