Progression and Prognosis of Gastric Stump Cancer

Background and Objectives: The incidence of gastric stump cancer (GSC) is increasing. The aim of this study is to determine the clinicopathologic feature and the differences of surgical outcome between GSC after partial gastrectomy for benign diseases (GSC-B) and GSC after partial gastrectomy for malignant tumors (GSC-M). Methods: Medical records of 42 patients with GSC-B and 47 patients with GSC-M who underwent surgical treatment were studied and analyzed retrospectively. Clinicopathologic parameters, the 5-year survival rate after operation mid prognostic factors, were analyzed retrospectively. Results: GSC was frequently detected in anastomotic site. Poorly differentiated cancer was common. No difference was found between patients with GSC-B and patients with GSC-M in terms of histologic type, tumor location, and distribution of tumor stage. GSC-B patients had a higher incidence in No. 7, 8, 9 lymph nodes than GSC-M patients. In contrast, the patients with GSC-M had higher incidence of metastasis to jejunal mesentery lymph nodes and No. 10, 11 lymph nodes. The overall 5-year survival rates were 38.1% for GSC-B and 10.4% for GSC-M, with significant difference (P < 0.05). Conclusions: GSC has a particular pattern in lymph node metastasis and organs invasion. Surgical resection is considered an effective therapeutic strategy for GSC. J. Surg. Oncol. 2009;100:472-476. (C) 2009 Wiley-Liss, Inc.