Abstract
Background
The incidence of remnant gastric cancer (RGC) after distal gastrectomy is 1–5%. However, as the survival rate of patients with gastric cancer improves due to early detection and treatment, more patients may develop RGC. There is no consensus on the surgical and postoperative management of RGC, and the clinicopathological characteristics correlated with the long-term outcomes remain unclear. Therefore, we have investigated the clinicopathological factors associated with the long-term outcomes of RGC.
Methods
We included 65 consecutive patients who underwent gastrectomy for RGC from January 2000 to December 2015 at the Osaka Medical College, Japan. The Kaplan–Meier method was used to create survival curves, and differences in survival were compared between the groups (clinical factors, pathological factors, and surgical factors) using the log-rank test. Multivariate analyses using the Cox proportional hazard model were used to identify factors associated with long-term survival.
Results
There were no significant differences in the survival based on clinical factors (age, body mass index, and diabetes mellitus) or the type of remnant gastrectomy. There were significant differences in the survival based on pathological factors and surgical characteristics (intraoperative blood loss and operation time). Multivariate analysis revealed that the T stage (hazard ratio, 4.70; 95% confidence interval [CI], 1.005–22.014; p = 0.049) and venous invasion (hazard ratio 3.047; 95% CI, 1.008–9.214; p = 0.048) were significant independent risk factors for long-term survival in patients who underwent radical resection for RGC.
Conclusions
T stage and venous invasion are important prognostic factors of long-term survival after remnant gastrectomy for RGC and may be key to managing and identifying therapeutic strategies for improving prognosis in RGC.
T stage and venous invasion are crucial prognostic factors for long-term survival of patients with remnant gastric cancer: A cohort study