Gastric remnant cancer as a metachronous multiple lesion.
The pathological characteristics and natural history of 35 gastric remnant cancers after partial gastrectomy for a malignant condition and 16 gastric cancers after gastrectomy for benign conditions were compared. Gastric remnant cancer following malignant disease was characterized by a well defined rather than diffuse appearance (in 43 versus 12 per cent of gastric remnant cancers after benign conditions, P < 0.05), location away from the anastomosis (83 versus 25 per cent, P < 0.05) and a shorter interval after the first operation (5-14 versus > or = 20 years, P < 0.01). The 15- and 16-year survival rates appeared to be worse for gastric remnant cancer after malignant than after benign disease, but there was no statistically significant difference between the two groups in a generalized Wilcoxon test. In the former, direct invasion to adjacent organs was frequently observed. These findings suggest that gastric remnant cancer after gastrectomy for malignancy may be a metachronous multiple lesion, while that following benign disease may occur as a new cancer caused by the partial gastrectomy. To improve the survival of patients with cancer after gastrectomy for malignancy, a rational extended operation may be useful.
Furukawa
H
H
Department of Surgery, Centre for Adult Diseases, Osaka, Japan.
Iwanaga
T
T
Hiratsuka
M
M
Imaoka
S
S
Ishikawa
O
O
Kabuto
T
T
Sasaki
Y
Y
Kameyama
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D013997:Time Factors