Newman E, Brennan M F, Hochwald S N, Harrison L E, Karpeh M S
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Am J Surg. 1997 Apr;173(4):292-7. doi: 10.1016/S0002-9610(96)00403-5.
Gastric cancer that occurs 5 or more years after distal gastric resection for benign disease is defined as gastric remnant carcinoma (GRC). The purpose of this study was to determine whether postresection outcome differs between GRC and primary proximal gastric cancer (PPGC).
Twenty-five patients with GRC who underwent resection between August 1985 and July 1994 were compared with 79 PPGC patients who underwent resection during the same time period.
Overall actuarial 5-year disease-specific survival was 63% for curatively resected GRC patients and 37% for the curatively resected PPGC patients (P = 0.1, log rank). No significant differences in survival were seen between the two groups when stratified for stage. On multivariate analysis of significant predictors of outcome for the 104 patients as a group, only the ability to do a curative resection was significant.
The outcome following resection of GRC is no different from that of other primary proximal gastric cancers of the same stage. Every effort should be made to perform a curative resection, as this is a significant predictor of outcome.
良性疾病远端胃切除术后5年或更长时间发生的胃癌被定义为残胃癌（GRC）。本研究的目的是确定GRC与原发性近端胃癌（PPGC）切除术后的结局是否存在差异。
将1985年8月至1994年7月期间接受手术切除的25例GRC患者与同期接受手术切除的79例PPGC患者进行比较。
根治性切除的GRC患者总体精算5年疾病特异性生存率为63%，根治性切除的PPGC患者为37%（P = 0.1，对数秩检验）。按分期分层时，两组生存率无显著差异。对这104例患者作为一个整体进行多因素分析，结果显示，仅根治性切除的能力具有显著意义。
GRC切除术后的结局与同期其他原发性近端胃癌的结局无差异。应尽一切努力进行根治性切除，因为这是结局的一个重要预测因素。
