Gastric stump carcinoma after distal subtotal gastrectomy for early gastric cancer: experience of 541 patients with long-term follow-up

Abstract Background Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer. Patients We assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago. Resu...

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Published inThe American journal of surgery Vol. 209; no. 6; pp. 1063 - 1068
Main Authors Morgagni, Paolo, M.D, Gardini, Andrea, M.D, Marrelli, Daniele, M.D, Vittimberga, Giovanni, M.D, Marchet, Alberto, M.D, de Manzoni, Giovanni, M.D, Di Cosmo, Maria Antonietta, M.D, Rossi, Gian Maria, M.D, Garcea, Domenico, M.D, Roviello, Franco, M.D
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.06.2015
Elsevier Limited
Subjects
Adult
Aged
Aged, 80 and over
Anastomosis, Roux-en-Y
Deaths
Distal subtotal gastrectomy
Early gastric cancer
Endoscopy
Female
Follow-Up Studies
Gastrectomy - methods
Gastric cancer
Gastric Stump
Gastric stump carcinoma
Gastroenterostomy - methods
Humans
Kaplan-Meier Estimate
Long-term follow-up
Lymphatic system
Male
Middle Aged
Multivariate analysis
Neoplasm Recurrence, Local - epidemiology
Proportional Hazards Models
Retrospective Studies
Risk
Stomach Neoplasms - epidemiology
Stomach Neoplasms - surgery
Studies
Surgery
Survival analysis
Treatment Outcome
Tumors
Gastric stump carcinoma
Long-term follow-up
Early gastric cancer
Distal subtotal gastrectomy
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Abstract Abstract Background Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer. Patients We assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago. Results GSC was diagnosed in 16 (2.9%) patients, giving a 4% cumulative risk of GSC 20 years after surgery. Diagnosis was made within 5 years of surgery in 10 patients and after 8 years in 6 cases. GSC occurred in 13/470 (2.8%) patients submitted to Billroth 2 reconstruction, 2/30 (6.7%) patients who underwent Billroth 1, and 1/41 (2.4%) patients after Roux-en-Y reconstruction. Significant risk factors observed for GSC were histologic type and sex. Other synchronous or metachronous extragastric tumors were registered in 56 (11.2%) patients. Conclusions The risk of GSC was low, even 20 years after subtotal gastrectomy for early gastric cancer. Lauren intestinal histotype and male sex were frequently associated with GSC. No correlation was observed between GSC and reconstruction technique or multifocality. Clinically speaking, GSC could be considered a subset of gastric cancer.
AbstractList Abstract Background Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer. Patients We assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago. Results GSC was diagnosed in 16 (2.9%) patients, giving a 4% cumulative risk of GSC 20 years after surgery. Diagnosis was made within 5 years of surgery in 10 patients and after 8 years in 6 cases. GSC occurred in 13/470 (2.8%) patients submitted to Billroth 2 reconstruction, 2/30 (6.7%) patients who underwent Billroth 1, and 1/41 (2.4%) patients after Roux-en-Y reconstruction. Significant risk factors observed for GSC were histologic type and sex. Other synchronous or metachronous extragastric tumors were registered in 56 (11.2%) patients. Conclusions The risk of GSC was low, even 20 years after subtotal gastrectomy for early gastric cancer. Lauren intestinal histotype and male sex were frequently associated with GSC. No correlation was observed between GSC and reconstruction technique or multifocality. Clinically speaking, GSC could be considered a subset of gastric cancer.
BACKGROUNDGastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer.PATIENTSWe assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago.RESULTSGSC was diagnosed in 16 (2.9%) patients, giving a 4% cumulative risk of GSC 20 years after surgery. Diagnosis was made within 5 years of surgery in 10 patients and after 8 years in 6 cases. GSC occurred in 13/470 (2.8%) patients submitted to Billroth 2 reconstruction, 2/30 (6.7%) patients who underwent Billroth 1, and 1/41 (2.4%) patients after Roux-en-Y reconstruction. Significant risk factors observed for GSC were histologic type and sex. Other synchronous or metachronous extragastric tumors were registered in 56 (11.2%) patients.CONCLUSIONSThe risk of GSC was low, even 20 years after subtotal gastrectomy for early gastric cancer. Lauren intestinal histotype and male sex were frequently associated with GSC. No correlation was observed between GSC and reconstruction technique or multifocality. Clinically speaking, GSC could be considered a subset of gastric cancer.
Background Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer. Patients We assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago. Results GSC was diagnosed in 16 (2.9%) patients, giving a 4% cumulative risk of GSC 20 years after surgery. Diagnosis was made within 5 years of surgery in 10 patients and after 8 years in 6 cases. GSC occurred in 13/470 (2.8%) patients submitted to Billroth 2 reconstruction, 2/30 (6.7%) patients who underwent Billroth 1, and 1/41 (2.4%) patients after Roux-en-Y reconstruction. Significant risk factors observed for GSC were histologic type and sex. Other synchronous or metachronous extragastric tumors were registered in 56 (11.2%) patients. Conclusions The risk of GSC was low, even 20 years after subtotal gastrectomy for early gastric cancer. Lauren intestinal histotype and male sex were frequently associated with GSC. No correlation was observed between GSC and reconstruction technique or multifocality. Clinically speaking, GSC could be considered a subset of gastric cancer.
Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer. We assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago. GSC was diagnosed in 16 (2.9%) patients, giving a 4% cumulative risk of GSC 20 years after surgery. Diagnosis was made within 5 years of surgery in 10 patients and after 8 years in 6 cases. GSC occurred in 13/470 (2.8%) patients submitted to Billroth 2 reconstruction, 2/30 (6.7%) patients who underwent Billroth 1, and 1/41 (2.4%) patients after Roux-en-Y reconstruction. Significant risk factors observed for GSC were histologic type and sex. Other synchronous or metachronous extragastric tumors were registered in 56 (11.2%) patients. The risk of GSC was low, even 20 years after subtotal gastrectomy for early gastric cancer. Lauren intestinal histotype and male sex were frequently associated with GSC. No correlation was observed between GSC and reconstruction technique or multifocality. Clinically speaking, GSC could be considered a subset of gastric cancer.
Author Di Cosmo, Maria Antonietta, M.D
Gardini, Andrea, M.D
Marrelli, Daniele, M.D
Morgagni, Paolo, M.D
de Manzoni, Giovanni, M.D
Garcea, Domenico, M.D
Roviello, Franco, M.D
Marchet, Alberto, M.D
Rossi, Gian Maria, M.D
Vittimberga, Giovanni, M.D
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  fullname: Vittimberga, Giovanni, M.D
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  fullname: Marchet, Alberto, M.D
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  fullname: Di Cosmo, Maria Antonietta, M.D
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  fullname: Rossi, Gian Maria, M.D
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  fullname: Garcea, Domenico, M.D
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  fullname: Roviello, Franco, M.D
BackLink https://www.ncbi.nlm.nih.gov/pubmed/25218580$$D View this record in MEDLINE/PubMed
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Keywords Gastric stump carcinoma
Long-term follow-up
Early gastric cancer
Distal subtotal gastrectomy
Language English
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Snippet Abstract Background Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation...
Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer....
Background Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with...
BACKGROUNDGastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with...
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StartPage 1063
SubjectTerms Adult
Aged
Aged, 80 and over
Anastomosis, Roux-en-Y
Deaths
Distal subtotal gastrectomy
Early gastric cancer
Endoscopy
Female
Follow-Up Studies
Gastrectomy - methods
Gastric cancer
Gastric Stump
Gastric stump carcinoma
Gastroenterostomy - methods
Humans
Kaplan-Meier Estimate
Long-term follow-up
Lymphatic system
Male
Middle Aged
Multivariate analysis
Neoplasm Recurrence, Local - epidemiology
Proportional Hazards Models
Retrospective Studies
Risk
Stomach Neoplasms - epidemiology
Stomach Neoplasms - surgery
Studies
Surgery
Survival analysis
Treatment Outcome
Tumors
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Title Gastric stump carcinoma after distal subtotal gastrectomy for early gastric cancer: experience of 541 patients with long-term follow-up
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