Early gastric stump cancer following distal gastrectomy

Abstract

Background-Gastric stump cancer (GSC) is usually diagnosed at an advanced stage, and consequently the prognosis is poor. Aims-To investigate the clinicopathological characteristics of GSC at an early stage to assist in its identification, and thereby improve its prognosis. Methods-Forty three patients with resected early GSC were compared with 156 patients with resected primary early cancer in the upper third of the stomach. Results-Sixty five per cent (28/43) of the early GSC patients showed the elevated type endoscopically, although the frequency of the depressed type in GSC has tended to increase in the past five years. This occurred in less than 26% (40/156) of the primary early cancers. Half of the early GSCs were located on the lesser curvature (47%), and revealed diVerentiated adenocarcinoma (81%) histologically. The male:female ratio of early GSC cases was about 6:1, which was much higher than that in patients with primary early cancer. The five year survival rates of patients with early GSCs and early primary cancers were 84% and 95%, respectively. GSC had a favourable prognosis, if it was detected at an early stage. Conclusion-To detect early GSC, our results suggest that special attention should be given to elevated as well as depressed lesions on the lesser curvature of the stomach, particularly in men, during endoscopic examinations. (Gut 1998;43:342-344)

Surgical management of gastric stump cancer: a report of 37 cases

“…As well differentiated adenocarcinoma is the most common histological type (Kaneko et al, 1998), which was also reconfirmed in our datum (24/37). The curative resectability rate of GSC in this series was about 56.7%; the median survival time of GSC in patients who underwent radical resection is significantly longer than that of patients who underwent palliative operation.…”

Does remnant gastric cancer really differ from primary gastric cancer? A systematic review of the literature by the Task Force of Japanese Gastric Cancer Association

“…Balfour first described the clinical entity of RGC in 1922 [4]. The incidence of metachronous RGC has been reported as 1.0-3.0 % [5][6][7]. Although Balfour's definition for RGC was occurrence of carcinoma in the remnant after operation for benign disease, later studies included cancer that was detected after 5 years following initial gastrectomy for malignant disease.…”

Limited subtotal gastrectomy for early remnant gastric cancer

“…Although there have been no guidelines for surgical treatment of RGC, it is usually detected at an advanced stage, and total gastrectomy (TG) has been accepted for a long time. At present, detection of early remnant gastric cancer (ERGC) is increasing as a result of the development of endoscopic technology and a surveillance program with periodic endoscopy [8][9][10]. Endoscopic mucosal resection and submucosal dissection are applicable for treatment of ERGC; however, endoscopic treatment in the remnant stomach is technically difficult because of the narrow inner space and presence of massive fibrosis around the suture line [11].…”