Can we apply the same indication of endoscopic submucosal dissection for primary gastric cancer to remnant gastric cancer?

Choi, Yoon Young; Kwon, In Gyu; Lee, Sang Kil; Kim, Hyun Ki; An, Ji Yeong; Cheong, Jae‐Ho; Mliwa, Richard Thomas; Shin, Sung Kwan; Lee, Yong Chan; Hyung, Woo Jin; Noh, Sung Hoon

doi:10.1007/s10120-013-0265-7

Cited by 9 publications

(4 citation statements)

References 19 publications

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“…The incidence of lymph node metastasis in early RGC is similar to that of lymph node metastasis in primary early GC[33,34]. Lymph node metastasis of RGC is affected by the current disease stage, not by the initial disease stage.…”

Section: Endoscopic Submucosal Dissection For Gastric Stump Cancermentioning

confidence: 99%

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Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?

Líu

et al. 2019

WJCC

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The incidence of remnant gastric cancer (RGC) is still increasing. Minimally invasive approaches including endoscopic resection, laparoscopic and robotic approaches, and function-preserving gastrectomy have been utilized as curative treatment methods for primary gastric cancer. However, adhesions and anatomical alterations due to previous gastrectomy make the use of minimally invasive approaches complicated and difficult for RGC. Application of these approaches for the treatment of RGC is still controversial. Endoscopic submucosal dissection is a favorable alternative therapy for the resection of early gastric cancer that occurs in the remnant stomach and can prevent unnecessary complications. The majority of retrospective studies have shown that endoscopic submucosal dissection is an effective and oncologically safe treatment modality for RGC. Subtotal gastrectomy could serve as a function-preserving gastrectomy for patients with early RGC and improve postoperative late-phase function. However, there are only two studies that demonstrate the feasibility and oncological efficacy of subtotal gastrectomy for RGC. The non-randomized controlled trials showed that compared to open gastrectomy, laparoscopic gastrectomy for RGC led to better short-term outcomes and similar oncologic results. Because of the rarity of RGC, future multicenter studies are required to determine the indications of minimally invasive treatment for RGC.

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Section: Endoscopic Submucosal Dissection For Gastric Stump Cancermentioning

confidence: 99%

“…However, only one study determined the indication of ESD for RGC. The study found that 17 patients who met the indications of ESD for primary GC had no lymph node metastases after radical gastrectomy of remnant stomach[34].…”

Section: Endoscopic Submucosal Dissection For Gastric Stump Cancermentioning

confidence: 99%

Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?

Líu

et al. 2019

WJCC

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“…Data from 14 studies was pooled in to identify whether the histology of GRC was a risk factor. We analyzed patients who had a well differentiated histology and moderately differentiated histology versus patients who had a poorly differentiated histology and an undifferentiated histology [10,[12][13][14][15]16,18,19,21,24,[27][28][29][30][31]. The statistics showed patients who had a well/moderately differentiated histology were at a lesser risk of being diagnosed with GRC.…”

Section: Histology (Well/moderately Differentiated Versus Poorly Differentiated and Undifferentiated)mentioning

confidence: 99%

Risk factors of gastric remnant cancer: a meta-analysis and systematic review

Ghoorun¹,

Liao²,

Lin³

et al. 2015

Glob Surg

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Aim: To investigate the risk factors of gastric remnant cancer.Methods: A search on PubMed, Embase, ISI Web of SCIENCE, Cochrane Library, CNKI, and Wanfang was performed to identify relevant literature published from January 1990 to May 2014. The effect of gastric remnant cancer was estimated by risk ratio (RRs) with 95% confidence intervals (CIs) for each study using a fixed effects or random effects model.Results: 28 studies with a total of 1132 patients met the inclusion criteria in our study. The risk for gastric remnant cancer was positively associated with a male gender, an initial ulcerative disease, a previous Billroth II anastomosis. Gastric remnant cancer was also more likely to be located at the site of initial anastomosis and was associated with a poorly differentiated and/or undifferentiated histology. However no significance was observed between the TNM stage and the gastric remnant cancer. Conclusion:Meta-analysis found that gastric remnant cancer is associated with gender, reason for initial surgery, type of initial surgery performed, location, histology. Inclusion and exclusion criteriaAll included studies were about GRC or gastric stump cancer. Only full-text literatures were included. The selected studies had data on at least one of the following: gender, reason for initial surgery, type of surgery performed during the initial surgery, location of GRC, GRC histology.Excluded studies were of studies not meeting the definition of GRC, literature published before January 1990, case reports, GRC reviews, and other meta-analyses. Studies in which the data could not

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“…Moreover, endoscopic submucosal dissection (ESD) of the remnant stomach is technically difficult because of the limited working space, particularly for lesions that involve the suture line or anastomosis, which contains staples and may have severe fibrosis ( 15 ). However, the indications of ESD for primary GC can be applied to RGC ( 16 ). Compared with surgical treatment, ESD is considered a minimally invasive treatment even for early GC in the remnant stomach, based on the reported favorable long-term outcomes ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for remnant gastric cancer after distal gastrectomy for gastric cancer: a retrospective database review

Sakamoto,

Wada,

Omichi

et al. 2023

J Gastrointest Oncol

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Background The number of patients with remnant gastric cancer (RGC) following gastrectomy for gastric cancer (GC) is increasing due to the increasing number of patients undergoing function-preserving gastrectomy and improved outcomes for patients with GC. A few studies involving a small number of cases reported male sex, old age, differentiated type, tumor depth and synchronous multiple GC were associated with RGC development. However, the risk factors for RGC development had not been fully understood. This study aimed to examine the clinicopathological features, followed up patients with GC after they underwent distal gastrectomy (DG), and evaluated the potential risk factors for RGC development. Methods A retrospective database review of 438 patients who underwent DG for GC at a single institution, from 2006 to 2017, was conducted. We investigated the relationship of clinicopathological features, operative findings, and postoperative course with RGC development was estimated using Cox proportional hazard analysis. The cumulative incidences of RGC were calculated using the Kaplan-Meier method. Results We retrospectively analyzed 405 cases. The median patient age was 69 years, and the patient cohort consisted of 263 men and 142 women. The Billroth-I reconstruction method was used in 204 cases, Billroth-II method was used in 3 cases, and Roux-en Y method was used in 198 cases. RGC was diagnosed in 11 of the 405 patients. The median follow-up period was 5 years. The cumulative incidences of RGC calculated by the Kaplan-Meier method were 3.0%, 4.1%, and 10.5% at 5, 10, and 15 years after DG, respectively. During the initial surgery, differentiated type was significantly associated with RGC development [hazard ratio (HR): 4.71, 95% confidence interval (CI): 1.02–21.80, P=0.05]. Male sex (HR: 2.97, 95% CI: 0.64–13.75, P=0.16), old age (≥70 years) (HR: 2.72, 95% CI: 0.78–9.47, P=0.11), and synchronous multiple GC (HR: 1.31, 95% CI: 0.28–6.08, P=0.73) were not associated with RGC development. Conclusions Patients who have undergone DG for differentiated type GC were statistically significantly associated with developing RGC. Intensive endoscopic surveillance would be needed for the patients who underwent DG for differentiated type GC.

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Can we apply the same indication of endoscopic submucosal dissection for primary gastric cancer to remnant gastric cancer?

Cited by 9 publications

References 19 publications

Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?

Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?

Risk factors of gastric remnant cancer: a meta-analysis and systematic review

Risk factors for remnant gastric cancer after distal gastrectomy for gastric cancer: a retrospective database review

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