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

doi:10.4240/wjgs.v13.i4.366

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World Journal of Gastrointestinal Surgery

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World J Gastrointest Surg. Apr 27, 2021; 13(4): 366-378
Published online Apr 27, 2021. doi: 10.4240/wjgs.v13.i4.366

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

Marcus Fernando Kodama Pertille Ramos, Marina Alessandra Pereira, Andre Roncon Dias, Anna Carolina Batista Dantas, Daniel Jose Szor, Ulysses Ribeiro Jr, Bruno Zilberstein, Ivan Cecconello

Marcus Fernando Kodama Pertille Ramos, Marina Alessandra Pereira, Andre Roncon Dias, Anna Carolina Batista Dantas, Daniel Jose Szor, Ulysses Ribeiro Jr, Bruno Zilberstein, Ivan Cecconello, Department of Gastroenterology, Instituto do Cancer, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo 01249000, Brazil

Author contributions: Ramos MFKP contributed to the study design; Ramos MFKP and Pereira MA contributed to data retrieval, critical analysis, statistical analysis, and drafting the manuscript; Dias AR, Dantas ACB, and Szor DJ contributed to data retrieval and manuscript review; Ribeiro Jr U, Zilberstein B, and Cecconello I contributed to critical analysis and manuscript review.

Institutional review board statement: The study was approved by the hospital ethics committee and registered online (https://plataformabrasil.saude.gov.br; CAAE: 25516719.3.0000.0065).

Informed consent statement: Informed consent was waived by the local Ethics Committee given the retrospective nature of the study.

Conflict-of-interest statement: The authors declare no conflict of interest.

Data sharing statement: No additional data are available.

Corresponding author: Marina Alessandra Pereira, MSc, Research Scientist, Department of Gastroenterology, Instituto do Cancer, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 251 Av Dr Arnaldo, São Paulo 01246000, Brazil. ma.ap@hotmail.com

Received: November 8, 2020
Peer-review started: November 8, 2020
First decision: December 20, 2020
Revised: December 28, 2020
Accepted: January 21, 2021
Article in press: January 21, 2021
Published online: April 27, 2021
Processing time: 163 Days and 1.5 Hours

ARTICLE HIGHLIGHTS

Research background

Remnant gastric cancer (RGC), defined as a tumor that develops in the stomach after a previous gastrectomy, is often reported as a tumor with a poor prognosis. However, due to its rarity and diversity, factors related to its prognosis and survival remain unclear.

Research motivation

The occurrence of RGC continues to be part of the reality of gastric cancer treatment, due to peptide ulcer resections performed in the past. Most studies that have investigated the surgical treatment of RGC enrolled only a few patients and provided only a brief descriptive analysis of their complications.

Research objectives

This study aimed to evaluate the clinicopathological characteristics and prognosis of RGC after previous gastrectomy for benign disease.

Research methods

All patients who underwent gastrectomy between 2009 and 2019 were retrospectively evaluated from a prospective medical database. 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.

Research results

A total of 41 RGC patients were included, and 120 PGC served as a comparison group. Despite presenting differences about some clinical characteristics, there was no significant difference between RGC and RGC patients concerning pathological tumor-node-metastasis and the occurrence of postoperative complications. Also, the survival rates of RGC were similar to the PGC group.

Research conclusions

RGC had clinicopathological characteristics and prognosis similar to PGC, including short-term outcomes.

Research perspectives

Our findings provide additional data about the characteristics and outcomes of the RGC that may assist to clarify factors related to the survival of these patients. As we suggest that RGC does not adversely affect patient prognosis and postoperative course, the inclusion of these patients in future trials could contribute to data that improve the survival of patients with RGC.