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Abstract
BackgroundAlthough cardiac cancer of the remnant stomach and primary cardiac cancer both occur in the same position, their clinical characteristics and outcomes have not been compared previously. The objective of this study was designed to evaluate the prognosis of cardiac cancer of the remnant stomach in comparison with primary cardiac cancer.MethodsIn this retrospective comparative study, clinical data and prognosis were compared in 48 patients with cardiac cancer of the remnant stomach and 96 patients with primary cardiac cancer who underwent radical resection from January 1995 to June 2007. Clinicopathologic characteristics, survival times, mortality, and complications were analyzed.ResultsThe 5-year survival rate was significantly higher in patients with primary cardiac cancer than in those with cardiac cancer of the remnant stomach (28.4% vs. 16.7%, P = 0.035). Serosal invasion, lymph node metastasis and tumor location were independent prognostic factors for survival. Subgroup analysis, however, showed similar survival rates in patients with primary cardiac cancer and cardiac cancer of the remnant stomach without serosal invasion (25.0% vs. 43.8%, P = 0.214) and without lymph node metastasis (25.0% vs. 38.8%, P = 0.255), as well as similar complication rates (20.8% vs. 11.5%, P = 0.138).ConclusionAlthough the survival rates after radical resection in patients with cardiac cancer of the remnant stomach were poorer than in those with primary cardiac cancer, they were similar in survival rates when patients without serosal invasion or lymph node metastasis. Therefore, early detection is an important way to improve overall survival in cardiac cancer of the remnant stomach.
Highlights
Cardiac cancer of the remnant stomach and primary cardiac cancer both occur in the same position, their clinical characteristics and outcomes have not been compared previously
Gastric remnant cancer is defined as a carcinoma detected in the remnant stomach more than 5 years after primary surgery for a benign disease or 10 years after primary surgery for a malignant disease, regardless of the pattern of the initial surgical resection or the type of reconstruction [2,3]
Impact of independent prognostic factors for survival in patients with cardiac cancer of the remnant stomach and primary cardiac cancer Subgroup analysis, showed the 5-year survival rates in patients with cardiac cancer of the remnant stomach and primary cardiac cancer were 15.0% and 25.0%, respectively (P = 0.041), with serosal invasion; and 10.7% and 21.6%, respectively (P = 0.013), with lymph node metastasis
Summary
Cardiac cancer of the remnant stomach and primary cardiac cancer both occur in the same position, their clinical characteristics and outcomes have not been compared previously. Due to a lack of specific symptoms, most patients are initially diagnosed at an advanced stage, resulting in low rates of curative resection and in poor prognosis [11,12]. Both cardiac cancer of the remnant stomach and primary cardiac cancer occur in the upper third of the stomach, but their clinical characteristics and outcomes have not been compared previously. This study analyzed clinical data in 48 patients with cardiac cancer of the remnant stomach and 96 patients with primary cardiac cancer who underwent radical resection from January 1995 to June 2007, in order to evaluate differences in patient prognosis
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