Gastric Remnant Cancer Following a Partial Gastrectomy for Benign Gastroduodenal Disease

Moon, Duk Ju; Yoo, Chang Hak; Noh, Sung Hoon; Min, Jin Sik

Abstract

BACKGROUND: Gastric cancer that occurs 5 or more years after a partial gastric resection for benign disease is defined as gastric remnant cancer. The purpose of this study was to examine the clinicopathologic features and the treatment results of sixteen cases of gastric remnant cancer following partial gastrectomies for benign gastroduodenal diseases.
METHODS
Sixteen patients who underwent operations for gastric cancer in the remnant stomach from January 1980 to December 1996 were evaluated retrospectively.
RESULTS
The mean age was 51.5 years, and 15 patients were male. All of them had undergone surgical treatment for benign disorders, including gastric ulcers (14 cases) and duodenal ulcers (2 cases), and the mean time interval between the primary operation and the diagnosis of gastric cancer was 24.5 years. Most patients presented vague, nonspecific symptoms, except two cases of early diagnosis without symptom. Surgical resection of the remnant stomach was performed in 13 patients of which 11 patients underwent a curative resection with curative intent. Of these 13 patients, a combined resection of adjacent organs was performed in 10 cases. Fifteen patients had advanced gastric cancer, most of which involved depth of invasions to seromuscular layers, and lymph-node metastases were found in 8 patients. Most of patients who underwent bypass surgery or palliative resection died within 1 year of the operation. Among the 11 patients who underwent a curative resection, 3 patients died within 1 month of the operation due to postoperative complications, 2 patients died of recurrent cancer, and another 6 patients are alive without evidence of recurrence.
CONCLUSIONS
Eearly detection of gastric cancer in the remnant stomach by periodic follow up is important, especially in high-risk groups, and the application of aggressive surgical treatment will provide for better patient survival.