Early stage carcinoma of the gastric remnant in Japan.

In recent years, the number of reported cases of early stage cancer of the remnant stomach has been on a gradual increase thanks to the improvement in diagnostic techniques and also to increasing dealings with cancer of the remnant stomach. In this study we reviewed 124 cases of early stage cancer of the remnant stomach which were reported in Japan by the end of 1990, including the 6 cases which we encountered ourselves, during the 11 years starting from 1980. Their average age was 57 years, with a range from 22 to 78 years. The male-to-female ratio was 2:7. There were 63 asymptomatic cases (61%). This fact suggests that periodical examinations are essential after the first operation on the stomach. Out of the 124 cases, 86 cases operated on for benign lesions (benign group) and the remaining 38 cases for malignant lesions (malignant group) for the first time. The average time between the first and the second surgery was 19.7 years in the benign group and 7.8 years in the malignant group. The initial surgery was performed mainly by Billroth II resection. The frequency of tumor development was higher in the nonsutured portion than in the anastomosed portion of the remnant stomach. Protuberant type lesions and differentiated carcinomas were prevalent according to the classification by gross type and histology, respectively. However, the anastomosed portion was most often involved in the subgroup of patients in whom lesions were detected more than 10 years after Billroth II resection for benign lesions.