Gastric stump cancer – unicentric analysis of 7 patients
Authors:
T. Jínek 1; L. Adamčík 1; M. Duda 1,2; M. Škrovina 1,3
Authors place of work:
Chirurgické oddělení Nemocnice Nový Jičín, a. s., Centrum vysoce specializované onkologické péče pro dospělé Nový Jičín
primář: MUDr. M. Škrovina, Ph. D.
1; II. chirurgická klinika LF UP Olomouc
přednosta: prof. MUDr. P. Bachleda, CSc.
2; I. chirurgická klinika LF UP Olomouc
přednosta: prof. MUDr. Č. Neoral, CSc.
3
Published in the journal:
Rozhl. Chir., 2015, roč. 94, č. 9, s. 362-366.
Category:
Original articles
Summary
Introduction:
Gastric stump cancer accounts for 1−4% of all gastric carcinomas. Originally this term included patients who previously underwent surgery due to peptic ulcer disease but today gastric stump cancer also includes patients diagnosed some time after primary gastric resection due to gastric cancer. The incidence is increasing. Gastric stump cancer is associated with poor prognosis and its reported resecability is around 40%.
Methods:
We retrospectively analyzed the data of 7 patients with a preoperatively histologically confirmed stump cancer who had been operated at the Department of Surgery at Nový Jičín Hospital during 2006−2014.
Results:
We operated 5 men and 2 women with the median age of 70 years (55−80). The primary surgical resection in all our patients was BII gastric resection due to peptic ulcer disease, and GSC had evolved within a median of 38 years (32−46) after primary intervention. None of the patients had been regularly screened by endoscopy following primary surgery. We performed five curative resections (four total gastrectomies, one subtotal gastrectomy). Our resecability rate was 71%. In two cases, only explorative laparotomy was performed due to generalisation of the malignancy. Two patients from the resected group died after 30 and 34 months due to progression of their disease; the other three patients are still alive after 17, 19 and 88 months.
Conclusion:
Gastric stump cancer is a malignancy often diagnosed in its late stages. Regural endoscopic screening after primary gastric resection for benign disease can lead to diagnosis at an earlier stage, thereby improving the resection rate and overall survival. This also applies to long-term follow-up of patients with primary subtotal gastrectomy for cancer. Lymphatic metastasizing of the carcinoma can often be different due to the previous surgical intervention and altered anatomy. This must be taken into account during operations.
Key words:
gastric stump cancer – surgical treatment – endoscopic screening
Zdroje
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