Remnant gastric cancer: An ordinary primary adenocarcinoma or a tumor with its own pattern?

Abstract

BACKGROUND Remnant gastric cancer (RGC) is defined as a tumor that develops in the stomach after a previous gastrectomy and is generally associated with a worse prognosis. However, there little information available regarding RGCs and their prognostic factors and survival. AIM To evaluate the clinicopathological characteristics and prognosis of RGC after previous gastrectomy for benign disease. METHODS Patients who underwent curative resection for primary gastric cancer (GC) at our institute between 2009 and 2019 were retrospectively evaluated. All RGC resections with histological diagnosis of gastric adenocarcinoma were enrolled in this study. Primary proximal GC (PGC) who underwent total gastrectomy was selected as the comparison group. Clinical and pathological data were collected from a prospective medical database. RESULTS A total of 41 patients with RGC and 120 PGC were included. Older age ( P = 0.001), lower body mass index ( P = 0.006), hemoglobin level ( P < 0.001), and number of resected lymph nodes resected (LN) ( P < 0.001) were associated with the RGC group. Lauren type, pathological tumor-node-metastasis, and perioperative morbimortality were similar between RGC and PGC. There was no difference in disease-free survival ( P = 0.592) and overall survival ( P = 0.930) between groups. LN status was the only independent factor related to survival. CONCLUSION RGC had similar clinicopathological characteristics to PGC. Despite the lower number of resected LN, RGC had a similar prognosis.

Does gastric stump cancer really differ from primary proximal gastric cancer? A multicentre, propensity score matching-used, retrospective cohort study

“…Overall, the GSC group exhibited similar characteristics to PGC patients. In addition, survival data processed by statistical methods showed a difference in survival time between the GSC group and the PGC group, which is contrary to the previous research results of Ramos et al [ 17 ]. As expected, among the patients we included, the number of lymph nodes after GSC surgery was significantly lower than that in the PGC group.…”

“…The results confirmed that the survival rate of patients with residual gastric cardia cancer after radical resection was lower than that of primary cardiac cancer patients, but the survival rate of patients without serous infiltration or lymph node metastasis was similar to that of primary cardiac cancer patients. Ramos et al [ 17 ] also obtained similar results, indicating that there is still a lot of controversy regarding the prognosis of GSC and PGC patients, and further clarification is needed in large-scale clinical trials, especially high-quality randomised controlled trials.…”

Identification of prognostic signatures in remnant gastric cancer through an interpretable risk model based on machine learning: a multicenter cohort study

“…This suggests that RGC may possess distinct biological characteristics from primary GC[ 1 , 55 , 56 ]. However, some researchers have compared RGC to primary GC and found no significant difference in survival rates between the two[ 57 – 59 ]. A few studies have investigated the clinicopathologic features and prognosis of RGC, but consensus has not been reached yet[ 1 , 60 , 61 ].…”