Clinicopathologic Study of Remnant Gastric Cancer

ABSTRACT

PURPOSE: Remnant gastric cancer (RGC) is usually diagnosed at an advanced stage, and consequently the prognosis is poor. This retrospective study was performed to evaluate the clinicopathological characteristics and prognosis of RGC. METHODS: A total of 39 patients, with RGC, were diagnosed after a partial gastrectomy, at the Dept. of Surgery, Korea University College of Medicine between September 1983 and December 2000 (7 for benign gastric diseases, the B group and 32 for gastric carcinoma, the M group). The clinicopathological features and 5-year survival rates were investigated for the two groups. RESULTS: The average age was 54.1+/-10.1, and a male predominance was shown. The latency period between the initial surgeries were 35.3+/-25.3 and 142.0+/-71.9 months for groups M and B, respectively. 21 (66%) of the tumors were located in the anastomosis site in the M group, with 4 (57.1%) in the non-anastomosis site in the B group. Significant differences were seen in the latency period and tumor location between the two groups. According to the operation method, RGC mainly developed in the non-anastomosis site in patients having undergone the Billroth I method, whereas it developed in the anastomosis site in cases having undergone the Billroth II method (P=0.047). The overall 5 year survival rate was 42.8%, 71.4% in the B group and 37.2% in the M group. CONCLUSION: There were differences in the latency periods and locations between the benign and malignant groups, and the prognosis with the remnant gastric cancer was no different from that of primary gastric cancer. These results suggest that the early detection of gastric cancer in the remnant stomach, by periodical follow up, is important.