Clinicopathological Study of Multifocal Gastric Cancer.

Clinical and histopathological features of remnant gastric cancers, after gastrectomy for synchronous multiple gastric cancers

“…On the other hand, few reports have demonstrated the occurrence rate or clinicopathological characters of remnant gastric cancers that developed after gastrectomy for multiple gastric cancers. Of these, the largest series from a Japanese group showed that the incidence of remnant gastric cancers after gastrectomy for solitary gastric cancers was 1.7%, whereas that after surgery for synchronous multiple lesions was 4.7% [20]. Results of our study are consistent with this report; our results add to the previous literature because we demonstrated that the proximal surgical margin is a potential indicator to predict the formation of remnant gastric cancers after gastrectomy for multiple lesions.…”

“…Since a high incidence of intestinal metaplasia is usually observed in the stomach of elderly males [17][18][19], it is reasonable to assume that patients with multiple gastric cancers are most commonly found among this sub-group. The present study revealed that 71.2% of main lesions in synchronous multiple gastric cancers were consistent with the histological type of sub-lesions, which is compatible with previous observations [20]. This result shows that about 30% of sublesions have different histological type from that of main lesions, suggesting that several other factors are involved in the formation of sub-lesions although intestinal metaplasia may be important in the initiation of multiple cancers.…”

Relationship Between the Histological Type of Initial Lesions and the Risk for the Development of Remnant Gastric Cancers After Gastrectomy for Synchronous Multiple Gastric Cancers

“…The present study further addressed that the combination of the undifferentiated type of initial lesions (main lesion and sublesion) was associated with a higher incidence of remnant gastric cancer after gastrectomy for synchronous multiple lesions. In previous studies, although a combination of differentiated adenocarcinomas was most frequently found as synchronous multiple gastric cancers, the incidence of a combination of undifferentiated carcinomas (Type C) was consistently found to be around 10% [21]; the results of the present study also showed a similar incidence of Type C tumors. We could not identify the differences in the underlying mechanism for the initiation of the remnant gastric cancer between a combination of differentiated carcinomas (Type A) and a combination of undifferentiated carcinomas (Type C) for multiple gastric cancers, but we could address that the higher incidence of remnant gastric cancer was found in patients with a Type C lesion.…”

Incidence of metachronous gastric cancer in the remnant stomach after synchronous multiple cancer surgery

“…There have been few reports comparing the incidence of metachronous cancer in the gastric remnant after partial gastrectomy for solitary and multiple gastric cancers [11,15,16]. Because these reports differ in their conclusions, it remains controversial whether it is higher after multiple cancer surgery.…”