A Retrospective Clinicopathologic Study of Remnant Gastric Cancer After Distal Gastrectomy

Introduction: Remnant gastric cancer (RGC) is a unique clinical entity with relatively less frequency in gastric cancer series and often reported to be detected at advanced stages and had poor prognosis. Methods: A total of 112 patients with RGCs from July 1991 to July 2008 were enrolled in this retrospective analysis. Results: A total number of 112 cases were composed of 20 (17.8%) differentiated carcinomas and 92 (82.2%) undifferentiated carcinomas. There are 64 (57.1%) patients with tumor at anastomotic site and 48 (42.9%) tumor at nonanastomotic site. The diameter of tumors was >= 4 cm in 83 (74.1%) patients. Borrmann III, IV accounted for 70.5% and 17.8% respectively. Three (2.6%) patients were classified as stage I, 16 as stage II (14.2%), 62 as stage III (55.3%), and 31 (27.6%) as stage IV. Percentage of T4 stage was 57.1%. Distant metastasis rate and lymph node metastasis rate were 27.6% and 58.9%, respectively. There were numerous clinicopathologic differences according to different original disease, initial reconstruction, and tumor location. The median overall survival time was 27.9 months. TNM stage and option of treatments were independent prognostic factors in multivariable analysis. Conclusions: The lifelong annual follow-up endoscopic examinations after the initial gastrectomy and radical resection may help to improve the prognosis of RGCs.