CLINICOPATHOLOGICAL EVALUATION OF CANCER OF THE REMNANT STOMACH

Abstract

To clarify the pathogenesis of cancer of the remnant stomach, we clinicopathologically evaluated 16 patients more than 10 years postgastrectomy. Four had undergone gastrectomy for gastric cancer (group A) and 12 for peptic ulcer (group B). Patients in group B were older than in group A. Billroth-I method was used in 13 cases and Billroth-II method in 3 cases. Billroth-II method was not used in group A. The interval after gastrecotmy was 12.3±3.9 years in group A and 25.3±7.6 years in group B (p<0.001). Resectability was 100% in group A and 50% in group B. Nine patients located in the surgical stump and 7 at other sites. Early gastric cancer was found in 5 cases and advanced cancer in 11 cases. Invasive advanced cases, such as type 3 or 4, accounted for 58.3% in group B. Nine cases (56.3%) were curable and curability in group B was less than in group A. Undifferentiated adenocarcinoma was found in 12 cases (75.%) and it accounted for 83.3% in group B. Histological stage III and IV lesions accounted for 58.3% of the cases in group B. Five-year survival rates after operation were 75.0% in group A and 31.4% in group B. The survival rates for the early cases or for the curative cases were better in both group than for the advanced cases or for the noncurative cases. Appropriate follow up enabled early detection for cancer of the remnant stomach and improved results of therapy in postgastrectomy patients regardless of whether the reason for the gastrectomy was cancer or peptic ulcer.