[Clinicopathological characteristics and prognosis of remnant stomach cancer--report of 45 cases].

OBJECTIVE

To investigate the clinicopathological characteristics and prognostic factors of remnant stomach cancer.

METHODS

The clinicopathological and prognosis data of 45 patients with remnant stomach cancer were retrospectively analyzed.

RESULTS

The remnant stomach cancer are likely to develop in males with a ratio of male to female: 44:1. Their initial operation modes of these patients were Billroth II subtotal gastrectomy in 40 patients, Billroth I subtotal gastrectomy in 4 and proximal subtotal gastrectomy in 1. The interval from the initial operation to the diagnosis of remnant stomach cancer was 5 to 42 years with an average of 23 years. Of these 45 patients, 28 had lesion at anastomotic site, 9 in the gastric cardia and 8 in other locations; 19 had radical resection, 16 palliative resection and 10 exploration alone except one who had an anastomosis of remnant stomach with the jejunum. The histology types included: 1 un-differentiated adenocarcinoma, 36 poorly-differentiated adenocarcinoma, 7 moderately-differentiated adenocarcinoma and 1 well-differentiated adenocarcinoma. The 1-, 3-, 5-year survival rates of patients with radical resection were significantly better than those treated with palliative resection, which was 100% vs. 62.5%, 78.8% vs. 25%, 47.2% vs. 0, respectively (P < 0.05). All ten patients without resection died within 2 years with an average survival time of 12 months. The 5-year survival rate of stage I, II, III and IV was 100%, 75%, 17.8% and 0, respectively (P < 0.05).

CONCLUSION

Remnant stomach cancer prevalently occurs in the male usually 10 years after Birroth II gastrectomy. The lesions is mainly located at anastomotic site. Poorly-differentiated adenocarcinoma is found to be the prevalent histological type of advanced remnant stomach cancer. The prognosis of remnant stomach cancer is correlated with pTNM stage and whether having been treated with complete resection or not. Patients with early remnant stomach cancer may survive for a long time if radical resection can be done.