|Table of Contents|

Risk factors for remnant gastric cancer and esophageal carcinoma for patients with benign gastric disease after distal gastrectomy

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 05
Page:
863-869
Research Field:
Publishing date:

Info

Title:
Risk factors for remnant gastric cancer and esophageal carcinoma for patients with benign gastric disease after distal gastrectomy
Author(s):
ZHANG Sihan1; 2; FANG Xuefen1; 2; WU Huiting3; LIN Qingcai4; XIE Xiaoqian5; LI Wen6; HUANG Xiaoyun1; 2; WANG Xiaozhong1; 2; CHEN Fenglin1; 2; ZHENG Biyun1; 2
Keywords:
distal gastrectomy; risk factor; remnant gastric cancer; esophageal cancer; nomogram
PACS:
R735
DOI:
10.3969/j.issn.1672-4992.2024.05.014
Abstract:
Objective:To evaluate the risk factors associated with the incidence of remnant gastric cancer(RGC) and esophageal cancer(EC) for patients with benign gastric disease after distal gastrectomy(DG).Methods:From 1/1/2010 to 1/1/2018,we retrospectively analyzed the medical records of these patients，and established a prediction model for the risk of EC and RGC after DG.Results:There were 301 patients included,11.96% patients were observed with remnant gastric cancer with the mean age of (67.83±9.14) years old,among which 83.33% were advanced stages and only 55.56% patients had the chance for surgery.RGC were most commonly found in residual gastric body and anastomosis.5.00% patients were observed with EC with the mean age of (68.00±8.73) years old,and most commonly located at the lower third thoracic esophagus.All of them were advanced stages and 80.00% lost the chance of surgery.The univariate and binary logistic regression analysis demonstrated that age≥65 years,surgery interval≥10 years and bile reflux were the independent risk for remnant gastric cancer,and age≥65 years and bile reflux were independent risk for esophageal cancer.Then we stratified the incidence into low-risk,intermediate-risk,and high-risk groups,and it was 1.72%,8.62%,28.99% for RGC respectively(P＜0.001) and 0.70%,4.88%,13.16% for EC respectively(P＜0.001).Conclusion:Patients with benign gastric disease after DG with age≥65 years and surgery interval≥10 years were recommended closely gastroscopic follow-up.If bile reflux is found,the lower third of esophagus,residual gastric body and anastomosis should be examined carefully.

References:

［1］PARK YE,KIM SW.Clinicopathologic features of remnant gastric cancer after curative distal gastrectomy according to previous reconstruction method:A retrospective cohort study［J］.World J Surg Oncol,2019,17(1):203.
［2］AHN HS,KIM JW,YOO MW,et al.Clinicopathological features and surgical outcomes of patients with remnant gastric cancer after a distal gastrectomy［J］.Ann Surg Oncol,2008,15(6):1632-1639.
［3］RAMOS M,PEREIRA MA,YAGI OK,et al.Surgical treatment of gastric cancer:A 10-year experience in a high-volume university hospital［J］.Clinics(Sao Paulo),2018,73(suppl 1):e543s.
［4］OHIRA M,TOYOKAWA T,SAKURAI K,et al.Current status in remnant gastric cancer after distal gastrectomy［J］.World J Gastroenterol,2016,22(8):2424-2433.
［5］KWON IG,CHO I,CHOI YY,et al.Risk factors for complications during surgical treatment of remnant gastric cancer［J］.Gastric Cancer,2015,18(2):390-396.
［6］SUNG H,FERLAY J,SIEGEL RL,et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］.CA Cancer J Clin,2021,71(3):209-249.
［7］PENNATHUR A,GIBSON MK,JOBE BA,et al.Oesophageal carcinoma［J］.Lancet,2013,381(9864):400-412.
［8］MAO Z,WANG B,DONG P,et al.The completely mobilized remnant stomach:A new choice to reconstruct the esophagus in lower thoracic esophageal carcinoma with a history of distal gastrectomy［J］.Surg Oncol,2018,27(3):539-543.
［9］NAKANISHI K,DAIKO H,KATO F,et al.Efficacy of preserving the residual stomach in esophageal cancer patients with previous gastrectomy［J］.Gen Thorac Cardiovasc Surg,2019,67(5):470-478.
［10］LIU GL,WANG X,HU HF,et al.The application of two-stage operation for high-risk patients with oesophageal cancer following gastrectomy［J］.J Gastrointest Surg,2022,26(10):2033-2040.
［11］TANAKA K,YAMASAKI M,YAMASHITA K,et al.Safety and efficacy of double-tract reconstruction with remnant stomach conservation in esophagectomy for patients with a history of distal gastrectomy［J］.Esophagus,2023,20(1):72-80.
［12］HASHIMOTO N,INAYAMA M,FUJISHIMA M,et al.Esophageal cancer after distal gastrectomy［J］.Dis Esophagus,2006,19(5):346-349.
［13］WADA H,DOKI Y,NISHIOKA K,et al.Clinical outcome of esophageal cancer patients with history of gastrectomy［J］.J Surg Oncol,2005,89(2):67-74.
［14］TACHIBANA M,ABE S,YOSHIMURA H,et al.Squamous cell carcinoma of the esophagus after partial gastrectomy［J］.Dysphagia,1995,10(1):49-52.
［15］KAMARAJAH SK,MADHAVAN A,CHMELO J,et al.Impact of smoking status on perioperative morbidity,mortality,and long-term survival following transthoracic esophagectomy for esophageal cancer［J］.Ann Surg Oncol,2021,28(9):4905-4915.
［16］MILLWOOD IY,LI L,SMITH M,et al.Alcohol consumption in 0.5 million people from 10 diverse regions of China:Prevalence,patterns and socio-demographic and health-related correlates［J］.Int J Epidemiol,2013,42(3):816-827.
［17］World Health Organization.International guide for monitoring alcohol consumption and related harm［R］.Geneva:World Health Organization,2000.
［18］KUBO M,SASAKO M,GOTODA T,et al.Endoscopic evaluation of the remnant stomach after gastrectomy:Proposal for a new classification［J］.Gastric Cancer,2002,5(2):83-89.
［19］YAQOOB P.Ageing alters the impact of nutrition on immune function［J］.Proc Nutr Soc,2017,76(3):347-351.
［20］XIE SH,LAGERGREN J.Risk factors for esophageal cancer［J］.Best Pract Res Clin Gastroenterol,2018,36-37:3-8.
［21］ABNET CC,ARNOLD M,WEI WQ.Epidemiology of esophageal squamous cell carcinoma［J］.Gastroenterology,2018,154(2):360-373.
［22］CORREA P.A human model of gastric carcinogenesis［J］.Cancer Res,1988,48(13):3554-3560.
［23］MATSUMOTO K,TANAKA S,TOYONAGA T,et al.Clinical impact of different reconstruction methods on remnant gastric cancer at the anastomotic site after distal gastrectomy［J］.Clin Endosc,2022,55(1):86-94.
［24］ZHANG LY,ZHANG J,LI D,et al.Bile reflux is an independent risk factor for precancerous gastric lesions and gastric cancer:An observational cross-sectional study［J］.J Dig Dis,2021,22(5):282-290.
［25］JIA W,XIE G,JIA W.Bile acid-microbiota crosstalk in gastrointestinal inflammation and carcinogenesis［J］.Nat Rev Gastroenterol Hepatol,2018,15(2):111-128.
［26］CHEN L,LU H,PENG D,et al.Activation of NOTCH signaling via DLL1 is mediated by APE1-redox-dependent NF-kappaB activation in oesophageal adenocarcinoma［J］.Gut,2023,72(3):421-432.
［27］LI HH,ZHANG QZ,XU L,et al.Clinical outcome of esophageal cancer after distal gastrectomy:A prospective study［J］.Int J Surg,2008,6(2):129-135.
［28］LIU S,ZHAO Z,HAN L,et al.Epstein-barr virus infection in gastric remnant carcinoma and recurrent gastric carcinoma in Qingdao of Northern China［J］.PLoS One,2016,11(2):e0148342.
［29］HIRABAYASHI M,GEORGES D,CLIFFORD GM,et al.Estimating the global burden of Epstein-Barr virus-associated gastric cancer:A systematic review and Meta-analysis［J］.Clin Gastroenterol Hepatol,2023,21(4):922-930 e921.

Memo

Memo:
National Natural Science Foundation of China（No.82203308）;国家自然科学基金青年基金项目(编号：82203308);福建省自然科学基金面上项目（编号：2020J011005）;福建省微创医疗中心建设项目（编号：2021-76）
Last Update: 2024-01-30