Short- and Long-term Outcomes of Surgical Treatment for Remnant Gastric Cancer After Distal Gastrectomy

Anticancer Res. 2019 Mar;39(3):1411-1415. doi: 10.21873/anticanres.13256.

Abstract

Background/aim: Remnant gastric cancer (RGC) after distal gastrectomy occurs in 1-2% of patients, while the biological features of RGC are unknown.

Patients and methods: A total of 22 consecutive patients with RGC who underwent total gastrectomy were analyzed. Their disease history included either gastric cancer (n=16) or peptic ulcer (n=6). Overall, 18 underwent open total gastrectomy (OTG) and 4 underwent laparoscopic total gastrectomy (LTG).

Results: The mean number of lymph nodes dissected and metastatic lymph nodes was larger in the Ulcer group than in the Carcinoma group (p<0.005). The mean operation time was longer in the LTG than OTG (p<0.005). The median blood loss tended to be smaller in the LTG (p=0.090). Five-year overall and recurrence-free survival rates were 94% and 81%, respectively.

Conclusion: The status of lymph node metastasis after surgery for RGC should be cautiously considered in the context of disease history. Both LTG and OTG can be treatment options for RGC.

Keywords: Remnant gastrectomy; laparoscopic operation; lymph node dissection; prognosis.

MeSH terms

  • Aged
  • Female
  • Gastrectomy*
  • Gastric Stump / pathology
  • Gastric Stump / surgery*
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis* / pathology
  • Male
  • Peptic Ulcer / pathology
  • Peptic Ulcer / surgery*
  • Stomach Neoplasms / surgery*
  • Treatment Outcome