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Annals of Surgical Oncology

, Volume 21, Issue 8, pp 2594–2600 | Cite as

Gastric Stump Cancer After Distal Gastrectomy for Benign Disease: Clinicopathological Features and Surgical Outcomes

  • Alberto Di LeoEmail author
  • 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
Gastrointestinal Oncology

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.

Keywords

Gastric Cancer Endoscopic Submucosal Dissection Early Gastric Cancer Gastric Resection Remnant Stomach 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

All the authors declare that they have not potential commercial conflicts of interest relevant to this article.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Alberto Di Leo
    • 1
    Email author
  • Corrado Pedrazzani
    • 1
  • Maria Bencivenga
    • 2
  • Arianna Coniglio
    • 3
  • Fausto Rosa
    • 4
  • Paolo Morgani
    • 5
  • Daniele Marrelli
    • 6
  • Alberto Marchet
    • 7
  • Luca Cozzaglio
    • 8
  • Simone Giacopuzzi
    • 2
  • Guido Alberto Massimo Tiberio
    • 3
  • Giovanni Battista Doglietto
    • 4
  • Giovanni Vittimberga
    • 5
  • Franco Roviello
    • 6
  • Francesco Ricci
    • 1
  1. 1.Unit of General Surgery, Rovereto HospitalAPSS of TrentoTrentoItaly
  2. 2.Unit of Upper G.I. SurgeryUniversity of VeronaVeronaItaly
  3. 3.Surgical ClinicUniversity of BresciaBresciaItaly
  4. 4.Department of Digestive SurgeryCatholic University of RomeRomeItaly
  5. 5.Department of General SurgeryMorgagni-Pierantoni HospitalForlìItaly
  6. 6.Division of Surgical OncologyUniversity of SienaSienaItaly
  7. 7.Department of Oncological and Surgical ScienceUniversity of PaduaPaduaItaly
  8. 8.Division of Surgical OncologyHumanitas HospitalMilanItaly

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