Gastric stump cancer after distal gastrectomy for benign disease: Clinicopathological features and surgical outcomes

Alberto Di Leo, Corrado Pedrazzani, Maria Bencivenga, Arianna Coniglio, Fausto Rosa, Paolo Morgani, Daniele Marrelli, Alberto Marchet, Luca Cozzaglio, Simone Giacopuzzi, Guido Alberto Massimo Tiberio, Giovanni Battista Doglietto, Giovanni Vittimberga, Franco Roviello, Francesco Ricci

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)2594-2600
Number of pages7
JournalAnnals of Surgical Oncology
Volume21
Issue number8
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Surgery
  • Oncology
  • Medicine(all)

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