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Surgical Endoscopy

, Volume 24, Issue 6, pp 1310–1317 | Cite as

Surveillance and treatment for second primary cancer in the gastric tube after radical esophagectomy

  • Takeo Bamba
  • Shin-ichi Kosugi
  • Manabu Takeuchi
  • Masaaki Kobayashi
  • Tatsuo Kanda
  • Atsushi Matsuki
  • Katsuyoshi Hatakeyama
Article

Abstract

Background

Recent improvement in the survival of patients after esophagectomy for esophageal cancer has led to increasing occurrence of second primary cancer in the pulled-up stomach as gastric tube cancer (GTC). However, a treatment strategy for GTC including surveillance has not been established. The aims of this study are to clarify the incidence and clinicopathological characteristics of GTC and to assess the treatment results of endoscopic resection.

Methods

Twenty-five patients with 29 GTC lesions treated between 1989 and 2007 were analyzed retrospectively.

Results

The median interval between esophagectomy and GTC detection was 86 months, and the 10-year cumulative incidence rate of GTC was 8.6%. Of 18 asymptomatic GTCs, 17 lesions (94.4%) were detected by periodic endoscopy and 15 (88.2%) of them were treated endoscopically. Of all 29 GTCs, endoscopic submucosal dissection (ESD) was performed in 10 GTCs with a completely curative resection rate of 90%, which was significantly higher than that of 7 GTCs treated with endoscopic mucosal resection (EMR) (14.3%, P = 0.004). In these 17 GTCs, no cancer recurrence developed during a median follow-up period of 24 months, and the 3-year survival rate was 80.8%.

Conclusions

For patients after esophagectomy with gastric pull-up, long-term follow-up including periodic endoscopy is necessary to detect a potentially curable GTC. ESD is a feasible and safe procedure for GTC, with oncologically favorable features.

Keywords

Gastric tube Endoscopic submucosal dissection Endoscopic surveillance 

Notes

Disclosures

Drs. Takeo Bamba, Shin-ichi Kosugi, Manabu Takeuchi, Masaaki Kobayashi, Tatsuo Kanda, Atsushi Matsuki, and Katsuyoshi Hatakeyama have no conflicts of interest to disclose. No financial support by commercial relationship was provided for this study.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Takeo Bamba
    • 1
  • Shin-ichi Kosugi
    • 1
  • Manabu Takeuchi
    • 2
    • 3
  • Masaaki Kobayashi
    • 2
    • 3
  • Tatsuo Kanda
    • 1
  • Atsushi Matsuki
    • 1
    • 2
  • Katsuyoshi Hatakeyama
    • 1
  1. 1.Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigata CityJapan
  2. 2.Department of EndoscopyNiigata University Medical and Dental Hospital Niigata CityJapan
  3. 3.Division of Gastroenterology and HepatologyNiigata University Graduate School of Medical and Dental SciencesNiigata City Japan

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