Gastric remnant cancer

A distinct entity or simply another proximal gastric cancer?

Thuy B. Tran, Ioannis Hatzaras, David J. Worhunsky, Gerardo A. Vitiello, Malcolm Hart Squires, Linda X. Jin, Gaya Spolverato, Konstantinos I. Votanopoulos, Carl Schmidt, Sharon Weber, Mark Bloomston, Clifford S. Cho, Edward A. Levine, Ryan C. Fields, Timothy M. Pawlik, Shishir K. Maithel, Jeffrey A. Norton, George A. Poultsides

Research output: Contribution to journalArticle

Abstract

Background The purpose of this study was to compare outcomes following resection of gastric remnant (GRC) and conventional gastric cancer. Methods Patients who underwent resection for gastric cancer in 8 academic institutions from 2000-2012 were evaluated to compare morbidity, mortality, and survival based on history of prior gastrectomy. Results Of the 979 patients who underwent gastrectomy with curative-intent during the 12-year study period, 55 patients (5.8%) presented with GRC and 924 patients (94.4%) presented with conventional gastric cancer. Patients with GRC were slightly older (median 69 vs. 66 years). GRC was associated with higher rates of complication (56% vs. 41%, P = 0.028), longer operative times (301 vs. 237 min, P <0.001), higher intraoperative blood loss (300 vs. 200 ml, P = 0.012), and greater need for blood transfusion (43% vs. 23%, P = 0.001). There were no significant differences in 30-day (3.6% vs. 4%) or 90-day mortality (9% vs. 8%) between the two groups. Overall survival rates were similar between GRC and conventional gastric cancer (5-year 20.3% vs. 38.6%, P = 0.446). Multivariate analysis revealed that history of gastrectomy was not predictive of survival while established predictors (older age, advanced T-stage, nodal involvement, blood transfusion, multivisceral resection, and any complication) were associated with poor survival. Conclusions Despite higher morbidity, prognosis after resection of gastric remnant cancer is similar to conventional gastric cancer.

Original languageEnglish (US)
Pages (from-to)877-882
Number of pages6
JournalJournal of Surgical Oncology
Volume112
Issue number8
DOIs
StatePublished - Dec 15 2015

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Gastric Stump
Stomach Neoplasms
Gastrectomy
Blood Transfusion
Survival
Morbidity
Mortality
Operative Time
Multivariate Analysis
Survival Rate

Keywords

  • gastrectomy
  • gastric cancer
  • gastric remnant
  • gastric stump

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Tran, T. B., Hatzaras, I., Worhunsky, D. J., Vitiello, G. A., Squires, M. H., Jin, L. X., ... Poultsides, G. A. (2015). Gastric remnant cancer: A distinct entity or simply another proximal gastric cancer? Journal of Surgical Oncology, 112(8), 877-882. https://doi.org/10.1002/jso.24080

Gastric remnant cancer : A distinct entity or simply another proximal gastric cancer? / Tran, Thuy B.; Hatzaras, Ioannis; Worhunsky, David J.; Vitiello, Gerardo A.; Squires, Malcolm Hart; Jin, Linda X.; Spolverato, Gaya; Votanopoulos, Konstantinos I.; Schmidt, Carl; Weber, Sharon; Bloomston, Mark; Cho, Clifford S.; Levine, Edward A.; Fields, Ryan C.; Pawlik, Timothy M.; Maithel, Shishir K.; Norton, Jeffrey A.; Poultsides, George A.

In: Journal of Surgical Oncology, Vol. 112, No. 8, 15.12.2015, p. 877-882.

Research output: Contribution to journalArticle

Tran, TB, Hatzaras, I, Worhunsky, DJ, Vitiello, GA, Squires, MH, Jin, LX, Spolverato, G, Votanopoulos, KI, Schmidt, C, Weber, S, Bloomston, M, Cho, CS, Levine, EA, Fields, RC, Pawlik, TM, Maithel, SK, Norton, JA & Poultsides, GA 2015, 'Gastric remnant cancer: A distinct entity or simply another proximal gastric cancer?', Journal of Surgical Oncology, vol. 112, no. 8, pp. 877-882. https://doi.org/10.1002/jso.24080
Tran TB, Hatzaras I, Worhunsky DJ, Vitiello GA, Squires MH, Jin LX et al. Gastric remnant cancer: A distinct entity or simply another proximal gastric cancer? Journal of Surgical Oncology. 2015 Dec 15;112(8):877-882. https://doi.org/10.1002/jso.24080
Tran, Thuy B. ; Hatzaras, Ioannis ; Worhunsky, David J. ; Vitiello, Gerardo A. ; Squires, Malcolm Hart ; Jin, Linda X. ; Spolverato, Gaya ; Votanopoulos, Konstantinos I. ; Schmidt, Carl ; Weber, Sharon ; Bloomston, Mark ; Cho, Clifford S. ; Levine, Edward A. ; Fields, Ryan C. ; Pawlik, Timothy M. ; Maithel, Shishir K. ; Norton, Jeffrey A. ; Poultsides, George A. / Gastric remnant cancer : A distinct entity or simply another proximal gastric cancer?. In: Journal of Surgical Oncology. 2015 ; Vol. 112, No. 8. pp. 877-882.
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abstract = "Background The purpose of this study was to compare outcomes following resection of gastric remnant (GRC) and conventional gastric cancer. Methods Patients who underwent resection for gastric cancer in 8 academic institutions from 2000-2012 were evaluated to compare morbidity, mortality, and survival based on history of prior gastrectomy. Results Of the 979 patients who underwent gastrectomy with curative-intent during the 12-year study period, 55 patients (5.8{\%}) presented with GRC and 924 patients (94.4{\%}) presented with conventional gastric cancer. Patients with GRC were slightly older (median 69 vs. 66 years). GRC was associated with higher rates of complication (56{\%} vs. 41{\%}, P = 0.028), longer operative times (301 vs. 237 min, P <0.001), higher intraoperative blood loss (300 vs. 200 ml, P = 0.012), and greater need for blood transfusion (43{\%} vs. 23{\%}, P = 0.001). There were no significant differences in 30-day (3.6{\%} vs. 4{\%}) or 90-day mortality (9{\%} vs. 8{\%}) between the two groups. Overall survival rates were similar between GRC and conventional gastric cancer (5-year 20.3{\%} vs. 38.6{\%}, P = 0.446). Multivariate analysis revealed that history of gastrectomy was not predictive of survival while established predictors (older age, advanced T-stage, nodal involvement, blood transfusion, multivisceral resection, and any complication) were associated with poor survival. Conclusions Despite higher morbidity, prognosis after resection of gastric remnant cancer is similar to conventional gastric cancer.",
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T1 - Gastric remnant cancer

T2 - A distinct entity or simply another proximal gastric cancer?

AU - Tran, Thuy B.

AU - Hatzaras, Ioannis

AU - Worhunsky, David J.

AU - Vitiello, Gerardo A.

AU - Squires, Malcolm Hart

AU - Jin, Linda X.

AU - Spolverato, Gaya

AU - Votanopoulos, Konstantinos I.

AU - Schmidt, Carl

AU - Weber, Sharon

AU - Bloomston, Mark

AU - Cho, Clifford S.

AU - Levine, Edward A.

AU - Fields, Ryan C.

AU - Pawlik, Timothy M.

AU - Maithel, Shishir K.

AU - Norton, Jeffrey A.

AU - Poultsides, George A.

PY - 2015/12/15

Y1 - 2015/12/15

N2 - Background The purpose of this study was to compare outcomes following resection of gastric remnant (GRC) and conventional gastric cancer. Methods Patients who underwent resection for gastric cancer in 8 academic institutions from 2000-2012 were evaluated to compare morbidity, mortality, and survival based on history of prior gastrectomy. Results Of the 979 patients who underwent gastrectomy with curative-intent during the 12-year study period, 55 patients (5.8%) presented with GRC and 924 patients (94.4%) presented with conventional gastric cancer. Patients with GRC were slightly older (median 69 vs. 66 years). GRC was associated with higher rates of complication (56% vs. 41%, P = 0.028), longer operative times (301 vs. 237 min, P <0.001), higher intraoperative blood loss (300 vs. 200 ml, P = 0.012), and greater need for blood transfusion (43% vs. 23%, P = 0.001). There were no significant differences in 30-day (3.6% vs. 4%) or 90-day mortality (9% vs. 8%) between the two groups. Overall survival rates were similar between GRC and conventional gastric cancer (5-year 20.3% vs. 38.6%, P = 0.446). Multivariate analysis revealed that history of gastrectomy was not predictive of survival while established predictors (older age, advanced T-stage, nodal involvement, blood transfusion, multivisceral resection, and any complication) were associated with poor survival. Conclusions Despite higher morbidity, prognosis after resection of gastric remnant cancer is similar to conventional gastric cancer.

AB - Background The purpose of this study was to compare outcomes following resection of gastric remnant (GRC) and conventional gastric cancer. Methods Patients who underwent resection for gastric cancer in 8 academic institutions from 2000-2012 were evaluated to compare morbidity, mortality, and survival based on history of prior gastrectomy. Results Of the 979 patients who underwent gastrectomy with curative-intent during the 12-year study period, 55 patients (5.8%) presented with GRC and 924 patients (94.4%) presented with conventional gastric cancer. Patients with GRC were slightly older (median 69 vs. 66 years). GRC was associated with higher rates of complication (56% vs. 41%, P = 0.028), longer operative times (301 vs. 237 min, P <0.001), higher intraoperative blood loss (300 vs. 200 ml, P = 0.012), and greater need for blood transfusion (43% vs. 23%, P = 0.001). There were no significant differences in 30-day (3.6% vs. 4%) or 90-day mortality (9% vs. 8%) between the two groups. Overall survival rates were similar between GRC and conventional gastric cancer (5-year 20.3% vs. 38.6%, P = 0.446). Multivariate analysis revealed that history of gastrectomy was not predictive of survival while established predictors (older age, advanced T-stage, nodal involvement, blood transfusion, multivisceral resection, and any complication) were associated with poor survival. Conclusions Despite higher morbidity, prognosis after resection of gastric remnant cancer is similar to conventional gastric cancer.

KW - gastrectomy

KW - gastric cancer

KW - gastric remnant

KW - gastric stump

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