Shinichi Kinami1, Masaki Aizawa2, Hiroharu Yamashita3, Koshi Kumagai4, Satoshi Kamiya5, Makoto Toda6, Takaomi Takahata7, Muneharu Fujisaki8, Hiroshi Miyamoto9, Hiroshi Kusanagi10, Kenta Kobayashi11, Marie Washio12, Kei Hosoda12, Takeo Kosaka13. 1. Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan. kinami@kanazawa-med.ac.jp. 2. Department of Digestive Surgery, Niigata Cancer Center Hospital, Niigata, Japan. 3. Department of Gastrointestinal Surgery, The University of Tokyo, Tokyo, Japan. 4. Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. 5. Department of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan. 6. Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan. 7. Department of Surgery, Okayama Saiseikai General Hospital, Okayama, Japan. 8. Department of Surgery, Jikei University School of Medicine, Tokyo, Japan. 9. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Kanagawa, Japan. 10. Department of General Surgery, Kameda Medical Center, Chiba, Japan. 11. Department of Gastric Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan. 12. Department of Upper Gastrointestinal Surgery, Kitasato University, Kanagawa, Japan. 13. Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan.
Abstract
BACKGROUND: The incidence of metachronous multiple gastric cancer (MMGC) after gastrectomy remains unclear. This study evaluated the incidences of MMGC according to specific gastrectomy types, including pylorus-preserving gastrectomy (PPG), proximal gastrectomy (PG), and function-preserving gastrectomy (FPG), which was categorized as segmental gastrectomy and local resection. METHODS: We conducted a questionnaire survey of the Japanese Society for Gastro-Surgical Pathophysiology members, who were asked to report their institutional numbers of radical gastrectomy cases for cancer between 2003 and 2012. The cases were categorized according to whether the remnant stomach's status was followed for > 5 years, confirmation of MMGC, time to diagnosis, and treatment for MMGC. We calculated the "precise incidence" of MMGC by dividing the number of MMGC cases by the number of cases in which the status of remnant stomach was followed up for > 5 years. RESULTS: The responses identified 33,731 cases of gastrectomy. The precise incidences of MMGC were 2.35% after distal gastrectomy (DG), 3.01% after PPG, 6.28% after PG (p < 0.001), and 8.21% after FPG (p < 0.001). A substantial proportion of MMGCs (36.4%) was found at 5 years after the initial surgery. The rates of MMGC treatment using endoscopic submucosal dissection were 31% after DG, 28.6% after PPG, 50.8% after PG (p < 0.001), and 67.9% after FPG (p < 0.001). CONCLUSIONS: The incidence of MMGC was 2.4% after DG, and higher incidences were observed for larger stomach remnants. However, the proportion of cases in which MMGC could be treated using endoscopic submucosal dissection was significantly higher after PG and FPG than after DG.
BACKGROUND: The incidence of metachronous multiple gastric cancer (MMGC) after gastrectomy remains unclear. This study evaluated the incidences of MMGC according to specific gastrectomy types, including pylorus-preserving gastrectomy (PPG), proximal gastrectomy (PG), and function-preserving gastrectomy (FPG), which was categorized as segmental gastrectomy and local resection. METHODS: We conducted a questionnaire survey of the Japanese Society for Gastro-Surgical Pathophysiology members, who were asked to report their institutional numbers of radical gastrectomy cases for cancer between 2003 and 2012. The cases were categorized according to whether the remnant stomach's status was followed for > 5 years, confirmation of MMGC, time to diagnosis, and treatment for MMGC. We calculated the "precise incidence" of MMGC by dividing the number of MMGC cases by the number of cases in which the status of remnant stomach was followed up for > 5 years. RESULTS: The responses identified 33,731 cases of gastrectomy. The precise incidences of MMGC were 2.35% after distal gastrectomy (DG), 3.01% after PPG, 6.28% after PG (p < 0.001), and 8.21% after FPG (p < 0.001). A substantial proportion of MMGCs (36.4%) was found at 5 years after the initial surgery. The rates of MMGC treatment using endoscopic submucosal dissection were 31% after DG, 28.6% after PPG, 50.8% after PG (p < 0.001), and 67.9% after FPG (p < 0.001). CONCLUSIONS: The incidence of MMGC was 2.4% after DG, and higher incidences were observed for larger stomach remnants. However, the proportion of cases in which MMGC could be treated using endoscopic submucosal dissection was significantly higher after PG and FPG than after DG.
Authors: K Miwa; H Hasegawa; T Fujimura; H Matsumoto; R Miyata; T Kosaka; I Miyazaki; T Hattori Journal: Carcinogenesis Date: 1992-12 Impact factor: 4.944
Authors: Yonghoon Choi; Nayoung Kim; Hyuk Yoon; Cheol Min Shin; Young Soo Park; Dong Ho Lee; Young Suk Park; Sang-Hoon Ahn; Yun-Suhk Suh; Do Joong Park; Hyung Ho Kim Journal: Gut Liver Date: 2022-05-15 Impact factor: 4.519