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《浙江大学学报(英文版)》 2005-01
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Surgical management of gastric stump cancer:a report of 37 cases

CHEN Li TIAN Hua~1 CHEN Jian HE Zhi-gang TAO Si-feng LOKESH Gurung~1 PENG Shu-you~1Department of Surgety,Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou 310009,China~2Department of Gastroenterology,School of Medicine,Ningbo University,Ningbo 315211,China  
Objective:To observe the clinicopathological characteristics of gastric stump cancer(GSC)and evaluate the benefitsof radical surgery of GSC.Methods:The clinicopathological characteristics and postoperative survival time of 37 GSC patientswho underwent surgery were investigated retrospectively.The survival time was compared according to the type of surgicaloperation(radical resection vs palliative operation).Twenty-one cases that received radical resection were analyzed based on thepTMN stage.Survival curves were traced by using Kaplan-Meier methods.Results:Most GSC(32/37)was detected in patientswho had received Billroth Ⅱ reconstruction after partial gastrectomy for benign gastric disease.The lesser curvature side and thesuture line of anastomosis were the most frequent sites where GSC occurred(27/37).Differentiated adenocarcinoma was thedominant histopathological type(24/37).The postoperative 5-year survival rate of early stage GSC patients(n=9)was significantlyhigher than advanced stage GSC(n=12)(55.6% vs 16.5%,x_L~2=11.48,P0.01).Five-year survival rate of 21 GSC patients withradical resection were 75%(3/4)for stage Ⅰ,60%(3/5)for stage Ⅱ,14.2%(1/7)for stage Ⅲ,and 0%(0/5)for stage Ⅳ respectively.The median survival time of 21 GSC patients who underwent radical resection was longer than those undergoing palliative op-eration(43.0 m vs 13.0 m,X_L~2=36.31,P0.01),the median survival time of stage Ⅳ patients with radical resection was 23.8months.Conclusions:Without remote metastasis,radical resection for GSC is possible,and is an effective way to improve theprognosis of GSC.Even in stage Ⅳ GSC,radical resection can still prolong the survival time.It is necessary for the patients withbenign gastric diseases who received partial gastrectomy to carry out the endoscopy follow-up,especially in patients with BillrothⅡ reconstruction procedure at 15-20 years.
【Fund】: Project(No.2004C34010) supportedbytheScienceandTechnologyBureauofZhejiangProvince China
【CateGory Index】: R735.2
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