Clinicopathological Features and Surgical Outcomes of Patients with Remnant Gastric Cancer after a Distal Gastrectomy
- 394 Downloads
The incidence of gastric cancer in the remnant stomach after distal gastrectomy is increasing. The aim of this study was to evaluate the clinicopathological features and surgical outcomes of remnant gastric cancer (RGC).
We reviewed the medical records of 58 patients who underwent laparotomy for RGC at Seoul National University Hospital between 2000 and 2005.
The mean interval between the first and second operations was 12.5 years, and the rate of RGC diagnosis by tests included the follow-up program was 41.4%. The 45 RGCs occurring after distal gastrectomy for initial gastric cancer had a shorter interval and were more frequently located at the non-anastomotic site than those following benign lesions (P <0.001 and P = 0.010). Of all patients, 41 (70.7%) underwent, and the overall 3-year survival rate was 62.4%. An early stage of the initial gastric cancer, no symptoms at diagnosis, curative resection, tumor size smaller than 6 cm, and an early TNM stage of the RGC were associated with longer survival; the initial gastric disease, the interval and the location of RGC were not.
The successful curative resection and an early stage of the RGC led to good outcomes. In considering the different latency periods of the two initial gastric diseases, appropriate follow-up programs should be developed.
KeywordsRemnant gastric cancer Survival Follow-up program
- 2.Ikeguchi M, Kondou A, Shibata S, Yamashiro H, et al. Clinicopathologic differences between carcinoma in the gastric remnant stump after distal partial gastrectomy for benign gastroduodenal lesions and primary carcinoma in the upper third of the stomach. Cancer 1994; 73:15–21PubMedCrossRefGoogle Scholar
- 8.Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma - 2nd English Edition. Gastric Cancer 1998; 1:10–24Google Scholar
- 15.Sobin LH, Wittekind C. (eds). TNM classification of malignant tumors(6th Edition), 2002Google Scholar
- 23.Nishidoi H, Koga S, Kaibara N. Possible role of duodenogastric reflux on the development of remnant gastric carcinoma induced by N-methyl-N’-nitro-N-nitroso-guanidine in rats. Journal of National Cancer Institute 1984; 72:1431–5Google Scholar