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World Journal of Surgery
Published in: World Journal of Surgery 8/2020

01-08-2020 | Gastrectomy | Original Scientific Report

Incidence of Multiple Metachronous Gastric Cancers After Pyloric-Preserving Gastrectomy

Authors: Masaki Aizawa, Hiroshi Yabusaki, Atsushi Matsuki, Takeo Bamba, Satoru Nakagawa

Published in: World Journal of Surgery | Issue 8/2020

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Abstract

Aim

Pylorus-preserving gastrectomy (PPG) is widely used for early gastric cancer located in the middle third of the stomach. The minimization of the extent of gastrectomy may increase the risk of metachronous multiple gastric cancer (MGC). We report the findings of a study that was conducted to evaluate the prevalence of MGC after PPG.

Methods

The clinical data of 533 patients who underwent PPG for gastric cancer between 1993 and 2018 were reviewed. The clinicopathological characteristics at the time of the primary treatment that were predictive of the development of MGC were explored. The median (range) observation period was 112.4 (8.1–290.7) months.

Results

Metachronous MGC was diagnosed in 33 of the 533 patients. The cumulative 5-year and 10-year event rates were 3.3% and 6.2%, respectively. The patient gender, presence/absence of synchronous MGC and the macroscopic type of the primary gastric cancer were significantly associated with the risk of development of metachronous MGC. Multivariate analysis identified the presence of synchronous MGC (hazard ratio [HR]: 4.828, 95% confidence interval [CI]; 1.611–12.30, p = 0.004) and Type 0-IIa primary gastric cancer (HR 2.810, 95% CI; 1.113–7.090, p = 0.029) as independent factors associated with the risk of development of MGC. All the patients could be treated by surgical or endoscopic resection for the metachronous MGC. Recurrence was observed in one patient.

Conclusions

There was quite a few incidence of development of metachronous MGC after PPG. Nevertheless, PPG remains reasonable treatment option, if adequate postoperative surveillance can be ensured.
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Metadata
Title
Incidence of Multiple Metachronous Gastric Cancers After Pyloric-Preserving Gastrectomy
Authors
Masaki Aizawa
Hiroshi Yabusaki
Atsushi Matsuki
Takeo Bamba
Satoru Nakagawa
Publication date
01-08-2020
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 8/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05492-4

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