Department of Surgery, Division of Gastroenterology, National Hospital Organization, Shikoku Cancer Center, 160 Minami-umemoto, Matsuyama, 791-0280, Japan.
World J Surg. 2010 Jul;34(7):1548-54. doi: 10.1007/s00268-010-0518-0.
Early gastric cancer patients have a good prognosis after radical resection. However, if the patients have a gastric remnant after the surgery, the risk of metachronous gastric cancer remains. The aim of this study was to clarify the risk factors for metachronous gastric cancer after partial gastrectomy for early gastric cancer.
Data on a series of 1281 consecutive gastrectomy patients with pathologically confirmed early gastric cancer from 1991 to 2007 in Shikoku Cancer Center were analyzed retrospectively.
The gastric remnants of 868 patients were periodically surveyed by endoscopic examination. Among those surveyed cases, 26 patients were diagnosed as having metachronous gastric cancer in the gastric remnant. They underwent curative resection by remnant gastrectomy (n = 13 patients) or endoscopic mucosal resection (n = 13 patients). Multivariate analysis showed that male sex, older age, submucosal invasion, and proximal gastrectomy were independent risk factors.
Our data suggested that more intensive endoscopic follow-up is needed for the remnant stomach in patients with these risk factors to detect metachronous gastric cancer at its early stage.
早期胃癌患者经根治性切除后预后良好。然而，如果患者在手术后仍有残胃，那么发生异时性胃癌的风险仍然存在。本研究旨在阐明早期胃癌行胃部分切除术后发生异时性胃癌的危险因素。
回顾性分析了 1991 年至 2007 年在四国癌症中心接受病理证实的连续 1281 例胃切除术患者的数据。
对 868 例患者的残胃进行了定期内镜检查。在接受检查的病例中，26 例患者被诊断为残胃发生异时性胃癌。这些患者接受了残胃切除术（n=13 例）或内镜黏膜切除术（n=13 例）的治愈性切除。多因素分析显示，男性、年龄较大、黏膜下浸润和近端胃切除术是独立的危险因素。
我们的数据表明，对于存在这些危险因素的患者，需要更密集的内镜随访以早期发现残胃中的异时性胃癌。
