An Ji Yeong, Choi Min-Gew, Noh Jae Hyung, Sohn Tae Sung, Kim Sung
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea.
Am J Surg. 2007 Aug;194(2):143-7. doi: 10.1016/j.amjsurg.2006.10.034.
Although the prognosis for patients with remnant gastric cancer has been considered to be poor, few reports exist concerning outcomes of these patients. The objective of this study was to evaluate clinicopathologic features and prognostic outcomes of patients with remnant primary gastric cancer compared with the same findings for patients with upper-one third cancer of the stomach.
Thirty-eight patients with remnant primary gastric cancer and 794 patients with primary upper one-third cancer who underwent surgery at Samsung Medical Center between 1995 and 2004 were enrolled in this study. Clinicopathologic characteristics, tumor stages, and survival times were analyzed.
The mean interval between previous gastrectomy and diagnosis of remnant primary gastric cancer was 18.8 years for patients who had undergone their first gastrectomy for malignant disease (n = 13) and 28.6 years for patients with benign disease (n = 25). Patients with remnant primary gastric cancer showed a greater male predominance compared with patients having upper one-third cancer (92.1% vs 65.5%, respectively, P = .001). Patient distribution according to operative curability, tumor size, stage, and histology showed no significant differences between the 2 groups. Overall 5-year survival rates of patients with remnant primary gastric cancer and those with upper one-third cancer were 53.7% and 62.9% (P = .346), respectively. Differences in the 5-year survival rates at each stage between the groups were not statistically significant.
Operative curability, tumor stages, and prognoses of patients with remnant primary gastric cancer are similar to those having upper one-third cancer. Early diagnosis and an aggressive surgical approach may be important to achieve better outcomes for patients with remnant primary gastric cancer.
尽管残胃癌患者的预后一直被认为较差，但关于这些患者预后情况的报道较少。本研究的目的是评估残胃原发性癌患者的临床病理特征和预后结果，并与胃上三分之一癌患者的相同结果进行比较。
本研究纳入了1995年至2004年期间在三星医疗中心接受手术的38例残胃原发性癌患者和794例原发性胃上三分之一癌患者。分析了临床病理特征、肿瘤分期和生存时间。
因恶性疾病首次接受胃切除术的患者，从上次胃切除到残胃原发性癌诊断的平均间隔时间为18.8年（n = 13），因良性疾病接受胃切除术的患者为28.6年（n = 25）。与胃上三分之一癌患者相比，残胃原发性癌患者男性占比更高（分别为92.1%和65.5%，P = 0.001）。两组患者在手术可治愈性、肿瘤大小、分期和组织学方面的分布无显著差异。残胃原发性癌患者和胃上三分之一癌患者的总体5年生存率分别为53.7%和62.9%（P = 0.346）。两组在各阶段的5年生存率差异无统计学意义。
残胃原发性癌患者的手术可治愈性、肿瘤分期和预后与胃上三分之一癌患者相似。早期诊断和积极的手术方法对于残胃原发性癌患者取得更好的治疗效果可能很重要。
