Clinical Characteristics And Prognosis Of 44 Cases Of Gastric Stump Carcinoma

Objective:To analyze the surgical treatment and clinical pathological features of gastric stump cancinoma and to re-understand the current surgical treatment of gastric stump cancinoma.Methods:44 cases of gastric stump cancinoma with complete medical records and follow-up records were analyzed retrospectively.Among them,26 cases were remnant gastric carcinoma patients,whose cases are benign after primary disease(RGCB)and 18 cases were remnant gastric carcinoma patients,whose cases are cancer after primary disease(RGCC).The clinical pathogenesis,surgical methods,histopathological characteristics and prognostic factors were compared and analyzed,and the effects of primary surgical anastomosis on the growth site and histopathology of gastric stump cancer were explored.Results:The onset time of RGCB after the first gastrectomy was 3 ~ 54 years(the median time was 38 years),and the time of onset after the first gastrectomy was 1 ~ 13 years(the median time was 4.5 years).There was significant differences between the two groups(P < 0.05).The radical resection rate of remnant gastric cancinoma was 47.7%(21 / 44),of which the radical resection rate of RGCB was 50.0%(13 /26),RGCC,44.4%,8 / 18),and the radical resection rate of residual gastric cancer was 47.7%(21 / 44).There was no significant difference between the two groups(P > 0.05).The cumulative 1-year overall survival rate was 68.2%,the 3-year survival rate was 29.5%,the 5-year survival rate was 4.5%,and the survival time was 0 ~ 76 months(median survival time 16months).The results of survival analysis showed that radical operation was the influencing factor of survival of patients with gastric stump cancer(P < 0.01).However,age,sex,the nature of the disease after the first operation and the degree of pathological differentiation were not related to the prognosis(P > 0.05).Conclusion:The interval between RGCB and the location of RGCC,gastric stump tumor is longer than that after the first gastrectomy,which is affected by the way of conducting primary surgical anastomose.Radical operation is the key factor to improve the prognosis of patients with gastric stump cancer.