Occurrence of non-gastric cancer in the digestive tract after remote partial gastrectomy: analysis of an Amsterdam cohort.

摘要: If peptic ulcer surgery favors the formation of carcinogenic N-nitroso compounds in gastric remnant, an increased risk cancer at sites gastrointestinal tract distant from stomach might be predicted. To estimate carcinomas digestive tract, other than stomach, occurring after partial gastrectomy, we analyzed Amsterdam cohort 2,633 post-gastrectomy patients operated on for benign disease between 1931 and 1960. Mortality study population was compared with general Dutch through person-year analysis. An excess mortality biliary (O/E:2.64; CL:1.32-4.72; p less 0.01) pancreatic (O/E:1.65; CL:1.06-2.44; 0.05) found males more 5 years surgery; females showed only first postoperatively (O/E:15.33; CL:1.85-55.43; 0.01), probably due to misdiagnosis. All non-gastric carried no cancer. In males, colorectal post-operatively significantly decreased (O/E:0.58; CL 0.34-0.92; 0.01). The biliary-tract which increases duration post-operative interval, is consistent a dose-response phenomenon. This therefore supports hypothesis that carcinogens are not locally activated but hepatically excreted initiate tree duct. Further exploration this mechanism carcinogenesis warranted, since it may also explain pathogenesis cancers without gastrectomy.