Full Text:   <2492>

CLC number: R735.2

On-line Access: 

Received: 2004-01-15

Revision Accepted: 2004-07-24

Crosschecked: 0000-00-00

Cited: 10

Clicked: 6259

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2005 Vol.6 No.1 P.38-42

http://doi.org/10.1631/jzus.2005.B0038


Surgical management of gastric stump cancer: a report of 37 cases


Author(s):  CHEN Li, TIAN Hua, CHEN Jian, HE Zhi-gang, TAO Si-feng, LOKESH Gurung, PENG Shu-you

Affiliation(s):  Department of Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; more

Corresponding email(s):   chenli@mail.hz.zj.cn

Key Words:  Gastric stump cancer, Surgery, Partial gastrectomy, Endoscopy, Prognosis


CHEN Li, TIAN Hua, CHEN Jian, HE Zhi-gang, TAO Si-feng, LOKESH Gurung, PENG Shu-you. Surgical management of gastric stump cancer: a report of 37 cases[J]. Journal of Zhejiang University Science B, 2005, 6(1): 38-42.

@article{title="Surgical management of gastric stump cancer: a report of 37 cases",
author="CHEN Li, TIAN Hua, CHEN Jian, HE Zhi-gang, TAO Si-feng, LOKESH Gurung, PENG Shu-you",
journal="Journal of Zhejiang University Science B",
volume="6",
number="1",
pages="38-42",
year="2005",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.2005.B0038"
}

%0 Journal Article
%T Surgical management of gastric stump cancer: a report of 37 cases
%A CHEN Li
%A TIAN Hua
%A CHEN Jian
%A HE Zhi-gang
%A TAO Si-feng
%A LOKESH Gurung
%A PENG Shu-you
%J Journal of Zhejiang University SCIENCE B
%V 6
%N 1
%P 38-42
%@ 1673-1581
%D 2005
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.2005.B0038

TY - JOUR
T1 - Surgical management of gastric stump cancer: a report of 37 cases
A1 - CHEN Li
A1 - TIAN Hua
A1 - CHEN Jian
A1 - HE Zhi-gang
A1 - TAO Si-feng
A1 - LOKESH Gurung
A1 - PENG Shu-you
J0 - Journal of Zhejiang University Science B
VL - 6
IS - 1
SP - 38
EP - 42
%@ 1673-1581
Y1 - 2005
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.2005.B0038


Abstract: 
Objective: To observe the clinicopathological characteristics of gastric stump cancer (GSC) and evaluate the benefits of radical surgery of GSC. Methods: The clinicopathological characteristics and postoperative survival time of 37 GSC patients who underwent surgery were investigated retrospectively. The survival time was compared according to the type of surgical operation (radical resection vs palliative operation). Twenty-one cases that received radical resection were analyzed based on the pTMN stage. Survival curves were traced by using Kaplan-Meier methods. Results: Most GSC (32/37) was detected in patients who had received Billroth II reconstruction after partial gastrectomy for benign gastric disease. The lesser curvature side and the suture line of anastomosis were the most frequent sites where GSC occurred (27/37). Differentiated adenocarcinoma was the dominant histopathological type (24/37). The postoperative 5-year survival rate of early stage GSC patients (n=9) was significantly higher than advanced stage GSC (n=12) (55.6% vs 16.5%, xL2=11.48, P<0.01). Five-year survival rate of 21 GSC patients with radical resection were 75% (3/4) for stage I, 60% (3/5) for stage II, 14.2% (1/7) for stage III, and 0% (0/5) for stage IV respectively. The median survival time of 21 GSC patients who underwent radical resection was longer than those undergoing palliative operation (43.0 m vs 13.0 m, xL2=36.31, P<0.01), the median survival time of stage IV patients with radical resection was 23.8 months. Conclusions: Without remote metastasis, radical resection for GSC is possible, and is an effective way to improve the prognosis of GSC. Even in stage IV GSC, radical resection can still prolong the survival time. It is necessary for the patients with benign gastric diseases who received partial gastrectomy to carry out the endoscopy follow-up, especially in patients with Billroth II reconstruction procedure at 15-20 years.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1] Caygill, C.P., Hill, M.J., Hall, C.N., Kirkham, J.S., Northfield, T.C., 1987. Increased risk of cancer at multiple site after gastric surgery for peptic ulcer. Gut, 28(8):924-928.

[2] Fukuhara, K., Osugi, H., Takada, N., Takemura, M., Ohmoto, Y., Kinoshita, H., 2003. Quantitative determinations of duodenogastric reflux, prevalence of Helicobacter pylori infection, and concentration of interleukin-8. World J Surg, 27(5):567-570.

[3] Gannon, C.J., Engbrecht, B., Napolitano, L.M., Bass, B.L., 2001. Gastric remnant carcinoma: reevaluation of screening endoscopy. Surg Endosc, 15(12):1488-1494.

[4] Greene, F.L., 1996. Management of gastric remnant carcinoma based on the results of a 15-year endoscopic screening program. Ann Surg, 223(6):701-708.

[5] JGCA (Japanese Gastric Cancer Association), 1998. Japanese Classification of Gastric Carcinoma. 2nd English edition. Gastric Cancer, 1(1):10-24.

[6] Kaneko, K., Kondo, H., Saito, D., Shirao, K., Yamaguchi, H., Yokota, G., Sano, T., Sasako, M., Yoshida, S., 1998. Early gastric stump cancer following distal gastrectomy. Gut, 43(3):342-344.

[7] Kunisaki, C., Shimada, H., Nomura, M., Hosaka, N., Akiyama, H., Ookubo, K., Moriwaki, Y., Yamaoka, H., 2002. Lymph node dissection in surgical treatment for remnant stomach cancer. Hepatogastroenterology, 49(44):580-584.

[8] Lo, S.S., Wu, C.W., Hsieh, M.C., Lui, W.Y., 1997. Is gastric remnant cancer clinically different from primary gastric cancer? Hepatogastroenterology, 44(13):299-301.

[9] Lorusso, D., Linsalata, M., Pezzolla, F., Berloco, P., Osella, A.R., Guerra, V., Di, L.A., Demma, I., 2000. Duodenogastric reflux and gastric mucosal polyamines in the non-operated stomach and in the gastric remnant after Billroth II gastric resection. A role in gastric carcinogenesis? Anticancer Res, 20(3B):2197-2201.

[10] Matsui, N., Yao, T., Akazawa, K., Nawata, H., Tsuneyoshi, M., 2001. Different characteristics of carcinoma in the gastric remnant: histochemical and immunohistochemical studies. Oncol Rep, 8(1):17-26.

[11] Pointer, R., Schwab, G., Konigsrainer, A., Bodner, E., Schmid, K.W., 1988. Early cancer of the gastric remnant. Gut, 29(3):298-301.

[12] Tanigawa, N., Nomura, E., Niki, M., Shinohara, H., Nishiguchi, K., Okuzawa, M., Toyoda, M., Morita, S., 2002. Clinical study to identify specific characteristics of cancer newly developed in the remnant stomach. Gastric Cancer, 5(1):23-28.

[13] Thorban, S., Boattcher, K., Etter, M., Roder, J.D., Busch, R., Siewert, J.R., 2000. Prognostic factors in gastric stump carcinoma. Ann Surg, 231(2):188-194.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2022 Journal of Zhejiang University-SCIENCE