Clinicopathologic features of remnant gastric cancer over time following distal gastrectomy

Table 1 Number of patients according to the different periods and treatment type

Year	RGC I			RGC II
	Curative resection	PR or no resection	No operation	Curative operation	PR or no resection	No operation
1980-1990	6	6	5	3	3	4
1990-2000	12	3	3	11	2	2
2000-2010	22	4	2	18	3	3
Total	42	13	10	32	8	9

PR: Palliative resection; RGC I: Remnant gastric cancer 2-10 years after gastrectomy; RGC II: Remnant gastric cancer > 10 years after gastrectomy.

Table 2 Surgical outcomes of the patients n (%)

Parameters	RGC I	RGC II	P value
	(n = 55)	(n = 40)
Type of surgery			0.803
No resection	5 (9.1)	4 (10.0)
Bypass surgery	2	3
Open biopsy only	3	1
Palliative resection	8 (14.5)	4 (10.0)
Curative resection	42 (76.4)	32 (80.0)
Resection type			0.189
Resection of RG or gastrectomy	30	26
Extended gastrectomy	12	6
Splenectomy	3	2
Whipple	4	0
Segmental T-colon resection	2	2
Distal pancreatectomy	0	2
Left lateral sectionectomy of liver	2	0
Diaphragm excision	1	0

RG: Remnant gastric; RGC I: Remnant gastric cancer 2-10 years after gastrectomy; RGC II: Remnant gastric cancer > 10 years after gastrectomy.

Table 3 Clinicopathologic features n (%)

Parameters	RGC I	RGC II	P value
Sex			0.805
Male	29 (69.0)	21 (65.6)
Female	13 (31.0)	11 (34.4)
Age (yr), mean ± SD	60.5 ± 11.6	62.3 ± 13.4	0.103
Tumor size, cm			0.301
< 4.0	16 (38.1)	15 (46.9)
≥ 4.0	26 (61.9)	17 (53.1)
Tumor location			0.038
Anastomotic site	13 (31.0)	18 (56.3)
Non-anastomotic site	19 (45.2)	6 (18.7)
Total stump	10 (23.8)	8 (25.0)
Reconstruction of 1st operation
Billroth I	31 (78.8)	9 (28.1)	< 0.001
Billroth II	11 (21.2)	23 (71.9)
Borrmann type			0.322
I + II	15 (35.7)	14 (43.7)
III + IV	27 (64.3)	18 (56.3)
Histology grade			0.421
Differentiated	19 (45.2)	12 (37.5)
Undifferentiated	23 (54.8)	20 (62.5)
Lauren grade			0.308
Intestinal	20 (47.6)	18 (56.3)
Diffuse	22 (52.4)	14 (43.7)
Tumor stage			0.106
I + II	15 (35.7)	16 (50.0)
III + IV	27 (64.3)	16 (50.0)
1st tumor stage			0.006
I + II	13 (39.4)	17 (77.3)
III + IV	20 (60.6)	5 (22.7)

RGC I: Remnant gastric cancer 2-10 years after gastrectomy; RGC II: Remnant gastric cancer > 10 years after gastrectomy.

Table 4 Analysis of the prognostic factors

Parameters	RGC I			RGC II
	5-YSR	P value		5-YSR	P value
	(%)	UA	MA	(%)	UA	MA
Sex		0.574			0.179
Male	31.9			51.0
Female	51.9			43.6
Age, yr		0.854			0.467
< 60	40.8			44.4
≥ 60	34.2			49.2
Tumor size (cm)		0.018	0.235		0.009	0.653
< 4.0	59.8			60.0
≥ 4.0	23.7			35.2
Reconstruction of 1st operation		0.875			0.644
Billroth I	34.4			44.4
Billroth II	45.5			49.0
Borrmann type		0.015	0.004		0.031	0.013
I + II	57.4			66.7
III + IV	25.9			36.9
Histologic grade		0.035	0.532		0.044	0.254
Differentiated	53.3			66.7
Undifferentiated	24.3			36.9
Lauren grade		0.026	0.108		0.032	0.321
Intestinal	56.9			55.6
Diffuse	22.9			36.7
Tumor stage		0.015	< 0.001		0.009	< 0.001
I + II	67.0			67.3
III + IV	18.1			27.5

MA: Multivariate analysis; RGC I: Remnant gastric cancer 2-10 years after gastrectomy; RGC II: Remnant gastric cancer > 10 years after gastrectomy; UA: Univariate analysis; 5-YSR: Five-year survival rate.