No abstract

A QUESTION REPEATEDLY discussed in recent years, but still unanswered, is whether a partial gastrectomy can lead to development of cancer in the remaining part of the stomach. This problem has more than academic interest, as partial gastrectomy is now a commonly used therapeutic method for relatively benign diseases, such as gastric and duodenal ulcers. Several pathologic factors operating in the resected stomach may be conceived to promote development of cancer. The acid production is usually impaired or abolished, the emptying is altered, and the abnormal communication with the intestine may lead to regurgitation of alkaline fluid into the stomach. The anacid atrophic-hypertrophic gastritis resulting from these changes may be imagined to form the basis for the subsequent development of cancer. On the other hand, there is also the possibility that the "ulcer disease" per se, apart from any changes caused by the operation, might be a factor in cancer pathogenesis.9 12 A number of cases in which partial gastrectomy has been followed by gastric cancer have been reported during the last 30 years. Similarly a number of cases have been reported of cancer developing after gastroenterostomy. From the literature Freedman et al. in a recent publication3 collected in all 58 cases of cancer, 23 cases developing after partial gastrectomy, the others after gastroenterostomy for gastric or duodenal ulcer. Although suggestive, these reports cannot be taken as evidence of any causal rela-*

No abstract