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Gastric Stump Cancer After Distal Gastrectomy for Benign Disease: Clinicopathological Features and Surgical Outcomes

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the present study was to analyze clinicopathologic features and long-term prognosis of gastric stump cancer (GSC) arising in the remnant stomach 5 years or later after partial gastrectomy for benign disease.

Methods

We reviewed the results of 176 patients resected with curative intent for GSC at 8 Italian centers belonging to the Italian Research Group for Gastric Cancer (GIRCG). The median (range) follow-up time for surviving patients was 71.2 (6–207) months.

Results

One hundred forty-six patients were men, the mean age at the time of diagnosis was 69.2 years, and the great majority (167 cases) underwent Billroth II reconstruction. R0 resection was achieved in 158 (90 %) patients, and in 94 (53 %) lymph node dissection was ≥D2. Postoperative mortality and complication rates were 6.2 and 43.2 %, respectively. T1 tumor was diagnosed in 45 (25 %) cases. Lymph node metastases were evident in 86 patients (49 %). Thirteen patients had involvement of the jejunal mesentery nodes (pJN+); five cases were T2–T3 and eight cases were T4. Overall 5-year survival rate was 53.1 %. Five-year survival rates were 68.1, 37.8, and 33.1 % for pT1, pT2-3, and pT4 tumors, respectively (P = 0.001). Five-year survival rate was 56.5 % for node-negative tumors (pN0), 32.3 % for tumors with nodal metastases without involvement of jejunal mesentery nodes (pN+), and 17.1 % for tumors with involvement of jejunal mesentery nodes (pJN+) (P = 0.002).

Conclusions

Our study suggests that an aggressive surgical approach can achieve a satisfactory outcome in GSC.

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Disclosure

All the authors declare that they have not potential commercial conflicts of interest relevant to this article.

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Authors and Affiliations

  1. Unit of General Surgery, Rovereto Hospital, APSS of Trento, Trento, Italy

    Alberto Di Leo, Corrado Pedrazzani & Francesco Ricci

  2. Unit of Upper G.I. Surgery, University of Verona, Verona, Italy

    Maria Bencivenga & Simone Giacopuzzi

  3. Surgical Clinic, University of Brescia, Brescia, Italy

    Arianna Coniglio & Guido Alberto Massimo Tiberio

  4. Department of Digestive Surgery, Catholic University of Rome, Rome, Italy

    Fausto Rosa & Giovanni Battista Doglietto

  5. Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy

    Paolo Morgani & Giovanni Vittimberga

  6. Division of Surgical Oncology, University of Siena, Siena, Italy

    Daniele Marrelli & Franco Roviello

  7. Department of Oncological and Surgical Science, University of Padua, Padua, Italy

    Alberto Marchet

  8. Division of Surgical Oncology, Humanitas Hospital, Milan, Italy

    Luca Cozzaglio

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  1. Alberto Di Leo
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  2. Corrado Pedrazzani
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Correspondence to Alberto Di Leo.

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Di Leo, A., Pedrazzani, C., Bencivenga, M. et al. Gastric Stump Cancer After Distal Gastrectomy for Benign Disease: Clinicopathological Features and Surgical Outcomes. Ann Surg Oncol 21, 2594–2600 (2014). https://doi.org/10.1245/s10434-014-3633-6

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  • DOI: https://doi.org/10.1245/s10434-014-3633-6

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