Gastric remnant cancer as a metachronous multiple lesion

• Published in: British journal of surgery Vol. 80; no. 1; p. 54
• Main Authors: Furukawa, H, Iwanaga, T, Hiratsuka, M, Imaoka, S, Ishikawa, O, Kabuto, T, Sasaki, Y, Kameyama, M
• Format: Journal Article
• Language: English
• Published: England 01-01-1993
• Subjects: Adult; Aged; Aged, 80 and over; Female; Gastrectomy - adverse effects; Gastrectomy - mortality; Humans; Male; Middle Aged; Risk Factors; Stomach Neoplasms - etiology; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Time Factors
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800800120

The pathological characteristics and natural history of 35 gastric remnant cancers after partial gastrectomy for a malignant condition and 16 gastric cancers after gastrectomy for benign conditions were compared. Gastric remnant cancer following malignant disease was characterized by a well defined rather than diffuse appearance (in 43 versus 12 per cent of gastric remnant cancers after benign conditions, P < 0.05), location away from the anastomosis (83 versus 25 per cent, P < 0.05) and a shorter interval after the first operation (5-14 versus > or = 20 years, P < 0.01). The 15- and 16-year survival rates appeared to be worse for gastric remnant cancer after malignant than after benign disease, but there was no statistically significant difference between the two groups in a generalized Wilcoxon test. In the former, direct invasion to adjacent organs was frequently observed. These findings suggest that gastric remnant cancer after gastrectomy for malignancy may be a metachronous multiple lesion, while that following benign disease may occur as a new cancer caused by the partial gastrectomy. To improve the survival of patients with cancer after gastrectomy for malignancy, a rational extended operation may be useful.