Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy

Abstract

Meticulous follow-up examination and early detection of RGC might lead to a better prognosis. Based on the initial gastric disease and the procedure of reconstruction, an appropriate follow-up interval and programs might enable early detection of RGC.

Effects of initial disease status on lymph flow following gastrectomy in cases of carcinoma in the remnant stomach

“…Excluding the flow to the anastomotic site, the lymphatic flows were similar to those in the gastric cancers that normally occurred in the upper third of the stomach. The lymphatic flows from the greater curvature to the splenic hilum and from the remnant stomach to the splenic artery appeared to be predominant in group M. Previous studies have reported that the frequencies of lymph node metastasis in the splenic hilum and along the splenic artery are higher in CRSs than in primary cancers at the upper third of the stomach [4,22,23]. These reports have primarily been on benign initial disease.…”

Does remnant gastric cancer really differ from primary gastric cancer? A systematic review of the literature by the Task Force of Japanese Gastric Cancer Association

“…In the eligible papers published after 2000, some articles reported the mean or median intervals between the initial surgery and RGC diagnosis. In particular, 7 studies reported the intervals stratified by RGC of the initial surgery for malignant or benign disease, although the background characteristics of patients varied substantially [23,26,28,[33][34][35][36]. The mean or median intervals between the initial surgery for malignant disease and RGC diagnosis seemed to be shorter than those between the initial surgery for benign disease and RGC diagnosis ( Table 1).…”

“…The incidence of lymph node metastases for RGC is not higher than that for primary gastric cancer from studies comparing the two groups [3,17,22,23,26,27], and some results suggest a rather higher incidence of lymph node metastases in primary gastric cancer [13,29] (Table 2). The ratio of node-positive patients may be affected by the stage distribution of the patients.…”

“…Lymph node involvement in the jejunal mesentery is a phenomenon peculiar to the RGC after Billroth II reconstruction, with the reported incidence ranging from 7.0 % to 46.8 % [3,6,14,15,26,[51][52][53][54][55][56] (Table 4). Several authors have reported relatively high incidences of lymph node metastases at the splenic hilum in patients with RGC [15,50,51,55].…”

“…Thirty-eight studies were given an A score, and 68 studies were given a B score. Finally, we conducted a publication-based meta-analysis using 20 studies that compared the 5-year survival rates between RGC and PGC [3,6,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. In addition, eight studies included data on TNM staging along with the survival data [3,6,13,14,16,17,23,29].…”