Gastric remnant carcinoma: Just another proximal gastric cancer or a unique entity?

Gastric cancer that occurs 5 or more years after distal gastric resection for benign disease is defined as gastric remnant carcinoma (GRC). The purpose of this study was to determine whether postresection outcome differs between GRC and primary proximal gastric cancer (PPGC). Twenty-five patients with GRC who underwent resection between August 1985 and July 1994 were compared with 79 PPGC patients who underwent resection during the same time period. Overall actuarial 5-year disease-specific survival was 63% for curatively resected GRC patients and 37% for the curatively resected PPGC patients ( P = 0.1, log rank). No significant differences in survival were seen between the two groups when stratified for stage. On multi-variate analysis of significant predictors of outcome for the 104 patients as a group, only the ability to do a curative resection was significant. The outcome following resection of GRC is no different from that of other primary proximal gastric cancers of the same stage. Every effort should be made to perform a curative resection, as this is a significant predictor of outcome.