Clinicopathologic characteristics and prognosis of gastric stump cancer

To evaluate the prognosis of patients with gastric stump cancer after previous distal gastrectomy for benign gastroduodenal disease, we compared 25 patients with resected gastric remnant cancer with 143 patients with primary cancer in the upper third of the stomach. The histopathological differences between gastric remnant cancer and primary cancer were not significant, except for esophageal invasion. The percentage of esophageal invasion in gastric remnant cancer is 16%, significantly lower than 56.6% in primary cancer. The overall 5-year survival rates were 46% and 25% for patients with resected remnant cancer (n = 25) and resected primary cancer (n = 143), respectively, and there was no statistical difference between the two groups. The 5-year survival rates for gastric remnant cancer with stage I or II and primary cancer with the same stages were 89% (n = 11) and 39% (n = 50), a statistically significant (p < 0.02) difference. On contrast, the 5-year survival rate for gastric remnant cancer with stage III or IV was 0%, which was significantly worse than 17% for primary cancer with the same stages (p < 0.05). The prognosis of gastric remnant cancer is better than that of primary cancer in the upper third of the stomach at its early stages, but it is worse at its late stages. An aggressive resection is recommended for gastric stump cancer.