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World Journal of Surgery
Published in: World Journal of Surgery 3/2020

01-03-2020 | Gastric Cancer | Original Scientific Report

Prognostic Significance of Hiatal Hernia in Patients with Gastric Cancer Located within the Upper-Third of the Stomach

Authors: Suguru Maruyama, Yoshihiko Kawaguchi, Hidenori Akaike, Kensuke Shiraishi, Ryo Saito, Hiroki Shimizu, Shinji Furuya, Naohiro Hosomura, Hidetake Amemiya, Hiromichi Kawaida, Makoto Sudo, Shingo Inoue, Hiroshi Kono, Daisuke Ichikawa

Published in: World Journal of Surgery | Issue 3/2020

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Abstract

Background

Gastric cancers located within the upper-third of the stomach (UGC), especially the esophagogastric junction GC (EGJGC), have distinct clinicopathological features due to their potential for multidirectional lymphatic spread. In this study, we investigated the clinical significance of hiatal hernias (HH) in patients with UGC, including EGJGC.

Methods

In this retrospective study, we assessed status of HH in 147 patients with UGC who underwent curative resection at our hospital and examined the correlation between the presence of HH (+) and multiple clinicopathological factors.

Results

Thirty-four patients (23%) were HH (+). However, we found no significant correlation between HH (+) and clinicopathological factors. HH (+) patients frequently developed lymph node recurrences. Prognosis was significantly better in patients with UGC and HH (−), compared to those with UGC and HH (+). Similarly, EGJGC patients who were HH (−) showed superior survival compared to HH (+) patients. Multivariate analysis found that the HH (+) (p = 0.004), histological type (p = 0.029), and nodal stage (p = 0.034) were independent prognostic factors.

Conclusions

The presence of HH might affect lymphatic spread of tumor cells, and consequently prognosis of patients with UGC. Therefore, special attention is needed in developing surgical and postoperative strategies for such patients with UGC who are HH (+).
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Metadata
Title
Prognostic Significance of Hiatal Hernia in Patients with Gastric Cancer Located within the Upper-Third of the Stomach
Authors
Suguru Maruyama
Yoshihiko Kawaguchi
Hidenori Akaike
Kensuke Shiraishi
Ryo Saito
Hiroki Shimizu
Shinji Furuya
Naohiro Hosomura
Hidetake Amemiya
Hiromichi Kawaida
Makoto Sudo
Shingo Inoue
Hiroshi Kono
Daisuke Ichikawa
Publication date
01-03-2020
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 3/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05236-z

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