A Clinical Study on the Malignant Potential of the Remnant Gastric Cancer

Yoshihiro Moriwaki, Takashi Suda, Fumihiko Kito, Toshio Imada, Kenzo Okada, Takako Okada, Kuniyasu Fukuzawa, Hirotoshi Akiyama, Hiroshi Takemura, Nobuko Nakamura*

Department of Surgery and Department of Pathology*, Saisei-kai Yokohama City Nanbu Hospital

We reviewed the records of 15 patients with remnant gastric cancer (R-cancer) who had survived more than 10 years after the first gastrectomy, compared with 123 patients with primary gastric cancer which was suspected to originate in the upper third of the stomach (C-cancer). Twenty-two percent of the cases of R-cancer were early cancer and there was no significant difference in the percentage of early cancers between the cases of R-cancer and C-cancer. The histologically differentiated type acounted for 67% of the R-cancer cases and INFα for 31% which was slightly higher than that of C-cancer case. But the resectability of R-cancer was 87%, significantly lower than that of C-cancer, 92%. In R-cancer cases the rate of curative resection was 67%, not significantly different from that of C-cancer cases. The survival rate for R-cancer patients was poorer than that for C-cancer patients until 1.5 years after the operation, but the long-term prognosis was almost equal for the two types. As the macroscopic forms of R-cancer cases were found to be Borrman 2 or 3, if the subjects were limited to those with Borrman 2 or 3, the prognosis for R-cancer patients was poorer. If they were limited to absolute curative cases, the prognosis was also poorer for the patients with R-cancer. By flow cytometry, aneuploid patterns were found in 75% of R-cancer patients and the mean value of the S-phase fraction (SPF) was 25%. Those values were higher than those of C-cancer and those reported for primary gastric cancer. These findings are thought to explain the high malignancy and poor prognosis of R-cancer.

Key words
malignant potential of remnant gastric cancer, DNA ploidy pattern of remnant gastric cancer

Reprint requests
Yoshihiro Moriwaki Department of Surgery, Saisei-kai Yokohama City Nambu Hospital
3-2-10 Kounandai, Kounan-ku, Yokohama, 233 JAPAN

Accepted
May 11, 1993

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