Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1, Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Esophagus. 2022 Jul;19(3):384-392. doi: 10.1007/s10388-022-00915-8. Epub 2022 Mar 3.
Survivors of esophageal cancer post-esophagectomy may sometimes develop gastric tube cancer (GTC). However, its clinical characteristics have not been elucidated. We conducted a retrospective nationwide survey of GTCs to clarify them.
A questionnaire on GTCs was sent by e-mail and mail to 116 institutions certified by the Japan Esophageal Society. A total of 608 GTC cases diagnosed and treated between 2001 and 2015 were registered from 62 institutions.
The median age at diagnosis was 71 years, with 88.9% being diagnosed with stage I. Sixty percent of GTC cases were in the anal third of the gastric tube and 79.7% were differentiated adenocarcinomas. The median interval between esophagectomy and GTC diagnosis was 6 years, with approximately 25% of patients being diagnosed more than 10 years later. The 5-year overall survivals (5-OSs) after endoscopic and surgical treatments for GTC were 75.9% and 52.7%, respectively. Patients whose GTC was diagnosed without symptoms or by regular follow-up examination showed better 5-OSs compared to others (69.7% vs. 41.2%, p < 0.0001; and 71.4% vs. 41.8%, p < 0.0001, respectively). The prognosis of GTC cases diagnosed within 2 years of the preceding upper gastrointestinal endoscopy (UGI) was better than that in cases diagnosed longer than 2 years (5-OS: 73.4% vs. 48.8%, p < 0.05).
This nationwide survey revealed the clinicopathological features of GTCs for the first time. Early detection is important in improving the prognosis of GTC, and it is recommended that UGI endoscopy be continued every 2 years for 10 or more years after esophagectomy.
食管癌根治术后幸存者有时可能会发展为胃管癌（GTC）。然而，其临床特征尚未阐明。我们进行了一项全国性的回顾性调查，以明确 GTC 的临床特征。
通过电子邮件和邮件向日本食管协会认证的 116 家机构发送了一份关于 GTC 的问卷。从 62 家机构共登记了 2001 年至 2015 年间诊断和治疗的 608 例 GTC 病例。
诊断时的中位年龄为 71 岁，其中 88.9%为 I 期。60%的 GTC 病例位于胃管的肛门第三部分，79.7%为分化型腺癌。GTC 诊断与食管癌之间的中位间隔为 6 年，约 25%的患者在 10 年以上被诊断。GTC 内镜和手术治疗后的 5 年总生存率（5-OS）分别为 75.9%和 52.7%。无症状或定期随访检查诊断的 GTC 患者的 5-OS 明显优于其他患者（69.7%比 41.2%，p<0.0001；71.4%比 41.8%，p<0.0001）。在上次上消化道内镜（UGI）后 2 年内诊断的 GTC 病例的预后优于 2 年以上诊断的病例（5-OS：73.4%比 48.8%，p<0.05）。
这项全国性调查首次揭示了 GTC 的临床病理特征。早期发现对改善 GTC 的预后至关重要，建议食管癌根治术后每 2 年进行一次 UGI 内镜检查，持续 10 年以上。
