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Clinical characteristics and management of gastric tube cancer after esophagectomy

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Abstract

Background

Gastric cancer is the second most common malignancy, overlapping with thoracic esophageal cancer (TEC). Among them, metachronous gastric tube cancers after TEC surgery have been increasing. The aims of this study were to examine the clinicopathological factors and treatment outcomes of gastric tube cancer (GTC) after TEC surgery.

Methods

Thirty-three GTCs in 30 cases after TEC treated between 1997 and 2016 were investigated retrospectively.

Results

Most cases were males. The median interval from TEC surgery to GTC occurrence was 57 (6.5–107.5) months. Almost 2/3 lesions occurred in the lower third of the gastric tube (21/33); 29 lesions (in 26 cases) were superficial cancers, and 4 lesions were advanced cancers. Twenty-two lesions of superficial cancer were differentiated type, and the remaining seven lesions were undifferentiated type. Treatment for superficial cancer had previously been performed with partial gastric tube resection (10 lesions), and the number of cases undergoing endoscopic submucosal dissection (ESD) had increased recently (19 lesions). Most cases with superficial cancer survived without relapse. Four lesions of advanced cancer were found after a relatively long interval following TEC surgery. Most lesions of advanced cancer were scirrhous, undifferentiated type, and they died due to GTC.

Conclusion

GTCs may occur late in the postoperative course following TEC surgery. If they are discovered at an early stage, these lesions can be cured with ESD. Long-term periodic endoscopic examinations after TEC surgery are important.

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References

  1. Poon RT, Law SY, Chu KM, et al. Multiple primary cancers in esophageal squamous cell carcinoma: incidence and implications. Ann Thorac Surg. 1998;65:1529–34.

    Article  PubMed  CAS  Google Scholar 

  2. Nagasawa S, Onda M, Sasajima K, et al. Multiple primary malignant neoplasms in patients with esophageal cancer. Dis Esophagus. 2000;13:226–30.

    Article  PubMed  CAS  Google Scholar 

  3. Kokawa A, Yamaguchi H, Tachimori Y, et al. Other primary cancers occurring after treatment of superficial oesophageal cancer. Br J Surg. 2001;88:439–43.

    Article  PubMed  CAS  Google Scholar 

  4. Okamoto N, Ozawa S, Kitagawa Y, et al. Metachronous gastric carcinoma from a gastric tube after radical surgery for esophageal carcinoma. Ann Thorac Surg. 2004;77:1189–92.

    Article  PubMed  Google Scholar 

  5. Mukasa M, Takedatsu H, Matsuo K, et al. Clinical characteristics and management of gastric tube cancer with endoscopic submucosal dissection. World J Gastroenterol. 2015;21:919–25.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sugiura T, Kato H, Tachimori Y, et al. Second primary carcinoma in the gastric tube constructed as an esophageal substitute after esophagectomy. J Am Coll Surg. 2002;194:578–83.

    Article  PubMed  Google Scholar 

  7. Ahn HS, Kim JW, Yoo MW, et al. Clinicopathological features and surgical outcomes of patients with remnant gastric cancer after a distal gastrectomy. Ann Surg Oncol. 2008;15:1632–9.

    Article  PubMed  Google Scholar 

  8. Shigemitsu K, Naomoto Y, Shirakawa Y, et al. Five cases of early gastric cancer in the reconstructed gastric tube after radical resection for esophageal cancer. Jpn J Clin Oncol. 2002;32:425–9.

    Article  PubMed  Google Scholar 

  9. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20:1–19.

    Article  Google Scholar 

  10. Bamba T, Kosugi S, Takeuchi M, et al. Surveillance and treatment for second primary cancer in the gastric tube after radical esophagectomy. Surg Endosc. 2010;24:1310–7.

    Article  PubMed  Google Scholar 

  11. Nonaka S, Oda I, Sato C, et al. Endoscopic submucosal dissection for gastric tube cancer after esophagectomy. Gastrointest Endosc. 2014;79:260–70.

    Article  PubMed  Google Scholar 

  12. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.

    Article  Google Scholar 

  13. Shirakawa Y, Noma K, Koujima T, et al. Operative technique of antethoracic esophageal reconstruction with pedicled jejunal flap. Esophagus. 2015;15:57–64.

    Article  Google Scholar 

  14. Takenaka R, Kawahara Y, Okada H, et al. Endoscopic submucosal dissection for cancers of the remnant stomach after distal gastrectomy. Gastrointest Endosc. 2008;67:359–63.

    Article  PubMed  Google Scholar 

  15. Imagawa A, Okada H, Kawahara Y, et al. Endoscopic submucosal dissection (ESD) for early gastric cancer: results and degrees of technical difficulty as well as success. Endoscopy. 2006;38:987–90.

    Article  PubMed  CAS  Google Scholar 

  16. Japan Esophageal Society. Japanese classification of esophageal cancer, 11th edition: part I. Esophagus. 2017;14:1–36.

    Article  Google Scholar 

  17. Japan Esophageal Society. Japanese classification of esophageal cancer, 11th edition: part II and III. Esophagus. 2017;14:37–65.

    Article  Google Scholar 

  18. Sobin LH, Gospodarowicz MK, Wittekind CH. TNM classification of malignant tumors (UICC international union against cancer). 7th ed. Oxford: Wiley-Blackwell; 2009.

    Google Scholar 

  19. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Warren S, Gates O. Multiple primary malignant tumors. A survey of the literature and a statistical study. Am J Cancer. 1932;16:1358–414.

    Google Scholar 

  21. Osumi W, Fujita Y, Hiramatsu M, et al. Endoscopic submucosal dissection allows less-invasive curative resection for gastric tube cancer after esophagectomy—a case series. Endoscopy. 2009;41:777–80.

    Article  PubMed  CAS  Google Scholar 

  22. Suzuki H, Kitamura M, Saito R, et al. Cancer of the gastric tube reconstructed through the posterior mediastinal route after radical surgery for esophageal cancer. Jpn J Thorac Cardiovasc Surg. 2001;49:466–9.

    Article  PubMed  CAS  Google Scholar 

  23. Kise Y, Kijima H, Shimada H, et al. Gastric tube cancer after esophagectomy for esophageal squamous cell cancer and its relevance to Helicobacter pylori. Hepatogastroenterology. 2003;50:408–11.

    PubMed  Google Scholar 

  24. Dixon MF, Mapstone NP, Neville PM, et al. Bile reflux gastritis and intestinal metaplasia at the cardia. Gut. 2002;51:351–5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan

    Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Takayuki Ninomiya, Shunsuke Tanabe, Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Shunsuke Kagawa & Toshiyoshi Fujiwara

  2. Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan

    Yoshiro Kawahara & Hiroyuki Okada

Authors
  1. Yasuhiro Shirakawa
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  2. Kazuhiro Noma
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  3. Naoaki Maeda
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  4. Takayuki Ninomiya
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  5. Shunsuke Tanabe
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  6. Satoru Kikuchi
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  7. Shinji Kuroda
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  8. Masahiko Nishizaki
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  9. Shunsuke Kagawa
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  10. Yoshiro Kawahara
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  11. Hiroyuki Okada
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  12. Toshiyoshi Fujiwara
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Corresponding author

Correspondence to Yasuhiro Shirakawa.

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Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent or substitute for it was obtained from all patients for being included in the study.

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Shirakawa, Y., Noma, K., Maeda, N. et al. Clinical characteristics and management of gastric tube cancer after esophagectomy. Esophagus 15, 180–189 (2018). https://doi.org/10.1007/s10388-018-0611-2

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  • DOI: https://doi.org/10.1007/s10388-018-0611-2

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