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SURGICAL TREATMENT OF GASTRIC STUMP CANCER: A COHORT STUDY OF 51 PATIENTS
Eric Drizlionoks1, Valdir Tercioti Junior1, João de Souza Coelho Neto1
1Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery, Digestive Diseases Surgical Unit - Campinas (SP), Brazil.
Summary
Gastric stump cancer treatment remains challenging. Personalized follow-up for high-risk patients is crucial for early detection and improved survival rates in gastric remnant neoplasia.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Gastric stump neoplasia is defined as cancer arising in the gastric remnant more than 5 years after initial gastric resection.
- This condition presents unique challenges in diagnosis and treatment due to the altered anatomy post-surgery.
Purpose of the Study:
- To analyze treatment outcomes and survival in 51 patients with gastric stump cancer.
- To evaluate the impact of total and subtotal gastrectomy, along with multi-visceral resections, on patient prognosis.
Main Methods:
- Retrospective review of 51 surgically treated gastric stump cancer cases (1989-2019).
- Analysis included patient demographics, surgical history, reconstruction types, resectability, procedures performed, complications (Clavien-Dindo), staging, and survival data.
Main Results:
- The study included 83.3% men, with a mean age of 66.9 years; the average interval to stump cancer diagnosis was 34.7 years.
- Most patients had undergone Billroth II reconstruction. Total gastrectomy was performed in 68.6%, subtotal in 11.8%, and 19.6% were unresectable.
- For resected cases, 3-year and 5-year survival rates were 43.6% and 29.7%, respectively.
Conclusions:
- Treatment for gastric stump neoplasia is complex and demanding.
- Personalized surveillance strategies are essential for identifying high-risk individuals.
- Early intervention and tailored follow-up can enhance clinical outcomes and long-term survival.
