Surgical results of remnant gastric cancer treatment

Ramos, Marcus Fernando Kodama Pertille; Pereira, Maria Claudia Machado; Oliveira, Yara Souza; Pereira, Marina Alessandra; Barchi, Leandro Cardoso; Dias, André Roncon; Zilberstein, Bruno; Ribeiro, Ulysses; Cecconello, Ivan

doi:10.1590/0100-6991e-20202703

Cited by 9 publications

(5 citation statements)

References 29 publications

(18 reference statements)

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“…In any case, the endoscopist should be more careful when performing ESD in the remnant stomach or gastric tube, to avoid perforations because of the previously mentioned anatomic features. On the other hand, the complication rate was higher in the present study than in surgery for primary EGC as reported, and the reason may be the formation of more extensive adhesions caused by the lymphadenectomy in the previous surgery [34].…”

Section: Discussioncontrasting

confidence: 58%

Comparison of Endoscopic Submucosal Dissection and Radical Surgery for Early Gastric Cancer in Remnant Stomach

Liu

Chen

Zhou

et al. 2022

JCM

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(1) Background: Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in the remnant stomach or gastric tube is not yet widespread and few studies have compared the short-term and long-term outcomes with radical surgery. (2) Methods: A total of 73 consecutive patients with EGC in the remnant stomach or gastric tube who underwent ESD or radical surgery between October 2009 and October 2020 were retrospectively analyzed in this study. Baseline characteristics, post-operative complications, quality of life (QOL), recurrence rate, overall survival (OS) and disease-free survival (DFS) were compared between the ESD and surgery groups. (3) Results: Among the 73 patients with EGC in the remnant stomach or gastric tube, 48 (65.8%) underwent ESD and 25 (34.2%) underwent surgery. The operation time (p = 0.000) and post-operative hospital stay (p = 0.002) of the ESD group were significantly shorter than those in the surgery group. The incidence of post-operative complications in the ESD group was significantly lower than that in surgery group (p = 0.001). The ESD group had significantly better functional scale scores and lower rates of fatigue, pain, appetite loss, financial difficulties, dysphagia, eating restrictions, hair loss, and poor body image than the surgery group. There was no significant difference in OS or DFS between the ESD and surgery groups (p = 0.124 and 0.344, respectively). (4) Conclusion: ESD can significantly shorten the operation time and hospital stay, reduce surgical complications, and provide better QOL for patients with EGC in the remnant stomach or gastric tube, and its long-term prognosis is no shorter than that of radical surgery.

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Section: Discussioncontrasting

confidence: 58%

Comparison of Endoscopic Submucosal Dissection and Radical Surgery for Early Gastric Cancer in Remnant Stomach

Liu

Chen

Zhou

et al. 2022

JCM

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“…The prognosis of GRC remains controversial. Some studies have reported that GRC shows similar prognosis to primary gastric cancer[ 20 - 22 ], whereas others have argued that the prognosis for GRC is worse[ 3 , 9 , 23 ]. In our study, we only enrolled patients with locally advanced GRC and 73.9% (67/74) of the patients were stage II or stage III.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of positive lymph node ratio in patients with locally advanced gastric remnant cancer

Zhuo,

Tian,

Han

et al. 2024

World J Gastrointest Oncol

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BACKGROUND Traditional lymph node stage (N stage) has limitations in advanced gastric remnant cancer (GRC) patients; therefore, establishing a new predictive stage is necessary. AIM To explore the predictive value of positive lymph node ratio (LNR) according to clinicopathological characteristics and prognosis of locally advanced GRC. METHODS Seventy-four patients who underwent radical gastrectomy and lymphadenectomy for locally advanced GRC were retrospectively reviewed. The relationship between LNR and clinicopathological characteristics was analyzed. The survival analysis was performed using Kaplan-Meier survival curves and Cox regression model. RESULTS Number of metastatic LNs, tumor diameter, depth of tumor invasion, Borrmann type, serum tumor biomarkers, and tumor-node-metastasis (TNM) stage were correlated with LNR stage and N stage. Univariate analysis revealed that the factors affecting survival included tumor diameter, anemia, serum tumor biomarkers, vascular or neural invasion, combined resection, LNR stage, N stage, and TNM stage (all P < 0.05). The median survival time for those with LNR0, LNR1, LNR2 and LNR3 stage were 61, 31, 23 and 17 mo, respectively, and the differences were significant (P = 0.000). Anemia, tumor biomarkers and LNR stage were independent prognostic factors for survival in multivariable analysis (all P < 0.05). CONCLUSION The new LNR stage is uniquely based on number of metastatic LNs, with significant prognostic value for locally advanced GRC, and could better differentiate overall survival, compared with N stage.

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“…It is technically difficult due to previous surgery, but possible if diagnosed early in a well-performing patient. Short-term outcomes such as hospital stay, 30-day mortality, and long-term outcomes such as disease-free survival and overall survival were similar between primary gastric cancer and GSC patient groups when curative resection of GSC is possible [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…The interval between the first and second surgeries in the patient population varied significantly depending on the underlying disorder (p <0.001). Patients with a history of benign disease developed GSC median 30 years after previous surgery (mean 24.42 ± 9.44 years). On the other hand, all patients with a history of gastric cancer developed GSC by 5-10 years of primary surgery (mean 6.0 ± 0.96).…”

Section: Demographicsmentioning

confidence: 99%

Clinicopathological Predisposing Factors for Gastric Stump Cancer and Its Management: A Single-Center Analytical Study

Sangu,

Rathinasamy

et al. 2023

Cureus

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Background The incidence of gastric stump carcinoma (GSC) is not declining because of the long latency period. The survival rate of treated gastric cancer patients has increased due to early detection and improvements in surgical techniques and chemotherapy. Increased survival rates and improved surveillance following gastric surgery have increased the incidence of GSC. Aim The study aims to investigate the clinicopathological factors affecting the interval between index gastric surgery and the occurrence of GSC, and our experience in the management of GSC is presented. Methods A retrospective review of patients diagnosed with GSC in our institution was completed. Patient characteristics and clinicopathological outcomes were analyzed. Results A total of 28 patients were included in this cohort with 17 (60.71%) males and 11 (39.28%) females. The mean interval from index surgery to the incidence of GSC was 24.42 years for benign etiology and six years for malignant etiology. Index surgeries were truncal vagotomy with 14 gastrojejunostomies (50%) and 14 subtotal gastrectomies (50%). The interval between index surgery and the incidence of GSC is not statistically significant concerning the type of surgery (p: 0.661), pathological TNM (tumor, nodes, metastases) stage (p: 0.520), pathological differentiation (p: 0.828), lymphovascular invasion (p: 0.252), perineural invasion (p: 0.672), and adjuvant therapy (p: -0.655). Survival was significantly higher in those patients who received curative resection in comparison to a palliative procedure (p: 0.041). Conclusion Strict surveillance for at least 10 years after initial gastric surgery is of utmost importance as half of the patients fated to develop GSC will do so within this time. In those patients with early diagnosis, no evidence of metastasis, and good performance status, curative surgery is feasible with acceptable morbidity.

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Surgical results of remnant gastric cancer treatment

Cited by 9 publications

References 29 publications

Comparison of Endoscopic Submucosal Dissection and Radical Surgery for Early Gastric Cancer in Remnant Stomach

Comparison of Endoscopic Submucosal Dissection and Radical Surgery for Early Gastric Cancer in Remnant Stomach

Predictive value of positive lymph node ratio in patients with locally advanced gastric remnant cancer

Clinicopathological Predisposing Factors for Gastric Stump Cancer and Its Management: A Single-Center Analytical Study

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