Remnant-stump gastric cancer following partial gastrectomy-clinicopathological studies

Forty-five cases of remnant-stump (R-S) gastric cancer were investigated retrospectively, comparing those which were initially benign (Group 1: 31 cases) with those which were initially malignant (Group 2: 14 cases). The incidence of R-S gastric cancer over all gastrectomy cases from 1967 to 1994 was 1.4% (45/3,282). The mean period until development of the R-S gastric cancer following partial gastrectomy was 21.6 years in Group 1 and was 15.8 years in Group 2 (p < 0.05). Of those R-S cases that underwent resection, total gastrectomy was selected for 82% in Group 1 and for 85% in Group 2. The incidence of negative lymph nodes was only 25% in Group 1 and 62% in Group 2 (p < 0.05). The pathological stage I was 21% in Group 1 and 54% in Group 2 (p < 0.05). The 5-year-survival rate was 32% in Group 1 and was 62% in Group 2 (p < 0.05). To improve the prognosis for R-S gastric cancer, periodic endoscopic follow-up examinations to find any R-S cancer at the earliest stage is most important, especially in cases of a partial gastrectomy for an initially benign case.