Analysis of Causes of Death in Patients Gastrectomized for Benign Gastroduodenal Diseases with Special Reference of Gastric Remnant Cancer

Takuji Iwase, Makoto Seki, Kunio Takagi, Tomoyuki Takahashi*

Department of Surgery, Cancer Institute Hospital
*Department of Surgery, Kasukabe Kosei Hospital

To clarify the risk for gastric remnant cancer, we investigated the long-term prognosis of patients gastrectomized for benign gastroduodenal diseases. 2,045 patients who underwent gastric surgery for benign diseases at the Cancer Institute Hospital, Tokyo, between 1946 and 1967 were followed up until the end of 1984. During the follow up period, 899 deaths were identified. There were 203 deaths from all cancers (22.7%) and 14 from gastric remnant cancer (1.6%). The relative risk of mortality was calculated as person-years at risk. A significant excess risk of dying from all cancers was observed among patients with an observation period of more than 20 years after surgery (O/E=1.46). Lung cancer mortality was significantly higher from the early postoperative stage (O/E=2.09). On the other hand, the risk of mortality from gastric cancer after gastrectomy was decreased both in the total cases (O/E=0.17) and in the cases in which more than 20 years had elapsed after surgery (O/E=0.27). The main cause of lower mortality from gastric remnant cancer was considered to be removal of the predisposing area of cancer in the stomach.

Key words
gastrectomy for benign diseases, cohort study, cancer mortality, gastric remnant cancer

Reprint requests
Takuji Iwase Department of Surgery, Cancer Institute Hospital
1-37-1 Kamiikebukuro, Toshimaku, Tokyo, 170 JAPAN

Accepted
September 12, 1990

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