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Gastric Cancer

, Volume 12, Issue 2, pp 88–94 | Cite as

A clinicopathological study of gastric stump carcinoma following proximal gastrectomy

  • Shigekazu Ohyama
  • Masanori Tokunaga
  • Naoki Hiki
  • Tetsu Fukunaga
  • Junko Fujisaki
  • Yasuyuki Seto
  • Toshiharu Yamaguchi
Original Article

Abstract

Background

We aimed to clarify the frequency and clinicopathological characteristics of gastric stump carcinoma following proximal gastrectomy.

Methods

Three-hundred and sixteen patients who had undergone curative proximal gastrectomy over a 21-year period from January 1984 through December 2004 were reviewed.

Results

Gastric stump carcinoma was observed in 17 patients (5.4%). The time interval between the initial gastrectomy and the treatment of gastric stump cancer was within 5 years in 3 patients, within 5–10 years in 8, and after 10 years in 6. Treatment included endoscopic resection (n = 4), completion total gastrectomy of the remnant stomach (n = 11), pancreatoduodenectomy (n = 1), and nonsurgical resection (n = 1). Pathologically, 9 carcinomas were differentiated and 8 were undifferentiated. In a review of reconstruction methods associated with disease stage, stage I was found in 6 of the 7 patients with esophagogastrostomy or short-segment jejunal interposition. On the other hand, stage I was found in only 3, but stage II–IV was found in 7 of the 10 patients with reconstruction by double-tract or long-segment jejunal interposition; thus, the tumor was more likely to be detected at an advanced stage after long-segment interposition (P = 0.049).

Conclusion

Gastric stump carcinoma following proximal gastrectomy occurred at a high frequency of 5.4% of initial resections. It is necessary to select a reconstruction method that facilitates postoperative endoscopic examination, as well as to follow up the patients after proximal gastrectomy in the long term for the early detection and early treatment of gastric stump carcinoma.

Key words

Gastric stump carcinoma Proximal gastrectomy Jejunal interposition 

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2009

Authors and Affiliations

  • Shigekazu Ohyama
    • 1
  • Masanori Tokunaga
    • 1
  • Naoki Hiki
    • 1
  • Tetsu Fukunaga
    • 1
  • Junko Fujisaki
    • 2
  • Yasuyuki Seto
    • 3
  • Toshiharu Yamaguchi
    • 1
  1. 1.Department of SurgeryCancer Institute Hospital of JFCRTokyoJapan
  2. 2.Department of Internal MedicineCancer Institute Hospital of JFCRTokyoJapan
  3. 3.Department of Gastrointestinal SurgeryThe University of Tokyo, Graduate School of MedicineTokyoJapan

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