Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2021; 13(4): 366-378
Published online Apr 27, 2021. doi: 10.4240/wjgs.v13.i4.366
Remnant gastric cancer: An ordinary primary adenocarcinoma or a tumor with its own pattern?
Marcus Fernando Kodama Pertille Ramos, Marina Alessandra Pereira, Andre Roncon Dias, Anna Carolina Batista Dantas, Daniel Jose Szor, Ulysses Ribeiro Jr, Bruno Zilberstein, Ivan Cecconello
Marcus Fernando Kodama Pertille Ramos, Marina Alessandra Pereira, Andre Roncon Dias, Anna Carolina Batista Dantas, Daniel Jose Szor, Ulysses Ribeiro Jr, Bruno Zilberstein, Ivan Cecconello, Department of Gastroenterology, Instituto do Cancer, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo 01249000, Brazil
Author contributions: Ramos MFKP contributed to the study design; Ramos MFKP and Pereira MA contributed to data retrieval, critical analysis, statistical analysis, and drafting the manuscript; Dias AR, Dantas ACB, and Szor DJ contributed to data retrieval and manuscript review; Ribeiro Jr U, Zilberstein B, and Cecconello I contributed to critical analysis and manuscript review.
Institutional review board statement: The study was approved by the hospital ethics committee and registered online (https://plataformabrasil.saude.gov.br; CAAE: 25516719.3.0000.0065).
Informed consent statement: Informed consent was waived by the local Ethics Committee given the retrospective nature of the study.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Marina Alessandra Pereira, MSc, Research Scientist, Department of Gastroenterology, Instituto do Cancer, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 251 Av Dr Arnaldo, São Paulo 01246000, Brazil. ma.ap@hotmail.com
Received: November 8, 2020
Peer-review started: November 8, 2020
First decision: December 20, 2020
Revised: December 28, 2020
Accepted: January 21, 2021
Article in press: January 21, 2021
Published online: April 27, 2021
Abstract
BACKGROUND

Remnant gastric cancer (RGC) is defined as a tumor that develops in the stomach after a previous gastrectomy and is generally associated with a worse prognosis. However, there little information available regarding RGCs and their prognostic factors and survival.

AIM

To evaluate the clinicopathological characteristics and prognosis of RGC after previous gastrectomy for benign disease.

METHODS

Patients who underwent curative resection for primary gastric cancer (GC) at our institute between 2009 and 2019 were retrospectively evaluated. All RGC resections with histological diagnosis of gastric adenocarcinoma were enrolled in this study. Primary proximal GC (PGC) who underwent total gastrectomy was selected as the comparison group. Clinical and pathological data were collected from a prospective medical database.

RESULTS

A total of 41 patients with RGC and 120 PGC were included. Older age (P = 0.001), lower body mass index (P = 0.006), hemoglobin level (P < 0.001), and number of resected lymph nodes resected (LN) (P < 0.001) were associated with the RGC group. Lauren type, pathological tumor-node-metastasis, and perioperative morbimortality were similar between RGC and PGC. There was no difference in disease-free survival (P = 0.592) and overall survival (P = 0.930) between groups. LN status was the only independent factor related to survival.

CONCLUSION

RGC had similar clinicopathological characteristics to PGC. Despite the lower number of resected LN, RGC had a similar prognosis.

Keywords: Stomach neoplasms, Gastric remnant, Gastric cancer, Remnant gastric cancer, Peptic ulcer, Gastric stump

Core Tip: This is a retrospective study to evaluate the clinicopathological character-istics, surgical outcomes, and survival of remnant gastric cancer (RGC) after previous gastrectomy for benign disease. We compared the RGC patients with primary proximal gastric cancer (PGC) who underwent total gastrectomy. The findings indicated that RGC and PGC had similar clinicopathological characteristics, including Lauren type and pathological tumor-node-metastasis stage, but RGC patients were older and had a lower number of resected lymph nodes. Although RGC is generally associated with a worse prognosis, there was no significant difference in perioperative morbimortality and survival between the groups.