Clinicopathologic Study and Surveillance of Residual Gastric Cancer after Proximal Gastrectomy

Sakae Nagaoka, Takafumi Bandoh, Toru Isoyama, Takeshi Endoh, Keisuke Sakai, Yoshikazu Maruyama, Mitsuru Noji, Naohisa Takayama and Akira Toyoshima

Department of Gastroenterological Surgery, The Japanese Red Cross Medical Center

Of 15 patients with residual gastric cancer after gastrectomy due to gastric cancer at The Japanese Red Cross Medical Center, 4 underwent proximal gastrectomy in initial operation. We studied the clinicopathology of residual gastric cancer after proximal gastrectomy of the 4 cases. Results showed that patients with residual cancer after proximal gastrectomy had a 2.8% frequency of occurrence and a 2.9 years mean time between initial operation and residual gastrectomy (11 to 50 months). All cases had a location in a non anastomotic area. All cases were early cancer and 3 were undifferentiated cancer invading the submucosal layer. Only one case showed lymph node metastasis, and all 4 patients survived and showed no sign of recurrence (4 to 125 months). Initial reconstruction was esophagogastrostomy in all cases, so it was easy to observe residual stomach with gastroscope. We also reviewed 24 cases of residual gastric cancer after proximal gastrectomy in the Japanese literature. The average of time between initial operation and residual gastrectomy was 7 years. Patients had a high frequency rate of well differentiated adenocarcinoma and advanced cancer. It is important to detect residual gastric cancer immediately noting the features mentioned above.

Key words
carcinoma of residual stomach, carcinoma after proximal gastrectomy, multiple gastric cancer

Reprint requests
Sakae Nagaoka Department of Gastroenterological Surgery, The Japanese Red Cross Medical Center
4-1-22 Hiroo, Shibuya-ku, 150-8935 JAPAN

Accepted
April 27, 2005

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