title: Gastric-carcinoma developing in the reconstructed gastric tube following esophagectomy - analysis of 58 cases.
abstract: Fifty-eight Japanese patients with secondary adenocarcinoma, which developed in the reconstructed gastric tube after esophagectomy for carcinoma of the esophagus, were reviewed from 20 case reports published over a period of twenty years. Following esophagectomy the gastric tube was replaced through the antesternal route in 32 patients (55.2%), through the retrosternal route in 19 (32.7%) and through the intrathoracic route in 7 (12.1%). Regarding the initial diagnosis of the secondary carcinoma, 28 patients (48.3%) had a self-palpable tumor in the anterior chest, 10 patients (17.2%) had a feeling of dysphagia, and two (3.4%) experienced epigastralgia. In eighteen patients (31.1%), the secondary carcinoma was detected incidentally at follow-up examinations, including two autopsied cases. The interval between esophagectomy and the detection of the secondary carcinoma in the gastric tube ranged from 7 to 255 months (mean 72.4 +/- 54.2 months). In 31 patients (53.4%) the secondary carcinoma was detected more than 5 years after esophagectomy. The mean survival period was 81.2 +/- 54.3 months with a range from 21 to 227 months after esophagectomy. These results thus emphasise the significance of lifetime check-ups for the reconstructed gastric tube, especially when the stomach is used as substitution for the esophagus.
authors.affiliation: KYUSHU UNIV,FAC MED,DEPT SURG 2,FUKUOKA 812,JAPAN.
authors.forename: K
authors.initials: K
authors.lastname: Kitamura
authors.forename: K
authors.initials: K
authors.lastname: Sugimachi