Department of General Surgery, Centro Hospitalar S. João, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal ; University of Porto Medical School, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal.
Biomed Res Int. 2013;2013:781896. doi: 10.1155/2013/781896. Epub 2013 Sep 16.
Considerable controversy persists about the biological behavior of gastric stump cancer (GSC). The aim of this study is to clarify if this cancer is just another proximal gastric cancer or if it emerges as a distinctive clinicopathologic entity.
This review of a prospectively collected gastric cancer database identified 73 patients with GSC in a single institution between January 1980 and June 2012 and compared them with 328 patients with proximal gastric cancer (PGC) and 291 patients with esophagogastric junction cancer (EGJC).
Patients with GSC were predominantly males. Eighty-three percent of GSC penetrated the subserosal or the serosal layers. The median number of lymph nodes retrieved in GSC patients was significantly lower than in PGC patients or in EGJC patients. Cumulative survival curves were not different between GSC, PGC, or EGJC patients. Unlike that observed in PGC and in EGJC, no significant differences in cumulative survival according to the TNM staging system were observed in GSC cases.
The outcome of patients with GSC displayed significant differences when compared to those with other proximal gastric cancers concerning the lack of survival association with the TNM staging system. Therefore a more suitable staging system should be designed for these unique cancers.
胃残胃癌（GSC）的生物学行为仍存在较大争议。本研究旨在阐明这种癌症是否仅仅是另一种近端胃癌，或者它是否作为一种独特的临床病理实体出现。
本研究回顾性分析了一家机构在 1980 年 1 月至 2012 年 6 月期间收集的胃癌数据库，共发现 73 例 GSC 患者，并与 328 例近端胃癌（PGC）患者和 291 例食管胃交界癌（EGJC）患者进行比较。
GSC 患者主要为男性。83%的 GSC 穿透浆膜下层或浆膜层。GSC 患者的淋巴结检出数明显低于 PGC 患者和 EGJC 患者。GSC、PGC 和 EGJC 患者的累积生存曲线无差异。与 PGC 和 EGJC 不同，GSC 病例中未观察到根据 TNM 分期系统的累积生存率存在显著差异。
与其他近端胃癌相比，GSC 患者的生存与 TNM 分期系统缺乏关联，其预后存在显著差异。因此，应设计更适合这些特殊癌症的分期系统。
