新辅助治疗提高了局部晚期胃癌（GC）实现根治性切除的可能性并改善预后。然而，对于局部晚期近端GC新辅助治疗后的最佳切除范围缺乏证据。本研究中，北京大学肿瘤医院330例患者接受了切除术，自1月份起对经组织学证实的近端GC进行新辅助治疗后达到治愈目的。 2009年至2022年12月。其中，45例患者接受近端胃切除术（PG），285例患者接受全胃切除术（TG）。本研究中，45例患者接受近端胃切除术（PG），285例患者接受全胃切除术（TG）。经过倾向评分匹配后，110 名患者（71 名 TG 和 39 名 PG）被纳入分析。 PG 和 TG 在短期结果和长期预后方面没有显着差异。具体来说，PG 的总体生存率与 TG 相当（P = 0.47）。亚组分析显示，虽然没有统计学意义，但对于肿瘤长径小于 4 cm 的患者，PG 在总生存期方面表现出优于 TG 的潜在优势 (P = 0.31)。然而，对于长径大于 4 cm 的个体，TG 的存活概率更高（P = 0.81）。在基线特征、手术安全性、术后恢复和术后并发症方面没有观察到实质性差异。对于对新辅助治疗有客观反应的局部晚期近端GC（长径<4cm），PG是一种替代手术方式。需要进一步的研究和前瞻性研究来验证这些发现并指导临床决策。版权所有 © 2024 中华医学会，由 Wolters Kluwer, Inc. 根据 CC-BY-NC-ND 许可制作。

Neoadjuvant therapy enhances the possibility of achieving radical resection and improves the prognosis for locally advanced gastric cancer (GC). However, there is a lack of evidence regarding the optimal extent of resection for locally advanced proximal GC after neoadjuvant therapy.In this study, 330 patients underwent resection in Peking University Cancer Hospital, with curative intent after neoadjuvant therapy for histologically confirmed proximal GC from January 2009 to December 2022. Among them, 45 patients underwent proximal gastrectomy (PG), while 285 underwent total gastrectomy (TG).In this study, 45 patients underwent proximal gastrectomy (PG), while 285 underwent total gastrectomy (TG). After propensity-score matching, 110 patients (71 TG and 39 PG) were included in the analysis. No significant differences between PG and TG regarding short-term outcomes and long-term prognosis were found. Specifically, PG demonstrated comparable overall survival to TG (P = 0.47). Subgroup analysis revealed that although not statistically significant, PG showed a potential advantage over TG in overall survival for patients with tumor-long diameters less than 4 cm (P = 0.31). However, for those with a long diameter larger than 4 cm, TG had a better survival probability (P = 0.81). No substantial differences were observed in baseline characteristics, surgical safety, postoperative recovery, and postoperative complications.For locally advanced proximal GC with objective response to neoadjuvant therapy (long diameter <4 cm), PG is an alternative surgical procedure. Further research and prospective studies are warranted to validate these findings and guide clinical decision-making.Copyright © 2024 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.