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[Surgical treatment and prognosis of gastric stump cancer]
Li-Xin Zhou1, Ze-Wei Zhang, Zhi-Yuan Xu
1Department of Hepatobiliary Pancreatic and Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China. zhoulxin8k@126.com
Background And Objective:
Gastric stump cancer (GSC) has unique biological behaviors and poor prognosis. The surgical treatment for GSC is complex. This study was to explore the clinical characteristics of GSC and the effect of operation patterns on long-term survival, and investigate its prognostic factors.
Methods:
The clinical data of 81 GSC patients, treated in Zhejiang Cancer Hospital from January 1990 to December 2007, were analyzed. Patients' survival was analyzed by Kaplan-Meier method; the prognosis was analyzed by Cox multivariate regression model.
Results:
Of the 81 patients, 47 (58.0%) received radical resection, 34 received non-radical operation (including palliative operation, short circuit or fistulation and exploration). The overall 1-, 3-, and 5-year survival rates were 69.1%, 24.3%, and 11.8% in the whole group. The 1-, 3-, and 5-year survival rates were significantly higher in radical resection group than in non-radical operation group (93.6% vs. 35.3%, 42.0% vs. 5.9%, 20.8% vs. 0, P<0.05). Cox multivariate regression analysis showed that clinical stage, pathologic classification, radical resection, peritoneal seeding and liver metastasis were related with the survival of GSC patients.
Conclusions:
Radical resection may help to improve the prognosis of GSC. Clinical stage, pathologic classification, radical resection, peritoneal seeding and liver metastasis are independent prognosis factors of GSC.
