Abstract
Geographical differences may exist in the risk of gastric stump cancer. Therefore, we performed meta-analysis of literature reports in Japan (n = 3), the USA (n = 4), and Europe (n = 20) on the risk of postgastrectomy cancer. The weighted mean relative risk of stump cancer in Japan was 0.28, 95% confidence limits 0.21-0.38 as compared to 1.53, 95% confidence limits 0.98-2.41 in the USA and 1.66, 95% confidence limits 1.55-1.79 in Europe. Thus, the risk of gastric cancer in the post-gastrectomy patient seems decreased in Japan and is significantly less than in the USA or Europe, where an increased risk exists. Since there is a high risk of gastric cancer of the intact stomach in Japan, the discovery of a low cancer risk in the gastric stump may provide evidence that these gastric cancers are two different entities.