title: Relationship between the histological type of initial lesions and the risk for the development of remnant gastric cancers after gastrectomy for synchronous multiple gastric cancers.
abstract: BACKGROUND
  Clinicopathological features of remnant gastric cancers after gastrectomy for synchronous multiple gastric cancers have not been fully addressed. In this study we evaluated the potential risk factors attributable to the development of remnant gastric cancers after initial gastrectomy for multiple gastric cancers.
  
  
  METHODS
  We retrospectively analyzed 3042 patients diagnosed with gastric cancers who underwent a gastrectomy. Of these, 922 total gastrectomy cases were excluded and the remaining 2120 cases were clinicopathologically investigated.
  
  
  RESULTS
  Among the 2120 patients, 1967 patients were histopathologically diagnosed with a solitary lesion and 153 patients with multiple lesions. The incidence of remnant gastric cancers was higher in patients with multiple lesions at initial surgery than in those with a solitary lesion (7/153 [4.5%] vs. 9/1967 [0.45%], p < 0.05). Among the patients with remnant gastric cancer, the percentages of cases with a combination of undifferentiated-type carcinoma (Type C), differentiated-type carcinoma (Type A), and differentiated- and undifferentiated-type carcinoma (Type B) as initial lesions were 15.0, 3.3, and 2.7%, respectively. Compared with those with no remnant gastric cancer, the incidence of the combination of undifferentiated-type carcinoma (Type C) as an initial lesion was significantly associated with a higher (p < 0.05) incidence of remnant gastric cancer.
  
  
  CONCLUSIONS
  As initial lesions, a combination of undifferentiated-type carcinoma was a potential risk factor for the development of remnant gastric cancers after initial gastrectomy.
authors.affiliation: Division of Digestive Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. takfujit@east.ncc.go.jp
authors.forename: Takeo
authors.initials: T
authors.lastname: Fujita
authors.forename: Naoto
authors.initials: N
authors.lastname: Gotohda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takahashi
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.forename: Masaru
authors.initials: M
authors.lastname: Konishi
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
mesh_terms: D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy; D018530:Gastric Stump / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*