Severance Hospital announced on Wednesday that Professor Kim Hyung-il of the Department of Gastrointestinal Surgery, in collaboration with cancer centers in the United States and Japan, has demonstrated the effectiveness of proximal gastrectomy.
This surgical technique preserves stomach function by removing only the upper part of the stomach affected by cancer.
Professor Kim conducted the research with teams from MD Anderson Cancer Center, Mayo Clinic, Memorial Sloan Kettering Cancer Center, and Keio University Hospital in Japan.
The study, with Professor Kim as the corresponding author, received funding from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).
Proximal gastrectomy is a procedure that partially removes the upper part of the stomach adjacent to the esophagus, primarily used in early-stage stomach cancer treatment. After removal, the remaining lower stomach is reconnected to the esophagus, maximizing digestive function. This approach reduces weight loss and nutritional issues due to dietary restrictions, improving patients’ quality of life.
To assess the effectiveness of proximal gastrectomy, the research team focused on patient satisfaction as a key indicator of functional preservation.
While this surgical method is already common in Eastern countries like South Korea and Japan, it remains limited in Western countries such as the United States, where clinical evidence of its effectiveness has not been widely established. This is largely due to the difference in cancer detection rates; Eastern countries have more early-stage stomach cancer diagnoses due to active health screenings, while in the West, stomach cancer is often diagnosed at more advanced stages.
Professor Kim, along with the study’s first author, Professor Ikoma from MD Anderson Cancer Center, and other researchers, formed a team to conduct the study from 2022 to 2024, involving 64 patients across five institutions.
The research utilized patient-reported outcomes (PRO), developed by MD Anderson Cancer Center and validated in the U.S., as a key metric. PRO allows patients to express their subjective experiences, such as pain, fatigue, and appetite, providing a patient-centered assessment of treatment effectiveness.
The research team compared the PRO of patients who underwent proximal gastrectomy with those who had total gastrectomy. Three months post-surgery, they found no statistical differences in quality of life indicators, such as loss of appetite and reflux.
Through these results, the team confirmed that proximal gastrectomy is as safe as total gastrectomy, while showing superior outcomes in terms of symptoms and weight loss. However, they noted that further studies with larger sample sizes are necessary to draw more definitive conclusions.
Professor Kim stated that this study marks the first step in evaluating patient satisfaction and effectiveness of proximal gastrectomy in collaboration with world-class cancer centers. We hope that this technique will be applied to suitable patients in Western countries, including the U.S., leading to higher patient satisfaction in stomach cancer treatment.
The results of this study were published in the latest issue of the international surgical journal, Surgical Endoscopy.