Clinicopathologic differences between early gastric remnant cancer and early primary gastric cancer in the upper third of the stomach.
OBJECTIVE
This study was designed to clarify the clinicopathologic characteristics and survival in early gastric remnant cancer and compare with early primary cancer in the upper third of the stomach.


METHODS
Twenty-five patients with early gastric remnant cancer, who underwent resection at Kanagawa Cancer Center and First Department of Surgery, Yokohama City University between 1974 and 1996 were evaluated in this study. Various clinicopathologic characteristics, such as age, sex, symptoms, size of tumor, depth of invasion, lymph node metastasis, cell differentiation, and survival were investigated and early gastric remnant cancer was compared with early primary cancer in the upper third of the stomach.


RESULTS
According to the macroscopic type, protruded type such as I or II type accounted for a great majority in early gastric remnant cancer, while II c depressed type was common in early primary cancer in the upper third of the stomach, comprising 64.2% of all cases. Pathological examination disclosed that well-differentiated carcinoma and mucosal carcinoma were more frequently observed in early gastric remnant cancer than in early primary cancer in the upper-third of the stomach. The 5-year survival rate was 83.5% for early primary cancer in the upper-third of the stomach. In contrast, no patients experienced recurrence after operation for early gastric remnant cancer.


CONCLUSIONS
From the view point of clinicopathological evaluation, gastric remnant cancer is a special from of gastric cancer. A follow-up program is important in order to detect early gastric remnant cancer. A low incidence of lymph node metastasis suggests that endoscopic mucosal resection of the tumor or limited operation could be performed under strict indication.
Imada
T
T
First Department of Surgery, Yokohama City University, School of Medicine, Japan.
Rino
Y
Y
Hatori
S
S
Shiozawa
M
M
Takahashi
M
M
Amano
T
T
Kondo
J
J
Kobayashi
O
O
Sairenji
M
M
Motohashi
H
H
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis