Risk factors for metachronous gastric cancer in the remnant stomach after early cancer surgery.
BACKGROUND
Early gastric cancer patients have a good prognosis after radical resection. However, if the patients have a gastric remnant after the surgery, the risk of metachronous gastric cancer remains. The aim of this study was to clarify the risk factors for metachronous gastric cancer after partial gastrectomy for early gastric cancer.


METHODS
Data on a series of 1281 consecutive gastrectomy patients with pathologically confirmed early gastric cancer from 1991 to 2007 in Shikoku Cancer Center were analyzed retrospectively.


RESULTS
The gastric remnants of 868 patients were periodically surveyed by endoscopic examination. Among those surveyed cases, 26 patients were diagnosed as having metachronous gastric cancer in the gastric remnant. They underwent curative resection by remnant gastrectomy (n = 13 patients) or endoscopic mucosal resection (n = 13 patients). Multivariate analysis showed that male sex, older age, submucosal invasion, and proximal gastrectomy were independent risk factors.


CONCLUSIONS
Our data suggested that more intensive endoscopic follow-up is needed for the remnant stomach in patients with these risk factors to detect metachronous gastric cancer at its early stage.
Nozaki
Isao
I
Department of Surgery, Division of Gastroenterology, National Hospital Organization, Shikoku Cancer Center, 160 Minami-umemoto, Matsuyama, 791-0280, Japan. isnozaki@shikoku-cc.go.jp
Nasu
Junichirou
J
Kubo
Yoshiro
Y
Tanada
Minoru
M
Nishimura
Rieko
R
Kurita
Akira
A
D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology; D018530:Gastric Stump; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D016609:Neoplasms, Second Primary; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery