Remnant gastric cancer: An ordinary primary adenocarcinoma or a tumor with its own pattern?

World J Gastrointest Surg. 2021 Apr 27;13(4):366-378. doi: 10.4240/wjgs.v13.i4.366.

Abstract

Background: Remnant gastric cancer (RGC) is defined as a tumor that develops in the stomach after a previous gastrectomy and is generally associated with a worse prognosis. However, there little information available regarding RGCs and their prognostic factors and survival.

Aim: To evaluate the clinicopathological characteristics and prognosis of RGC after previous gastrectomy for benign disease.

Methods: Patients who underwent curative resection for primary gastric cancer (GC) at our institute between 2009 and 2019 were retrospectively evaluated. All RGC resections with histological diagnosis of gastric adenocarcinoma were enrolled in this study. Primary proximal GC (PGC) who underwent total gastrectomy was selected as the comparison group. Clinical and pathological data were collected from a prospective medical database.

Results: A total of 41 patients with RGC and 120 PGC were included. Older age (P = 0.001), lower body mass index (P = 0.006), hemoglobin level (P < 0.001), and number of resected lymph nodes resected (LN) (P < 0.001) were associated with the RGC group. Lauren type, pathological tumor-node-metastasis, and perioperative morbimortality were similar between RGC and PGC. There was no difference in disease-free survival (P = 0.592) and overall survival (P = 0.930) between groups. LN status was the only independent factor related to survival.

Conclusion: RGC had similar clinicopathological characteristics to PGC. Despite the lower number of resected LN, RGC had a similar prognosis.

Keywords: Gastric cancer; Gastric remnant; Gastric stump; Peptic ulcer; Remnant gastric cancer; Stomach neoplasms.