title: Incidence of metachronous gastric cancer in the remnant stomach after synchronous multiple cancer surgery.
abstract: BACKGROUND
  In the preoperative evaluation for gastric cancer, high-resolution endoscopic technologies allow us to detect small accessory lesions. However, it is not known if the gastric remnant after partial gastrectomy for synchronous multiple gastric cancers has a greater risk for metachronous cancer. The purpose of this study was to determine the incidence of metachronous cancer in this patient subset compared with that after solitary cancer surgery.
  
  
  METHODS
  Data on a consecutive series of 1,281 patients gastrectomized for early gastric cancer from 1991 to 2007 were analyzed retrospectively. The 715 gastric remnants after distal gastrectomy were periodically surveyed by endoscopic examination in Shikoku Cancer Center. Among those surveyed cases, 642 patients were pathologically diagnosed with solitary lesion (SO group) and 73 patients with synchronous multiple lesions (MU group) at the time of the initial surgery.
  
  
  RESULTS
  In the follow-up period, 15 patients in the SO group and 3 patients in the MU group were diagnosed as having metachronous cancer in the gastric remnant. The cumulative 4-year incidence rate was 1.9 % in the SO group and 5.5 % in the MU group. The difference did not reach the significant level by the log-rank test.
  
  
  CONCLUSIONS
  The incidence of metachronous cancer is higher after multiple cancer surgery; however, the difference is not statistically significant.
authors.affiliation: Department of Surgery, National Hospital Organization, Shikoku Cancer Center, 160 Minami-umemoto, Matsuyama, 791-0280, Japan, isnozaki@shikoku-cc.go.jp.
authors.forename: Isao
authors.initials: I
authors.lastname: Nozaki
authors.forename: Shinji
authors.initials: S
authors.lastname: Hato
authors.forename: Takaya
authors.initials: T
authors.lastname: Kobatake
authors.forename: Koji
authors.initials: K
authors.lastname: Ohta
authors.forename: Yoshirou
authors.initials: Y
authors.lastname: Kubo
authors.forename: Rieko
authors.initials: R
authors.lastname: Nishimura
authors.forename: Akira
authors.initials: A
authors.lastname: Kurita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D018530:Gastric Stump / Q000473:pathology*; D005773:Gastroscopy; D006801:Humans; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult