Gastric Stump Carcinoma: A Clinical Analysis Of 15 Cases

Background and aims:The incidence of gastric stump carcinoma is growing in recent years. Patients are generally at advanced stages on admissions due to disregarding the symptoms related to cancer. This report is aimed to analyze the clinocopathologic features of gastric stump carcinoma and investigate the experience about the diagnosis and treatment of gastric stump carcinoma.Patients and methods:The clinical data of fifteen patients with gastric stump carcinoma arising from the remnant stomach between Aug 2000 and Mar 2010 were retrospectively analyzed. Clinicopathologic features such as age, gender, time interval between the initial operation and diagnosis of gastric remnant cancer, preoperative symptoms, surgical management, and tumor characteristics, such as location, histopathology, presence of distant metastasis, and stages were documented.Results:Two patients were diagnosed by routine surveillance and the other patients were symptomatic at the time of diagnosis. The mean time interval was 11.7 years. There was only one female patient. At previous operation, seven patients performed Billroth I reconstruction, five patients received Billrothâ…¡reconstruction, two patients underwent esophagogastrostomy and the left one was unknown. The site of tumor growth was predominantly in the anastomotic area(8/15), but may occur anywhere in the stump(7/15),such as fundus(1/15), body(5/15) and cardia(1/15). One patient lost the chance for operation and the other fourteen patients were qualified for surgery. The resectability rate was 60%(n=9). Nine patients received curative resection, two patients performed palliative surgery and the others were given diagnostic laparotomy without removing the tumor. Among the nine patients receiving curative resection, two patients were found to be early gastric stump carcinoma, the left seven patients were in advanced stages. Among the fifteen patients, seven patients were found to be in stageâ…£, two patients in stage III, two patients in stage II and four patients in stage I.Conclusion:Special attention should be given to people who underwent partial gastrectomy. A close follow-up is needed in order to detect an early gastric stump carcinoma.