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Clinical outcomes of recurrent gastric cancer detected by upper endoscopy after curative total gastrectomy

Abstract

Background/aims

Endoscopically detected tumor recurrence after curative total gastrectomy is very rare. We reviewed the clinicopathological and endoscopic findings together with the clinical outcomes of these patients.

Methods

Seventeen patients with recurrent gastric cancer detected by upper gastrointestinal endoscopy who underwent curative total gastrectomy between January 1990 and May 2011 at the Asan Medical Center were analyzed retrospectively.

Results

Of the 17 patients, 5 were resectable at the time of diagnosis of recurrence and 12 were unresectable. The median interval between total gastrectomy and diagnosis of recurrence was 20.2 months (interquartile range 12.4-42.1 months). The tumors were located in the anastomotic area in 8 patients, in the proximal part of the afferent or efferent loop in 7, and in the stump of the afferent loop in 2 patients. With regard to the endoscopic findings, a mass was found in 8 cases, an ulcer in 2, stricture in 4, and nodularities in 3. Operations were performed in 3 patients, chemotherapy in 10 (including 2 receiving adjuvant chemotherapy), and conservative management in 6. Fourteen patients died from progression of the disease and the median survival period from recurrence for all 17 patients was 5.3 months (interquartile range 1.2-7.7 months).

Conclusions

Local recurrence of gastric cancer detected by upper gastrointestinal endoscopy after curative total gastrectomy has a poor prognosis.

Tumori 2017; 103(2): 164 - 169

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000575

Authors

Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim

Article History

Disclosures

Financial support: None.
Conflict of interest: The authors have no conflicts of interest related to this work.

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Authors

Affiliations

  • Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea

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