Considerations on the Management of Multiple Gastric Cancer from the Viewpoint of Postoperative Surveillance and Diagnosis of Remnant Cancer

Yasuhiro Kodera, Yoshitaka Yamamura, Akihito Torii, Katsuhiko Uesaka, Takashi Hirai, Kenzo Yasui, Takeshi Morimoto, Tomoyuki Kato, Tsuyoshi Kito

Department of Gastroenterological Surgery, Aichi Cancer Center

Multiple gastric cancer presents a great problem, due to the prevalence of various types of limited operations that leave patients with greater gastric remnants. Overlooking multiple lesions would lead to the emergence of remnant cancer. To obtain further information on this problem, we studied the clinicopathological features of multiple gastric cancer and remnant cancer diagnosed over the past 16 years. Multiple cancer was found in 6.4% of all the gastric cancer patients who underwent curative resection and gastric remnant cancer in 1.8 to 2.8% of the same population over the same period. These percentages do not add up to the unexpectedly high frequency of multiple cancer recently reported from histopathological studies of serially cut specimens. The other cancerous lesions are expected to have been resected unnoticed in the gastrectomies performed. This means that limited operations by wedge resection or endoscopy could leave the missed lesions untreated, leading to the increase in remnant cancer. The prognosis of remnant cancer has improved due to efforts to achieve early diagnosis. Such efforts would be mandatory if limited operations are to be justified.

Key words
multiple gastric cancer, gastric remnant cancer

Reprint requests
Yasuhiro Kodera Department of Gastroenterological Surgery, Aichi Cancer Center
1-1 Kanokoden, Chikusa-ku, Nagoya, 464 JAPAN

Accepted
June 14, 1995

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