Which of the following statements about the surgical treatment of gastric cancer is false?

A. Patients with tumors of the middle and proximal thirds should undergo total gastrectomy.

DISCUSSION: Depending on the size and extent of the tumor, cancers of the gastroesophageal junction may extend proximally into the esophagus for a varying distance. Reconstruction may be required in the abdomen, chest, or neck, depending on extension and whether the operation is to be palliative or curative. Palliative resection yields better results than palliative bypass, which is unreliable for relieving obstruction. Japanese patients typically are younger and thinner than their Western counterparts. In addition, they have a higher prevalence (up to 50%) of early gastric cancer. Depending on the size and particular location of the tumor, patients with small middle-third tumors or small lesions of the cardia may undergo subtotal proximal gastrectomy and reconstruction with a gastric tube. If 6-cm. margins can be obtained on either side of the lesion, total gastrectomy is unnecessary and may be associated with a higher risk of morbidity.