Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy
Open Access
- 1 January 2012
- journal article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 18 (22), 2832-2836
- https://doi.org/10.3748/wjg.v18.i22.2832
Abstract
AIM: To re-evaluate the recent clinicopathological features of remnant gastric cancer (RGC) and to develop desirable surveillance programs. METHODS: Between 1997 and 2008, 1149 patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery, Kyoto Prefectural University of Medicine, Japan. Of these, 33 patients underwent gastrectomy with lymphadenectomy for RGC. Regarding the initial gastric disease, there were 19 patients with benign disease and 14 patients with gastric cancer. The hospital records of these patients were reviewed retrospectively. RESULTS: Concerning the initial gastric disease, the RGC group following gastric cancer had a shorter interval [P < 0.05; gastric cancer vs benign disease: 12 (2-22) vs 30 (4-51) years] and were more frequently reconstructed by Billroth-I procedure than those following benign lesions (P < 0.001). Regarding reconstruction, RGC following Billroth-II reconstruction showed a longer interval between surgical procedures [P < 0.001; Billroth-II vs Billroth-I: 32 (5-51) vs 12 (2-36) years] and tumors were more frequently associated with benign disease (P < 0.001) than those following Billroth-I reconstruction. In tumor location of RGC, after Billroth-I reconstruction, RGC occurred more frequently near the suture line and remnant gastric wall. After Billroth-II reconstruction, RGC occurred more frequently at the anastomotic site. The duration of follow-up was significantly associated with the stage of RGC (P < 0.05). Patients diagnosed with early stage RGC such as stage I-II tended to have been followed up almost every second year. CONCLUSION: Meticulous follow-up examination and early detection of RGC might lead to a better prognosis. Based on the initial gastric disease and the procedure of reconstruction, an appropriate follow-up interval and programs might enable early detection of RGC.Keywords
This publication has 18 references indexed in Scilit:
- Current State of Gastric Stump Carcinoma in Japan: Based on the Results of a Nationwide SurveyWorld Journal of Surgery, 2010
- Morbidity and mortality in the Italian Gastric Cancer Study Group randomized clinical trial of D1 versus D2 resection for gastric cancerBritish Journal of Surgery, 2010
- Clinicopathological Features and Surgical Outcomes of Patients with Remnant Gastric Cancer after a Distal GastrectomyAnnals of Surgical Oncology, 2008
- Endoscopic submucosal dissection for cancers of the remnant stomach after distal gastrectomyGastrointestinal Endoscopy, 2008
- Treatment of gastric remnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knifeWorld Journal of Gastroenterology, 2008
- Endoscopic resection of early gastric cancerGastric Cancer, 2007
- A Multicenter Study on Oncologic Outcome of Laparoscopic Gastrectomy for Early Cancer in JapanAnnals of Surgery, 2007
- Cancer of the gastric stump following distal gastrectomy for cancerBritish Journal of Surgery, 2006
- Global Cancer Statistics, 2002CA: A Cancer Journal for Clinicians, 2005
- Magnifying Endoscopy Combined with Narrow Band Imaging System for Early Gastric Cancer: Correlation of Vascular Pattern with Histopathology (including video)Endoscopy, 2004