What is the recommended treatment for a gastric tumor that is less than 5 cm from the OG junction?

The recommended treatment for a gastric tumor located less than 5 cm from the gastroesophageal (OG) junction is total gastrectomy with lymphadenectomy. This approach is generally indicated due to the potential for high rates of lymphatic spread and the proximity of the tumor to the gastroesophageal junction, where significant anatomical structures are located.

Total gastrectomy involves the complete removal of the stomach, which is necessary in cases where there is a risk of cancer spreading to surrounding tissues or lymph nodes. Lymphadenectomy, which entails the removal of nearby lymph nodes, is crucial as it helps to ensure that any potential metastatic disease is addressed. This is essential for comprehensive cancer treatment and improving long-term outcomes for the patient.

Other treatment options, such as subtotal gastrectomy, standard gastrectomy, or localized radiation therapy, may not be as effective for tumors in this specific location. Subtotal gastrectomy would leave a portion of the stomach intact, which may not adequately address the cancer if it is closely associated with the OG junction. Standard gastrectomy, depending on the definition, may also not provide the same level of oncological clearance. Localized radiation therapy, while useful in certain contexts, is more common as an adjunct therapy