Clinicopathological features of gastric cancer in the remnant stomach

The clinicopathological features of 34 cases of gastric cancer in the remnant stomach were examined.Twenty-three patients who underwent primary gastrectomy for benign gastric disease (Group I) and 11 patients who received gastrectomy because of primary gastric cancer (Group II) were studied.The median age at diagnosis of gastric remnant cancer was 62.2 years in Group I and 63.7 years in Group II. The median time interval between the primary operation and the appearance of gastric cancer was 12.6 years in Group I and 6.5 years in Group II. Almost all patients were symptomatic; presenting epigastralgia and constriction. The first diagnostic procedure for these patients was barium examination of the remnant stomach except one patient diagnosed by emergency gastroscopy for hematemesis. Seventy percent of patients in Group I had advanced gastric cancer, most of which were invasive to seromuscular layers, whereas in Group II early gastric cancer was dominant (55%). The prognostic evaluation after the second surgery showed that patients with early stages of cancer had longer survival in both Groups.These results suggest that early detection of gastric cancer in the remnant stomach by periodical follow up is important and that the application of aggressive surgery for this disease will provide better patient survival.