Paolo Morgagni1, Andrea Gardini2, Daniele Marrelli3, Giovanni Vittimberga2, Alberto Marchet4, Giovanni de Manzoni5, Maria Antonietta Di Cosmo5, Gian Maria Rossi4, Domenico Garcea2, Franco Roviello3. 1. Department of General Surgery, Morgagni-Pierantoni Hospital, via Carlo Forlanini 34, 47121 Forlì, Italy. Electronic address: p.morgagni@ausl.fo.it. 2. Department of General Surgery, Morgagni-Pierantoni Hospital, via Carlo Forlanini 34, 47121 Forlì, Italy. 3. Surgical Oncology Unit, University of Siena, Via Banchi di Sotto 55, 53100 Siena, Italy. 4. Second Surgical Clinic, Padua University, via 8 Febbraio 2, 35122 Padua, Italy. 5. First Surgical Clinic, Verona University, via dell'Artigliere 19, 37129 Verona, Italy.
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.
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.
Authors: H Nienhüser; S Blank; L Sisic; R Kunzmann; U Heger; K Ott; M W Büchler; T Schmidt; A Ulrich Journal: Chirurg Date: 2017-04 Impact factor: 0.955
Authors: Luigi Basso; Gaetano Gallo; Daniele Biacchi; Maria Vittoria Carati; Giuseppe Cavallaro; Luca Esposito; Andrea Giuliani; Luciano Izzo; Paolo Izzo; Antonietta Lamazza; Andrea Polistena; Mariarita Tarallo; Alessandro Micarelli; Enrico Fiori Journal: J Clin Med Date: 2022-03-09 Impact factor: 4.241