Clinicopathological features and outcome of patients with remnant gastric cancer

Abstract

To evaluate the clinicopathologic features and the efficacy of surgical treatment in gastric stump cancer. Forty-two patients undergone operation for gastric stump cancer, including 9 cases with Billroth I (reconstruction and 33 cases with Billroth II reconstruction, in our department were enrolled in the study. Clinicopathological features, 5-year survival rate and prognostic factors were analyzed retrospectively. Gastric stump cancer occurred more frequently in anastomotic site and poorly-differentiated cancer was the common histological type. For patients with Billroth I reconstruction, the rates of lymph node metastasis in No.1, No.3, No.10, No.11 stations were more than 30.0%, and that in No.12 station was 22.2%. For patients with Billroth II reconstruction, the rates of lymph node metastasis in No.1, No.2, No.3, No.4, No.10, No.11, No.12 stations were more than 30.0%, and that in No.14 station was 25.0%. The rate of lymph node metastasis in jejunal mesentery was 27.3%. The percentage of pancreatic invasion and hepatoduodenal ligament invasion were 66.7% and 33.3% respectively for patients with Billroth I reconstruction. The percentage of transverse colon invasion and pancreatic invasion were 25.0% and 75.0% respectively for patients with Billroth II reconstruction. The overall 5-year survival rate of patients with gastric stump cancer was 0.38. The 5-year survival rates in I, II, III and IV were 0.86, 0.50, 0.13 and 0 respectively. There were significant differences among stages (P <0.05). Gastric stump cancer has a particular pattern in lymph node metastasis and direct organ invasion. Surgical resection is an effective therapeutic strategy for this disease.