The outcome of patients with remnant primary gastric cancer compared with those having upper one-third gastric cancer

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.