Clinical and Histopathological Features of Remnant Gastric Cancers, After Gastrectomy for Synchronous Multiple Gastric Cancers

Background: Remnant gastric cancers have been extensively investigated; however, little has been unveiled the features of remnant gastric cancers with regard to the existence of synchronous multiple lesions. We evaluated the clinicopathological features of remnant gastric cancers, after initial gastrectomy for both single and multiple gastric cancers. Methods: We retrospectively analyzed 3,042 patients diagnosed with gastric cancers who underwent gastrectomy. Of these, total gastrectomy cases were excluded, and remaining 2,120 cases were investigated. Results: Among the 2.120 patients, 1,967 patients were histopathologically diagnosed with solitary lesion and 153 patients with multiple lesions. The incidence of remnant gastric cancers was higher in patients with multiple lesions at initial surgery than those with solitary lesion (P < 0.05). Moreover, remnant cancers developed within shorter duration of follow-up after treatment of synchronous multiple lesions compared to those that developed after treatment of solitary lesions (P = 0.05). Among the patients treated for synchronous multiple lesions, distance from the oral margin was a potential risk factor for the development of secondary cancers in the remnant stomach. Conclusions: Patients with synchronous Multiple gastric cancers are more susceptible to the development of secondary cancers in their remnant stomach. These patients need careful follow-up after initial gastrectomy. J. Surg. Oncol. 2009;100:466-471. (C) 2009 Wiley-Liss, Inc.