Stump Recurrences after Curative Gastrectomy for Gastric Cancer

Original

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2008;8(1):32-37.
Published online July 10, 2008.

위암의 근치적 위절제술 후 발생한 잔위 및 문합부 재발

강정묵ㆍ양종인ㆍ임종필ㆍ김상균ㆍ김주성ㆍ정현채ㆍ송인성

서울대학교 의과대학 내과학교실, 간연구소

Abstract

Background/Aims
The aims of the study were to define the incidence and the clinicopathologic features of stump cancer compared with other types of recurrence. Methods: We reviewed follow up records of 583 patients of gastric cancer who underwent curative resection between June 1995 and June 1997 and 12 patients who was diagnosed as stump cancer through endocopic biopsy since August 2002. Results: The incidence of stump recurrence after gastrectomy is 2.9%, which occupies 11% (17/149) of all recurrence. The higher incidence of stump cancer was noted in shallower depth of invasion, absence of lymph node metastasis, differentiated carcinoma and partial gastrectomy compared with other types of recurrence. The mean interval between initial gastrectomy and stump recurrence was 47.9 months and significantly longer than that of peritoneal dissemination and hematogenous recurrence. Among 29 stump cancers, the resectible rate was 38% and higher in remnant stomach cancer and late recurrence. Conclusions: Stump recurrences is not uncommon especially in gastrectomized patients for early stage cancer and the majority of recurrences occurred within 5 years after initial gastrectomy. So, careful periodic endoscopic surveilence for the early detection of stump cancer is required especially in these group during initial 5 years postgastrectomy. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2008;8:32-37)

Key Words: Stomach cancer, Recurrence, Remnant stomach, Anastomotic site