Treatment and outcome of patients with gastric remnant cancer after resection for peptic ulcer disease Journal Article
| Authors: | Mezhir, J. J.; Gonen, M.; Ammori, J. B.; Strong, V. E.; Brennan, M. F.; Coit, D. G. |
| Article Title: | Treatment and outcome of patients with gastric remnant cancer after resection for peptic ulcer disease |
| Abstract: | Background. To study the pathology, treatment, and outcome of patients with gastric remnant cancer (GRC) after resection for peptic ulcer disease (PUD). Methods. Review of a prospective gastric cancer database identified patients with GRC after gastrectomy for PUD. Clinicopathologic and treatment-related variables were obtained. Multivariate analysis was performed for factors associated with disease-specific survival (DSS). Results. From January 1985 to April 2010, 4402 patients with gastric adenocarcinoma were treated at our institution and 105 patients (2.4%) had prior gastrectomy for PUD. Prior resections were most often Billroth II (N = 97, 92%). The median time from initial resection to development of GRC was 32 years (3-60 years), and the majority of tumors were located at the gastrointestinal anastomosis (N = 72, 69%). Median DSS was 1.3 years (0.6-2.1 years). Patients who had resection had a significantly better outcome than patients who did not have resection (median DSS 5 vs 0.35 years, P<.0001). Factors associated with DSS on multivariate analysis included advanced T-stage (HR 16.5 (CI 2.2-123.4), P = .0006) and lymph node metastasis (HR 1.1 (CI 1.0-1.2), P<.0001). Stage-specific survival following R0 resection was similar to patients with conventional gastric cancer. Conclusions. Patients have a lifetime risk for the development of GRC following resection for PUD. As with conventional gastric cancer, determinants of survival of patients with GRC include advanced T stage and nodal metastasis. Patients with GRC amenable to curative resection exhibit the best DSS and have stage-specific outcomes similar to patients with conventional gastric cancer. © Society of Surgical Oncology 2010. |
| Keywords: | adult; cancer survival; aged; cancer surgery; major clinical study; advanced cancer; cancer staging; outcome assessment; lymph node metastasis; tumor localization; data base; gastrectomy; stomach cancer; partial gastrectomy; gastrectomy billroth ii; total stomach resection; intestine anastomosis; peptic ulcer |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 18 |
| Issue: | 3 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2011-03-01 |
| Start Page: | 670 |
| End Page: | 676 |
| Language: | English |
| DOI: | 10.1245/s10434-010-1425-1 |
| PROVIDER: | scopus |
| PUBMED: | 21063791 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 23 June 2011" - "CODEN: ASONF" - "Source: Scopus" |
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