Surgery Today

, Volume 48, Issue 5, pp 552–557 | Cite as

Incidence and treatment of metachronous gastric cancer after proximal gastrectomy

  • Yoshinori Iwata
  • Seiji Ito
  • Kazunari Misawa
  • Yuichi Ito
  • Koji Komori
  • Tetsuya Abe
  • Yasuhiro Shimizu
  • Masahiro Tajika
  • Yasumasa Niwa
  • Kazuhiro Yoshida
  • Taira Kinoshita
Original Article


Background and purpose

Proximal gastrectomy (PG) is a widely accepted function-preserving surgical procedure; however, the incidence and treatment of metachronous gastric cancer (MGC) after PG have been the subject of a number of reports.


We collected data from 1576 consecutive patients who underwent gastrectomy for gastric cancer between January, 2003 and December, 2010, and analyzed the outcomes of 671 patients treated with PG or distal gastrectomy (DG) for cT1N0 disease. We also discuss the treatments for MGC.


MGC was diagnosed within a median follow-up of 52.8 months after PG and DG in six (6.6%) and nine (1.8%) patients, respectively. The cumulative prevalence of MGC after PG was significantly higher than that after DG; P = 0.005. Univariate and multivariate analysis revealed male sex and PG as significant risk factors for MGC (P = 0.014 and P = 0.026, respectively). Five of the six patients who underwent PG were treated by endoscopic submucosal dissection.


The incidence of MGC after PG was significantly higher than that after DG. However, most of the MGCs that developed after PG could be treated by endoscopic submucosal dissection.


Gastric remnant cancer Metachronous gastric cancer Proximal gastrectomy Endoscopic submucosal dissection Endoscopic surveillance 



This work was supported in part by a Health Labour Sciences Research Grant (H26-053).

Compliance with ethical standards

Conflict of interest

We have no conflicts of interest to declare.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Yoshinori Iwata
    • 1
  • Seiji Ito
    • 1
  • Kazunari Misawa
    • 1
  • Yuichi Ito
    • 1
  • Koji Komori
    • 1
  • Tetsuya Abe
    • 1
  • Yasuhiro Shimizu
    • 1
  • Masahiro Tajika
    • 2
  • Yasumasa Niwa
    • 2
  • Kazuhiro Yoshida
    • 3
  • Taira Kinoshita
    • 1
  1. 1.Department of Gastroenterological SurgeryAichi Cancer Center HospitalNagoyaJapan
  2. 2.Department of EndoscopyAichi Cancer Center HospitalNagoyaJapan
  3. 3.Department of Surgical OncologyGifu University School of MedicineGifuJapan

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