Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2015; 21(19): 5972-5978
Published online May 21, 2015. doi: 10.3748/wjg.v21.i19.5972
Clinicopathologic features of remnant gastric cancer over time following distal gastrectomy
De-Wei Zhang, Biao Dong, Zhen Li, Dong-Qiu Dai
De-Wei Zhang, Biao Dong, Zhen Li, Dong-Qiu Dai, Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang 110032, Liaoning Province, China
Author contributions: Zhang DW and Dai DQ conceived the study; Zhang DW, Li Z, and Dong B collected and analyzed the data; Zhang DW, Dong B, and Dai DQ designed the study and participated in writing the paper; Zhang DW submitted the final manuscript and all authors read and approved the final manuscript.
Ethics approval: This retrospective study was approved by the Ethics Committee of The Fourth Affiliated Hospital, China Medical University. All patient records and information were anonymized and deidentified prior to analysis.
Informed consent: All study participants or their legal guardian provided informed written consent prior to this study.
Conflict-of-interest: All the authors declare that they have no conflict of interest.
Data sharing: Technical appendix, statistical methods, and some datasets are available from the corresponding author at syzhangdewei@sohu.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: De-Wei Zhang, Associate Professor, Associate Chief Physician, Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital of China Medical University, Chongshan East Road, Huanggu District, Shenyang 110032, Liaoning Province, China. syzhangdewei@sohu.com
Telephone: +86-24-62043191 Fax: +86-24-62043191
Received: December 20, 2014
Peer-review started: December 21, 2014
First decision: January 8, 2015
Revised: January 21, 2015
Accepted: February 13, 2015
Article in press: February 13, 2015
Published online: May 21, 2015
Processing time: 150 Days and 20.3 Hours
Abstract

AIM: To investigate remnant gastric cancer (RGC) at various times after gastrectomy, and lay a foundation for the management of RGC.

METHODS: Sixty-five patients with RGC > 2 years and < 10 years after gastrectomy (RGC I) and forty-nine with RGC > 10 years after gastrectomy (RGC II) who underwent curative surgery were enrolled in the study. The clinicopathologic factors, surgical outcomes, and prognosis were compared between RGC I and RGC II.

RESULTS: There was no significant difference in surgical outcomes between RGC I and RGC II. For patients reconstructed with Billroth II, significantly more patients were RGC II compared with RGC (71.9% vs 21.2%, P < 0.001), and more RGC II patients had anastomotic site locations compared to RGC I (31.0% vs 56.3%, P = 0.038). The five-year survival rates for the patients with RGC I and RGC II were 37.6% and 47.9%, respectively, but no significant difference was observed. Borrmann type and tumor stage were confirmed to be independent prognostic factors in both groups.

CONCLUSION: RGC II is located on the anastomotic site in higher frequency and more cases develop after Billroth II reconstruction than RGC I.

Keywords: Clinical pathology; Recurrence; Remnant gastric cancer; Survival

Core tip: This article is an important paper about clinicopathologic features of remnant gastric cancer (RGC) and the comparison of RGC with time interval of > 2 and ≤ 10 years (RGC I) after prior gastrectomy for gastric cancers. RGC after 10 years was easier to locate on the anastomotic site than RGC I. The predominant reconstruction type of the first operation is Billroth I for RGC I and Billroth II for RGC II. There may be different pathogeneses in different subgroups of RGC.