World Journal of Surgery

, Volume 42, Issue 3, pp 782–787 | Cite as

Carcinoma in the Remnant Stomach During Long-Term Follow-up After Distal Gastrectomy for Gastric Cancer: Analysis of Cumulative Incidence and Associated Risk Factors

  • Takaaki HanyuEmail author
  • Atsuhiro Wakai
  • Takashi Ishikawa
  • Hiroshi Ichikawa
  • Hitoshi Kameyama
  • Toshifumi Wakai
Original Scientific Report



The number of patients with remnant gastric cancer following resection of gastric cancer may increase. The aims of this study were to investigate the development of remnant gastric cancer after distal gastrectomy for gastric cancer and to examine its cumulative incidence, clinicopathological characteristics, and risk factors.


We examined 437 patients with relapse-free survival for 5 years or more after distal gastrectomy with Billroth I reconstruction for gastric cancer performed between 1985 and 2005.


A total of 17 patients suffered from remnant gastric cancer. The cumulative incidence was 3.7% at 10 years and 5.4% at 20 years. The median time until development of remnant gastric cancer was 79 months (range 30–209 months). The presence of synchronous multiple gastric cancers was a significant independent risk factor for remnant gastric cancer (hazard ratio 4.036; 95% confidence interval 1.478–11.02; P = 0.006). Of the 17 patients, the 13 whose remnant gastric cancer was detected via regular endoscopy showed better prognoses than the patients detected by other means (P < 0.001).


The cumulative incidence of remnant gastric cancer was 5.4% at 20 years. In particular, patients who had multiple gastric cancers at initial gastrectomy were at higher risk for remnant gastric cancer. Therefore, long-term endoscopic surveillance is important.


Compliance with ethical standards

Conflicts of interest

No conflict of interest to declare.


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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Takaaki Hanyu
    • 1
    Email author
  • Atsuhiro Wakai
    • 1
  • Takashi Ishikawa
    • 1
  • Hiroshi Ichikawa
    • 1
  • Hitoshi Kameyama
    • 1
  • Toshifumi Wakai
    • 1
  1. 1.Division of Digestive and General Surgery, Graduate School of Medical and Dental SciencesNiigata UniversityNiigata CityJapan

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