June 1994

Gastric Remnant Cancer Has a Better Prognosis Than Primary Gastric Cancer

Author Affiliations

From the Second Department of Surgery, the University of Innsbruck, Austria (Drs Pointner, Wetscher, Gadenstätter, and Bodner), and the Department of Surgery, Creighton University, Omaha, Neb (Dr Hinder).

Arch Surg. 1994;129(6):615-619. doi:10.1001/archsurg.1994.01420300057008

Objective:  To study the prognosis of gastric remnant cancer following radical resection (group 1) compared with that of primary gastric cancer of the upper third of the stomach following radical resection (group 2).

Design:  Cohort study with a 5-year follow-up.

Setting:  A university hospital in Austria.

Patients:  Group 1 consisted of 43 patients, and group 2, of 61. Postoperative deaths and deaths during the follow-up period that were not related to gastric cancer were excluded. Fifteen patients in group 1 (34.9%) presented with stage I cancer; 10 (23.3%), stage II; 13 (30.2%), stage III; and five (11.6%), stage IV. Twenty patients in group 2 (32.8%) presented with stage I cancer; 12 (19.7%), stage II; 15 (24.6%), stage III; and 14 (22.9%), stage IV (Union Internationale Contre le Cancer staging classification, 1987).

Main Outcome Measures:  Overall and stage-related 5-year survival rates.

Results:  The overall 5-year survival rate was 53.5% in group 1 and 32.8% in group 2 (P<.05). The stage-related 5-year survival rate in group 1 was 100% for stage I and 80% for stage II. In group 2, the stage-related 5-year survival rate was 65% for stage I and 25% for stage II (both, P<.01). No significant difference was noted for stages III and IV.

Conclusion:  The prognosis of cancer of the gastric remnant presenting as stage I or II is good and is significantly better than that of the equivalent stages of primary cancer of the upper third of the stomach.(Arch Surg. 1994;129:615-619)