Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

Clinicopathologic Analysis of Remnant Gastric Cancer after Distal Partial Gastrectomy: Experience of Single Center during 15 Years

  • Choi, Seung-Hui (Department of Surgery, School of Medicine, Ajou University) ;
  • Kim, Tae-Gyun (Department of Surgery, School of Medicine, Ajou University) ;
  • Kim, June-Young (Department of Surgery, School of Medicine, Ajou University) ;
  • Hur, Hoon (Department of Surgery, School of Medicine, Ajou University) ;
  • Han, Sang-Uk (Department of Surgery, School of Medicine, Ajou University) ;
  • Cho, Yong-Kwan (Department of Surgery, School of Medicine, Ajou University) ;
  • Kim, Myung-Wook (Department of Surgery, School of Medicine, Ajou University)
  • Received : 2010.05.17
  • Accepted : 2010.06.07
  • Published : 2010.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Remnant gastric cancer (RGC) are generally detected at advanced stages or infiltration of adjacent organs. We retrospectively reviewed the surgical outcomes and clinicopathologic results of remnant gastric cancers that have operated during fourteen years in one institution of Korea. Materials and Methods: 34 patients who were diagnosed with RGC at Ajou University Hospital from April 1995 to October 2009 were enrolled. We analyzed the features of previous operation, and according to these results, surgical outcomes and clinicopathologic results for RGC were analyzed. Results: Of 34 patients, 20 patients had previously undergone distal gastrectomy for malignant disease, and 14 patients for benign disease. The period between previous operation and surgery for RGC in the patients underwent operation for malignant disease was shorter than that in benign patients (P<0.001). In surgical field, 31 patients (91.0%) were resected and curative resection was possible in 23 patients (67.6%). When 31 patients who underwent resection for RGC were divided into previous malignant and benign disease, there was no significantly different in terms of surgical outcomes and pathologic findings between two groups. Meanwhile, the patients who recently (after 2005) underwent surgery for RGC showed less advanced stage compared with the patients who underwent surgery before 2004. Conclusions: Resection was possible in the higher proportion (91.0%) of patients diagnosed with RGC compared with previous reports. The cause of previous operation did not effect on the surgical outcomes for surgery of RGC. Recent trend of RGC is to increase the proportion of early stage gastric cancer. Therefore, surgeons should consider curatively surgical resection for RGC the regardless of pattern of previous operation.

Keywords

References

  1. Park CH, Song KY, Kim SN. Treatment results for gastric cancer surgery: 12 years' experience at a single institute in Korea. Eur J Surg Oncol 2008;34:36-41. https://doi.org/10.1016/j.ejso.2007.03.004
  2. Kim JP. Current status of surgical treatment of gastric cancer. J Surg Oncol 2002;79:79-80. https://doi.org/10.1002/jso.10050
  3. Landau E, Sullivan ME, Dwight RW, Donaldson RM Jr. Partial gastrectomy for duodenal ulcer. Comparison of late results in relation to the indication for surgery. N Engl J Med 1961;264:428-430. https://doi.org/10.1056/NEJM196103022640902
  4. Ahn HS, Kim JW, Yoo MW, Park DJ, Lee HJ, Lee KU, et al. Clinicopathological features and surgical outcomes of patients with remnant gastric cancer after a distal gastrectomy. Ann Surg Oncol 2008;15:1632-1639. https://doi.org/10.1245/s10434-008-9871-8
  5. Kim W, Lee JH, Kim JJ, Chin HM, Jeon HM, Park CH, et al. Clinical analysis of the gastric stump cancer-classification proposed by the Korea gastric cancer association. J Korean Surg Soc 2004;66:177-182.
  6. Kim SS, Kim KR, Kim SJ, Kim JS, Mok YJ. Clinicopathologic study of remnant gastric cancer. J Korean Surg Soc 2003; 65:217-222.
  7. Lee KH, Lee JI, Bang HY, Noh WC, Hwang DY, Choi DW, et al. Clinical analysis of operative treatment of remnant gastric cancer. J Korean Cancer Assoc 1999;31:964-971.
  8. An JY, Youn HG, Ha TK, Choi MG, Kim KM, Noh JH, et al. Clinical significance of tumor location in remnant gastric cancers developed after partial gastrectomy for primary gastric cancer. J Gastrointest Surg 2008;12:689-694. https://doi.org/10.1007/s11605-007-0437-z
  9. Kaneko K, Kondo H, Saito D, Shirao K, Yamaguchi H, Yokota T, et al. Early gastric stump cancer following distal gastrectomy. Gut 1998;43:342-344. https://doi.org/10.1136/gut.43.3.342
  10. Sobin LH, Wittenkind CH; International Union Against Cancer (UICC), eds. TNM Classification of Malignant Tumors. 6th ed. New York: Wiley, 1997.
  11. Sinning C, Schaefer N, Standop J, Hirner A, Wolff M. Gastric stump carcinoma - epidemiology and current concepts in pathogenesis and treatment. Eur J Surg Oncol 2007;33:133- 139. https://doi.org/10.1016/j.ejso.2006.09.006
  12. Takeno S, Noguchi T, Kimura Y, Fujiwara S, Kubo N, Kawahara K. Early and late gastric cancer arising in the remnant stomach aft er distal gastrectomy. Eur J Surg Oncol 2006;32:1191-1194. https://doi.org/10.1016/j.ejso.2006.04.018
  13. Tanigawa N, Nomura E, Niki M, Shinohara H, Nishiguchi K, Okuzawa M, et al. Clinical study to identify specific characteristics of cancer newly developed in the remnant stomach. Gastric Cancer 2002;5:23-28.
  14. Ovaska JT, Havia TV, Kujari HP. Retrospective analysis of gastric stump carcinoma patients treated during 1946-1981. Acta Chir Scand 1986;152:199-204.
  15. Sasako M, Maruyama K, Kinoshita T, Okabayashi K. Surgical treatment of carcinoma of the gastric stump. Br J Surg 1991; 78:822-824. https://doi.org/10.1002/bjs.1800780718
  16. Viste A, Bjornestad E, Opheim P, Skarstein A, Thunold J, Hartveit F, et al. Risk of carcinoma following gastric operations for benign disease. A historical cohort study of 3470 patients. Lancet 1986;2:502-505.
  17. Matsui N, Yao T, Akazawa K, Nawata H, Tsuneyoshi M. Diff erent characteristics of carcinoma in the gastric remnant: histochemical and immunohistochemical studies. Oncol Rep 2001;8:17-26.
  18. Lacaine F, Houry S, Huguier M. Stomach cancer aft er partial gastrectomy for benign ulcer disease. A critical analysis of epidemiological reports. Hepatogastroenterology 1992;39:4-8.
  19. Lundegårdh G, Adami HO, Helmick C, Zack M, Meirik O. Stomach cancer after partial gastrectomy for benign ulcer disease. N Engl J Med 1988;319:195-200. https://doi.org/10.1056/NEJM198807283190402
  20. Toftgaard C. Gastric cancer after peptic ulcer surgery. A historic prospective cohort investigation. Ann Surg 1989; 210:159-164. https://doi.org/10.1097/00000658-198908000-00004
  21. Firat O, Guler A, Sozbilen M, Ersin S, Kaplan H. Gastric remnant cancer: an old problem with novel concerns. Langenbecks Arch Surg 2009;394:93-97. https://doi.org/10.1007/s00423-008-0382-7
  22. Siewert JR, Bottcher K, Stein HJ. Operative strategies. In: Wanebo HJ, editor. Surgery for Gastrointestinal Cancer. 1st ed. Philadelphia: Lippincott-Raven, 1997:319-325.
  23. Han SL, Hua YW, Wang CH, Ji SQ, Zhuang J. Metastatic pattern of lymph node and surgery for gastric stump cancer. J Surg Oncol 2003;82:241-246. https://doi.org/10.1002/jso.10228
  24. Park DJ, Lee HJ, Kim HH, Yang HK, Lee KU, Choe KJ. Predictors of operative morbidity and mortality in gastric cancer surgery. Br J Surg 2005;92:1099-1102. https://doi.org/10.1002/bjs.4952
  25. Lee HJ, Yang HK, Ahn YO. Gastric cancer in Korea. Gastric Cancer 2002;5:177-182. https://doi.org/10.1007/s101200200031

Cited by

  1. Clinicopathologic characteristics and prognosis of remnant gastric cancer vol.13, pp.2, 2017, https://doi.org/10.14216/kjco.17012