Abstract
BackgroundSurvival rate of patients treated for gastric cancer has increased due to early detection and improvements of surgical technique and chemotherapy. Increase in survival rate has led to an increase in the risk for remnant gastric cancer (RGC). The purpose of this study was to investigate clinicopathologic features of RGC according to previous reconstruction method and factors affecting the interval from previous curative distal gastrectomy for gastric cancer to RGC occurrence.MethodsMedical records of patients diagnosed with RGC at Yeungnam University Medical Center from January 2000 to December 2017 who had a history of distal gastrectomy with D2 LN dissection due to gastric cancer were reviewed retrospectively.ResultsForty-eight patients were enrolled in this study. The mean interval of 48 RGC patients was 105.6 months (8.8 years). RGC after Billroth II reconstruction recurred more often at anastomosis site than RGC after Billroth I reconstruction (p = 0.001). The mean interval of RGC after Billroth I reconstruction was 67 months, shorter than 119 months of RGC after Billroth II reconstruction (p = 0.003). On the contrary, interval showed no difference according to stage of previous gastric cancer, remnant gastric cancer, or sex (p = 0.810, 0.145, and 0.372, respectively).ConclusionsRGC after Billroth I reconstruction tends to arise earlier at non-anastomosis site than RGC after Billroth II. Therefore, we should examine non-anastomosis site carefully from the beginning of surveillance after gastric cancer surgery with Billroth I reconstruction for better outcome.
Highlights
Gastric cancer is the fifth most common cancer and the third cause of death due to cancer in the world [1]
Interval of remnant gastric cancer (RGC)-M according to Lauren classification was 138.5 months for intestinal type, 76.2 months for diffuse type, and 103 months for mixed type, demonstrating statistically significant difference (p = 0.044, Cohen’s d = − 0.805, − 0.474)
There was no significant difference in the interval by previous proximal resection margin (PRM) or stage of previous gastric cancer or stage of RGC
Summary
Gastric cancer is the fifth most common cancer and the third cause of death due to cancer in the world [1]. It is especially common in the Republic of Korea and Japan compared with its population. It is the most common cancer in Korean males [2]. Remnant gastric cancer (RGC) is a carcinoma that develops in the remnant stomach after gastrectomy. Survival rate of patients treated for gastric cancer has increased due to early detection and improvements of surgical technique and chemotherapy. Increase in survival rate has led to an increase in the risk for remnant gastric cancer (RGC). The purpose of this study was to investigate clinicopathologic features of RGC according to previous reconstruction method and factors affecting the interval from previous curative distal gastrectomy for gastric cancer to RGC occurrence
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