Shukla A, Kalayarasan R, Gnanasekaran S, Pottakkat B. Appraisal of gastric stump carcinoma and current state of affairs. World J Clin Cases 2023; 11(13): 2864-2873 [PMID: 37215417 DOI: 10.12998/wjcc.v11.i13.2864]
Corresponding Author of This Article
Ankit Shukla, DNB, Senior Resident, Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER Campus Rd, Gorimedu, Puducherry 605006, India. nkitshukla@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
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/
World J Clin Cases. May 6, 2023; 11(13): 2864-2873 Published online May 6, 2023. doi: 10.12998/wjcc.v11.i13.2864
Appraisal of gastric stump carcinoma and current state of affairs
Ankit Shukla, Raja Kalayarasan, Senthil Gnanasekaran, Biju Pottakkat
Ankit Shukla, Raja Kalayarasan, Senthil Gnanasekaran, Biju Pottakkat, Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Author contributions: All the authors did the literature search. Shukla A wrote the first draft of the review; Kalayarasan R conceptualized the work, supervised the writing, gave intellectual inputs; all the authors critically revised the manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ankit Shukla, DNB, Senior Resident, Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER Campus Rd, Gorimedu, Puducherry 605006, India. nkitshukla@hotmail.com
Received: December 28, 2022 Peer-review started: December 28, 2022 First decision: March 9, 2023 Revised: March 21, 2023 Accepted: March 30, 2023 Article in press: March 30, 2023 Published online: May 6, 2023
Abstract
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.
Core Tip: Gastric stump carcinoma is a rare malignancy with many unanswered questions regarding precise staging, molecular subtyping, and surgical management. The spectrum of its incidence is changing due to better medical management of peptic ulcer disease, increased survival of patients with malignancies, and malignancy in gastric stump following various other surgeries. The altered pattern of lymphatic spread deems further research to develop a newer staging system. Endoscopic surveillance with early gastric stump carcinoma detection made endoscopic resection and minimally invasive surgery feasible in selected patients with improved quality of life.
