Prognostic factors for gastric stump cancer / 中华普通外科杂志

ABSTRACT

Objective:To analyze the clinical characteristics and prognostic factors of gastric stump cancer.Method:The clinical data of 126 gastric stump cancer patients from Jan 1995 to Dec 2014 were collected . We analyzed the survival and prognosis of patients in terms of gender, tumor location, size, clinicopathological stage and treatment methods.Results:For primary surgery, B-Ⅱ GI reconstruction were more likely associated with gastric stump cancer, accounting for 69.8% of the total cases, and cancer was more likely to occur at the anastomotic stoma and in its vicinity, accounting for 62.3%. The 1'- , 3'- , and 5-year survival rates of 126 patients were 90.4%, 57.9%, and 41.2%, respectively. The 1'-, 3'- and 5-year overall survival rates in radical operation group were 96.9%, 74.2% and 53.6% respectively, while it was 69.0%, 3.4% and 0 respectively in palliative operation group (all P<0.01). Univariate analysis showed that tumor size, invasion depth, lymph node metastasis, distant organ metastasis, TNM stage, histological type, treatment mode and chemotherapy were related to the prognosis (all P<0.01). By multivariate analysis, radical resection and chemotherapy were protective factors for the prognosis ( P<0.01). Conclusion:Most gastric stump cancer are associated with distal subtotal gastrectomy and B-Ⅱ reconstruction . Radical resection is an effective therapy for gastric stump cancer.