Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2015; 21(6): 1865-1871
Published online Feb 14, 2015. doi: 10.3748/wjg.v21.i6.1865
Prognostic factors and survival in patients with gastric stump cancer
Hua Huang, Wei Wang, Zhong Chen, Jie-Jie Jin, Zi-Wen Long, Hong Cai, Xiao-Wen Liu, Ye Zhou, Ya-Nong Wang
Hua Huang, Jie-Jie Jin, Zi-Wen Long, Hong Cai, Xiao-Wen Liu, Ye Zhou, Ya-Nong Wang, Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Hua Huang, Jie-Jie Jin, Zi-Wen Long, Hong Cai, Xiao-Wen Liu, Ye Zhou, Ya-Nong Wang, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Wei Wang, Zhong Chen, Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
Author contributions: Huang H and Wang W performed the research; Chen Z, Jin JJ, Long ZW, Cai H, Liu XW, Zhou Y and Wang YN analyzed the data and drafted the article.
Supported by National Natural Science Foundation of China, No. 81272726; Specialized Research Fund for the Doctoral Program of Higher Education, China, No. 20110071120097; and Shanghai Municipal Health Bureau Research Project, No. 20114174.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ya-Nong Wang, MD, PhD, Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai 200032, China. wangyanongsh@gmail.com
Telephone: +86-21-64430130 Fax: +86-21-64430130
Received: August 12, 2014
Peer-review started: August 13, 2014
First decision: August 27, 2014
Revised: September 12, 2014
Accepted: October 14, 2014
Article in press: October 15, 2014
Published online: February 14, 2015
Processing time: 182 Days and 20.8 Hours
Abstract

AIM: To elucidate the clinicopathological characteristics and prognostic factors of gastric stump cancer (GSC).

METHODS: The clinical data for 92 patients with GSC were collected at Fudan University Shanghai Cancer Center. The prognostic factors were analyzed with Cox proportional hazard models.

RESULTS: GSC tended to occur within 25 years following the primary surgery, when the initial disease is benign, whereas it primarily occurred within the first 15 years post-operation for gastric cancer. Patients with regular follow-up after primary surgery had a better survival rate. The multivariate Cox regression analysis revealed that Borrmann type I/II (HR = 3.165, 95%CI: 1.055-9.500, P = 0.040) and radical resection (HR = 1.780, 95%CI: 1.061-2.987, P = 0.029) were independent prognostic factors for GSC. The overall 1-, 3-, and 5-year survival rates of the 92 patients were 78.3%, 45.6% and 27.6%, respectively. The 1-, 3-, and 5-year survival rates of those undergoing radical resection were 79.3%, 52.2%, and 37.8%, respectively. The 5-year survival rates for stages I, II, III, and IV were 85.7%, 47.4%, 16.0%, and 13.3%, respectively (P = 0.005).

CONCLUSION: The appearance of GSC occurs sooner in patients with primary malignant cancer than in patients with a primary benign disease. Therefore, close follow-up is necessary. The overall survival of patients with GSC is poor, and curative resection can improve their prognosis.

Keywords: Gastric stump cancer; Clinicopathological characteristics; Prognosis

Core tip: We retrospectively analyzed 92 patients. This study indicated that gastric stump cancer (GSC) has unique clinicopathologic characteristics, early detection of GSC is indeed possible, close follow-up is necessary and the radical resection may significantly improve the survival.