Clinicopathological Characteristics of Remnant Gastric Cancer After a Distal Gastrectomy

• Published in: Journal of gastrointestinal surgery 2010-02, Vol.14 (2), p.277-281
• Main Authors: Ojima, Toshiyasu, Iwahashi, Makoto, Nakamori, Mikihito, Nakamura, Masaki, Naka, Teiji, Katsuda, Masahiro, Iida, Takeshi, Tsuji, Toshiaki, Hayata, Keiji, Takifuji, Katsunari, Yamaue, Hiroki
• Format: Article
• Language: English
• Subjects: Aged; Cancer; Female; Gastrectomy; Gastric Stump - pathology; Gastric Stump - surgery; Gastroenterology; Gastroscopy; Humans; Male; Medical research; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Original Article; Prognosis; Stomach Diseases - surgery; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgery
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-009-1090-5

Introduction The survival rate of patients with remnant gastric cancer (RGC) is unfavorable in comparison to that of cancer in the nonresected stomach. However, when RGC is curatively resected, no significant differences have been reported between both groups in regard to survival. The aim of this study is to analyze the clinicopathological factors influencing a curative resection of RGC. Methods Thirty-eight consecutive patients with RGC from January 1, 1994 through March 31, 2009 were enrolled in this retrospective study. Results Their primary diseases were gastric cancers (21; 55.3%) and benign diseases (17; 44.7%). The type of the reconstruction methods of first gastrectomy were Billroth I (28; 73.7%) and Billroth II (10; 26.3%). A total of 31 patients underwent a laparotomy. Twenty patients underwent a curative resection, four patients underwent a palliative resection, and seven underwent a nonresective operation. A total of seven patients underwent an endoscopic resection for early gastric cancer, and all patients received a curative resection. Univariate and multivariate logistic regression analyses were performed to identify the clinicopathological and background factors influencing a curative resection of RGC. A multivariate analysis revealed only an annual follow-up endoscopic examination after the initial gastrectomy to be an independent factor for a curative resection ( p  = 0.016; odds ratio, 35.3). Conclusions An annual follow-up endoscopic examination an after initial gastrectomy may be related to improving the prognosis of patients with RGC.