Retrospective analysis of gastric stump carcinoma patients treated during 1946-1981

Thirty-seven (1.1%) cases of gastric stump carcinoma were found among 3 441 gastric carcinomas treated during 1946-1981. The findings and treatment of gastric stump carcinoma were compared with gastric carcinoma without previous Billroth II resection. The mean age of patients with gastric stump carcinoma and with gastric carcinoma without previous Billroth II resection was identical. Gastric stump carcinoma showed a strong male preponderance, with a male:female ratio of 36:1. The average time interval from the original operation to the discovery of the stump carcinoma was 23.3 years. The interval was greater with lower age at the gastric resection. The primary ulcer disease, whether gastric or duodenal, had no influence on the development of gastric stump carcinoma. The resectability and amount of radical operations were lower than in gastric carcinomas and prognosis poorer with a 5-year survival rate of 7.1%. The differences were statistically not significant, however. The proportion of gastric stump carcinoma showed an increasing tendency toward the end of the study. The frequency was 3.3% during the last period (1976-1981). After a time interval of 15 years from gastric resection, all male patients at the age of 55-60 years should be examined endoscopically.