ORIGINAL RESEARCH article
Front. Surg.
Sec. Surgical Oncology
This article is part of the Research TopicSurgical Management and Outcomes for Gastric CancerView all 9 articles
Does Different Surgical Approaches Affect Tolerance to Postoperative Adjuvant Chemotherapy in Early-Stage Upper Gastric Cancer?
Provisionally accepted
- Xiangyang Central Hospital, Xiangyang, China
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Objective: To compare the effects of laparoscopic radical proximal gastrectomy with double-tract reconstruction (LPG-DTR) versus laparoscopic radical total gastrectomy with Roux-en-Y reconstruction (LTG-RY) on tolerance to postoperative adjuvant chemotherapy in early-stage upper gastric cancer, providing evidence for surgical strategy selection and its impact on chemotherapy outcomes.Methods: In this retrospective cohort study, clinical data were collected from 76 patients with early-stage upper gastric cancer who underwent postoperative chemotherapy following either LPG-DTR or LTG-RY at our institution between January 2020 and January 2023. Patients were stratified into the DTR group (n=35) and RY group (n=41) based on surgical approach and digestive reconstruction.Results:Compared with the R-Y group, the DTR group had a longer operation time, and a smaller number of lymph node dissections (all P < 0.05).Chemotherapy completion rates showed no significant intergroup difference (all P>0.05).The DTR group demonstrated:Lower incidence of grade ≥2 adverse events (per CTCAE v5.0 criteria),Reduced requirement for granulocyte colony-stimulating factor (G-CSF)Increased utilization of antiemetics (e.g., ondansetron, azasetron) (all P<0.05).Conclusion: LPG-DTR is associated with attenuated myelosuppression and decreased incidence of specific chemotherapy-related toxicities (thrombocytopenia, hepatotoxicity, peripheral neuropathy). Preservation of partial gastric function may underlie these advantages and potentially improve quality of life during adjuvant treatment.
Keywords: Gastric neoplasms, Proximal gastrectomy, Double-tract reconstruction, Total gastrectomy, Roux-en-Y reconstruction, chemotherapy tolerance
Received: 15 Jun 2025; Accepted: 20 Nov 2025.
Copyright: © 2025 Zuo and liao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: 晓锋 liao, liaoxiaofeng66@163.com
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