Shukla Ankit, Kalayarasan Raja, Gnanasekaran Senthil, Pottakkat Biju
Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India.
World J Clin Cases. 2023 May 6;11(13):2864-2873. doi: 10.12998/wjcc.v11.i13.2864.
Gastric stump carcinoma, also known as remnant gastric carcinoma, is a malignancy arising in the remnant stomach following gastrectomy for a benign or malignant condition. Enterogastric reflux and preexisting risk factors in a patient with gastric cancer are the major contributors to the development of gastric stump carcinoma. The occurrence of gastric stump carcinoma is time-dependent and seen earlier in patients operated on for malignant rather than benign diseases. The tumor location is predominantly at the anastomotic site towards the stomach. However, it can occur anywhere in the remnant stomach. The pattern of lymph node involvement and the type of surgery required is distinctly different compared to primary gastric cancer. Gastric stump carcinoma is traditionally considered a malignancy with a dismal outcome. However, recent advances in diagnostic and therapeutic strategies have improved outcomes. Recent advances in molecular profiling of gastric stump carcinoma have identified distinct molecular subtypes, thereby providing novel therapeutic targets. Also, reports of gastric stump carcinoma following pancreatoduodenectomy and bariatric surgery highlight the need for more research to standardize the diagnosis, staging, and treatment of these tumors. The present review aims to provide an overview of gastric stump carcinoma highlighting the differences in clinicopathological profile and management compared to primary gastric carcinoma.
胃残端癌,又称残胃癌,是指因良性或恶性疾病行胃切除术后,残胃发生的恶性肿瘤。胃癌患者的胃肠反流及既往存在的危险因素是胃残端癌发生的主要原因。胃残端癌的发生与时间有关,在因恶性疾病而非良性疾病接受手术的患者中出现得更早。肿瘤位置主要在靠近胃的吻合口处。然而,它也可能发生在残胃的任何部位。与原发性胃癌相比,其淋巴结转移模式及所需手术类型明显不同。传统上,胃残端癌被认为是一种预后不良的恶性肿瘤。然而,诊断和治疗策略的最新进展改善了预后。胃残端癌分子谱分析的最新进展已确定了不同的分子亚型,从而提供了新的治疗靶点。此外,胰十二指肠切除术和减肥手术后发生胃残端癌的报道凸显了开展更多研究以规范这些肿瘤的诊断、分期和治疗的必要性。本综述旨在概述胃残端癌,强调其与原发性胃癌相比在临床病理特征和管理方面的差异。