Xu Dong-kui, Zhao Ping, Wang Cheng-feng, Shao Yong-fu, Lin Hong-wei, Tian Yan-tao
Department of Abdominal Surgical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2006 Nov;28(11):852-4.
To investigate the clinicopathological characteristics and prognostic factors of remnant stomach cancer.
The clinicopathological and prognosis data of 45 patients with remnant stomach cancer were retrospectively analyzed.
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).
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.
探讨残胃癌的临床病理特征及预后因素。
回顾性分析45例残胃癌患者的临床病理及预后资料。
残胃癌好发于男性，男女比例为44∶1。患者初次手术方式为毕Ⅱ式胃大部切除术40例，毕Ⅰ式胃大部切除术4例，近端胃大部切除术1例。初次手术至残胃癌诊断时间为5～42年，平均23年。45例患者中，吻合口处病变28例，贲门部9例，其他部位8例；行根治性切除19例，姑息性切除16例，单纯探查10例，另有1例行残胃空肠吻合术。组织学类型包括：未分化腺癌1例，低分化腺癌36例，中分化腺癌7例，高分化腺癌1例。根治性切除患者的1、3、5年生存率明显优于姑息性切除患者，分别为100%对62.5%、78.8%对25%、47.2%对0（P＜0.05）。10例未切除患者均在2年内死亡，平均生存时间12个月。Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的5年生存率分别为100%、75%、17.8%、0（P＜0.05）。
残胃癌好发于男性，多在毕Ⅱ式胃切除术后10年左右发生。病变主要位于吻合口处。低分化腺癌是进展期残胃癌的主要组织学类型。残胃癌预后与pTNM分期及是否行根治性切除有关，早期残胃癌患者行根治性切除可长期生存。
