Hu Xiang, Tian Da-Yu, Cao Liang, Yu Yi
Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, Dalian 116011, China.
J Surg Oncol. 2009 Nov 1;100(6):472-6. doi: 10.1002/jso.21370.
The incidence of gastric stump cancer (GSC) is increasing. The aim of this study is to determine the clinicopathologic feature and the differences of surgical outcome between GSC after partial gastrectomy for benign diseases (GSC-B) and GSC after partial gastrectomy for malignant tumors (GSC-M).
Medical records of 42 patients with GSC-B and 47 patients with GSC-M who underwent surgical treatment were studied and analyzed retrospectively. Clinicopathologic parameters, the 5-year survival rate after operation and prognostic factors, were analyzed retrospectively.
GSC was frequently detected in anastomotic site. Poorly differentiated cancer was common. No difference was found between patients with GSC-B and patients with GSC-M in terms of histologic type, tumor location, and distribution of tumor stage. GSC-B patients had a higher incidence in No. 7, 8, 9 lymph nodes than GSC-M patients. In contrast, the patients with GSC-M had higher incidence of metastasis to jejunal mesentery lymph nodes and No. 10, 11 lymph nodes. The overall 5-year survival rates were 38.1% for GSC-B and 10.4% for GSC-M, with significant difference (P < 0.05).
GSC has a particular pattern in lymph node metastasis and organs invasion. Surgical resection is considered an effective therapeutic strategy for GSC.
胃残端癌（GSC）的发病率正在上升。本研究的目的是确定胃残端癌的临床病理特征，以及良性疾病胃部分切除术后发生的胃残端癌（GSC-B）与恶性肿瘤胃部分切除术后发生的胃残端癌（GSC-M）之间手术结果的差异。
回顾性研究和分析42例接受手术治疗的GSC-B患者和47例接受手术治疗的GSC-M患者的病历。对临床病理参数、术后5年生存率和预后因素进行回顾性分析。
GSC常发生于吻合口部位。低分化癌较为常见。GSC-B患者和GSC-M患者在组织学类型、肿瘤位置和肿瘤分期分布方面未发现差异。GSC-B患者第7、8、9组淋巴结转移发生率高于GSC-M患者。相比之下，GSC-M患者空肠系膜淋巴结及第10、11组淋巴结转移发生率更高。GSC-B患者的总体5年生存率为38.1%，GSC-M患者为10.4%，差异有统计学意义（P<0.05）。
GSC在淋巴结转移和器官侵犯方面具有特定模式。手术切除被认为是治疗GSC的有效策略。
