Clinicopathological characteristics of remnant gastric cancer after a distal gastrectomy.
BACKGROUND
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.
Ojima
Toshiyasu
T
Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
Iwahashi
Makoto
M
Nakamori
Mikihito
M
Nakamura
Masaki
M
Naka
Teiji
T
Katsuda
Masahiro
M
Iida
Takeshi
T
Tsuji
Toshiaki
T
Hayata
Keiji
K
Takifuji
Katsunari
K
Yamaue
Hiroki
H
D000368:Aged; D005260:Female; D005743:Gastrectomy; D018530:Gastric Stump / Q000473:pathology* / Q000601:surgery; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013272:Stomach Diseases / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*