Clinicopathologic features of remnant gastric cancer over time following distal gastrectomy.

Abstract

To investigate remnant gastric cancer (RGC) at various times after gastrectomy, and lay a foundation for the management of RGC. Sixty-five patients with RGC > 2 years and < 10 years after gastrectomy (RGC I) and forty-nine with RGC > 10 years after gastrectomy (RGC II) who underwent curative surgery were enrolled in the study. The clinicopathologic factors, surgical outcomes, and prognosis were compared between RGC I and RGC II. There was no significant difference in surgical outcomes between RGC I and RGC II. For patients reconstructed with Billroth II, significantly more patients were RGC II compared with RGC (71.9% vs 21.2%, P < 0.001), and more RGC II patients had anastomotic site locations compared to RGC I (31.0% vs 56.3%, P = 0.038). The five-year survival rates for the patients with RGC I and RGC II were 37.6% and 47.9%, respectively, but no significant difference was observed. Borrmann type and tumor stage were confirmed to be independent prognostic factors in both groups. RGC II is located on the anastomotic site in higher frequency and more cases develop after Billroth II reconstruction than RGC I.