CLINICOPATHOLOGICAL 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 comp ared 25 patients with resected gastric remnant cancer with 143 patient s with primary cancer in the upper third of the stomach. The histopath ological 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) a nd resected primary cancer (n = 143), respectively, and there was no s tatistical difference between the two groups. The 5-year survival rate s for gastric remnant cancer with stage I or II and primary cancer wit h the same stages were 89% (n = 11) and 39% (n = 50), a statistically significant (p < 0.02) difference. On contrast, the 5-year survival ra te for gastric remnant cancer with stage III or IV was 0%, which was s ignificantly 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 stage s, but it is worse at its late stages. An aggressive resection is reco mmended for gastric stump cancer.