Surgery (Stomach)

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 gastrectomy does not improve survival, compared to subtotal or partial gastrectomy.

Types of Surgery	X = complete * = partial o = optional • = see note under procedure
	Tissue Removed
	Lesion	Stomach (Upper)	Stomach (Lower)	Lymph Nodes	Other Organs#
Local surgical excision Includes excision of ulcer, other lesions or stomach tissue with evidence of tumor	X
Polypectomy	X
Partial/subtotal/hemigastrectomy --upper (proximal) portion Includes sleeve resection of stomach • may include part of esophagus		*		X	•
Antrectomy		X		X
Partial/subtotal/hemigastrectomy --lower (distal) portion. Includes sleeve resection of stomach • may include part of duodenum			X	X	•
Gastropylorectomy			X	X
Billroth I • includes part of duodenum			X	X	•
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 anastomosis, total gastrectomy following previous partial resection for other reason		X	X	X	°
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

# May include spleen, omentum, mesentery, or mesocolon