Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy

• Published in: World journal of gastroenterology : WJG 2012-06, Vol.18 (22), p.2832-2836
• Main Authors: Komatsu, Shuhei, Ichikawa, Daisuke, Okamoto, Kazuma, Ikoma, Daito, Tsujiura, Masahiro, Nishimura, Yukihisa, Murayama, Yasutoshi, Shiozaki, Atsushi, Ikoma, Hisashi, Kuriu, Yoshiaki, Nakanishi, Masayoshi, Fujiwara, Hitoshi, Ochiai, Toshiya, Kokuba, Yukihito, Otsuji, Eigo
• Format: Article
• Language: English
• Subjects: Aged; Brief; Chi-Square Distribution; Disease Progression; Early Detection of Cancer; Female; Gastrectomy - adverse effects; Gastrectomy - mortality; Gastric Stump - pathology; Gastric Stump - surgery; Humans; Japan; Lymph Node Excision; Male; Middle Aged; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Neoplasm Staging; Reoperation; Retrospective Studies; Risk Assessment; Risk Factors; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Survival Analysis; Time Factors; Treatment Outcome; 切除术; 早期检测; 早期阶段; 时间间隔; 有限元分析; 胃癌; 远端; 随访
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i22.2832

AIM： TO re-evaluate the recent clinicopathological fea- tures of remnant gastric cancer （RGC） and to develop desirable surveillance programs.METHODS： Between 1997 and 2008, 1149 patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery, Kyoto Prefectural Uni- versity of Medicine, Japan. Of these, 33 patients un- derwent gastrectomy with lymphadenectomy for RGC. Regarding the initial gastric disease, there were 19 patients with benign disease and 14 patients with gas- tric cancer. The hospital records of these patients were reviewed retrospectively. RESULTS： Concerning the initial gastric disease, the RGC group following gastric cancer had a shorter in- terval [P 〈 0.05; gastric cancer vs benign disease： 12 （2-22） vs 30 （4-51） years] and were more frequently reconstructed by Billroth- I procedure than those fol- lowing benign lesions （P 〈 0.001）. Regarding recon- struction, RGC following Billroth-]_l reconstruction showed a longer interval between surgical procedures [P 〈 0.001; Billroth-11 vs Billroth- I ： 32 （5-51） vs 12 （2-36） years] and tumors were more frequently associated with benign disease （P 〈 0.001） than those following Billroth- I reconstruction. In tumor location of RGC, after Billroth- I reconstruction, RGC occurred more fre- quently near the suture line and remnant gastric wall. After Billroth- 1I reconstruction, RGC occurred more fre- quently at the anastomotic site. The duration of follow- up was significantly associated with the stage of RGC （P 〈 0.05）. Patients diagnosed with early stage RGC such as stage Ⅰ-Ⅱ tended to have been followed up almost every second year. CONCLUSION： Meticulous follow-up examination and early detection of RGC might lead to a better prognosis. Based on the initial gastric disease and the procedure of reconstruction, an appropriate follow-up interval and programs might enable early detection of RGC.