Fujita Takeo, Gotohda Naoto, Takahashi Shinichiro, Nakagohri Toshio, Konishi Masaru, Kinoshita Taira
Division of Digestive Surgery, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan.
J Surg Oncol. 2009 Nov 1;100(6):466-71. doi: 10.1002/jso.21352.
Remnant gastric cancers have been extensively investigated; however, little has been unveiled the features of remnant gastric cancers with regard to the existence of synchronous multiple lesions. We evaluated the clinicopathological features of remnant gastric cancers, after initial gastrectomy for both single and multiple gastric cancers.
We retrospectively analyzed 3,042 patients diagnosed with gastric cancers who underwent gastrectomy. Of these, total gastrectomy cases were excluded, and remaining 2,120 cases were investigated.
Among the 2,120 patients, 1,967 patients were histopathologically diagnosed with solitary lesion and 153 patients with multiple lesions. The incidence of remnant gastric cancers was higher in patients with multiple lesions at initial surgery than those with solitary lesion (P < 0.05). Moreover, remnant cancers developed within shorter duration of follow-up after treatment of synchronous multiple lesions compared to those that developed after treatment of solitary lesions (P = 0.05). Among the patients treated for synchronous multiple lesions, distance from the oral margin was a potential risk factor for the development of secondary cancers in the remnant stomach.
Patients with synchronous multiple gastric cancers are more susceptible to the development of secondary cancers in their remnant stomach. These patients need careful follow-up after initial gastrectomy.
残胃癌已得到广泛研究；然而，关于同步多发病变的存在，残胃癌的特征鲜为人知。我们评估了初次胃切除术后单发和多发胃癌患者的残胃癌临床病理特征。
我们回顾性分析了3042例接受胃切除术的胃癌患者。其中，排除了全胃切除病例，对其余2120例进行了研究。
在2120例患者中，1967例经组织病理学诊断为单发病变，153例为多发病变。初次手术时多发病变患者的残胃癌发生率高于单发病变患者（P < 0.05）。此外，与单发病变治疗后相比，同步多发病变治疗后随访期间残癌发生时间更短（P = 0.05）。在同步多发病变治疗的患者中，距切缘距离是残胃发生继发性癌症的潜在危险因素。
同步多发胃癌患者更容易在残胃发生继发性癌症。这些患者在初次胃切除术后需要仔细随访。
