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Different risks of nodal metastasis by tumor location in remnant gastric cancer after curative gastrectomy for gastric cancer

  • Kazuya Takahashi
  • Takaki YoshikawaEmail author
  • Shinji Morita
  • Takahiro Kinoshita
  • Masahiro Yura
  • Sho Otsuki
  • Masanori Tokunaga
  • Yukinori Yamagata
  • Akio Kaito
  • Hitoshi Katai
Original Article

Abstract

Background

Curative surgery for remnant gastric cancer (RGC) after gastrectomy for gastric cancer (GC) can be challenging. We examined the risk factors for lymph node metastasis in RGC, especially for tumors located at the greater curvature (G) or non-greater curvature (NG), to determine the appropriate indications of curative surgery.

Methods

Data from the two high-volume centers of Japan between 1998 and 2018 were retrospectively reviewed. Among the 137 patients enrolled in this study, 34 were classified as the G group and 103 as the NG group. The incidence of lymph node metastasis and its risk factors was evaluated.

Results

Lymph node metastasis was observed in 21.2% (29/137), including 38.2% (13/34) in the G group and 15.5% (16/103) in the NG group (p = 0.008). A logistic regression analysis showed that tumor location of G or NG (p = 0.042), tumor size (p = 0.002) and depth of invasion (p = 0.009) were significant independent risk factors for nodal metastasis. Risk classification using these factors showed that clinical T1–T2 with a maximum size < 35 mm located at the non-greater curvature had the lowest nodal metastatic risk (4.3%).

Conclusions

Tumor location at the G or NG was a significant risk factor for nodal metastasis in RGC. When selecting curative surgery for RGC, physicians should consider the nodal metastatic risk calculated by the tumor location, size and depth of invasion.

Keywords

Remnant gastric cancer Nodal metastasis Initial gastrectomy for gastric cancer 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the 1964 Declaration of Helsinki and later versions. Informed consent to be included in the study, or the equivalent, was obtained from all patients.

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019

Authors and Affiliations

  • Kazuya Takahashi
    • 1
  • Takaki Yoshikawa
    • 1
    Email author
  • Shinji Morita
    • 1
  • Takahiro Kinoshita
    • 2
  • Masahiro Yura
    • 1
  • Sho Otsuki
    • 1
  • Masanori Tokunaga
    • 2
  • Yukinori Yamagata
    • 1
  • Akio Kaito
    • 2
  • Hitoshi Katai
    • 1
  1. 1.Gastric Surgery DivisionNational Cancer Center HospitalTokyoJapan
  2. 2.Gastric Surgery DivisionNational Cancer Center Hospital EastKashiwaJapan

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