title: Gastric stump cancer after distal gastrectomy for benign disease: clinicopathological features and surgical outcomes.
abstract: OBJECTIVE
  The purpose of the present study was to analyze clinicopathologic features and long-term prognosis of gastric stump cancer (GSC) arising in the remnant stomach 5 years or later after partial gastrectomy for benign disease.
  
  
  METHODS
  We reviewed the results of 176 patients resected with curative intent for GSC at 8 Italian centers belonging to the Italian Research Group for Gastric Cancer (GIRCG). The median (range) follow-up time for surviving patients was 71.2 (6-207) months.
  
  
  RESULTS
  One hundred forty-six patients were men, the mean age at the time of diagnosis was 69.2 years, and the great majority (167 cases) underwent Billroth II reconstruction. R0 resection was achieved in 158 (90 %) patients, and in 94 (53 %) lymph node dissection was ≥D2. Postoperative mortality and complication rates were 6.2 and 43.2 %, respectively. T1 tumor was diagnosed in 45 (25 %) cases. Lymph node metastases were evident in 86 patients (49 %). Thirteen patients had involvement of the jejunal mesentery nodes (pJN+); five cases were T2-T3 and eight cases were T4. Overall 5-year survival rate was 53.1 %. Five-year survival rates were 68.1, 37.8, and 33.1 % for pT1, pT2-3, and pT4 tumors, respectively (P = 0.001). Five-year survival rate was 56.5 % for node-negative tumors (pN0), 32.3 % for tumors with nodal metastases without involvement of jejunal mesentery nodes (pN+), and 17.1 % for tumors with involvement of jejunal mesentery nodes (pJN+) (P = 0.002).
  
  
  CONCLUSIONS
  Our study suggests that an aggressive surgical approach can achieve a satisfactory outcome in GSC.
authors.affiliation: Unit of General Surgery, Rovereto Hospital, APSS of Trento, Trento, Italy, dileomd@libero.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Di Leo
authors.forename: Corrado
authors.initials: C
authors.lastname: Pedrazzani
authors.forename: Maria
authors.initials: M
authors.lastname: Bencivenga
authors.forename: Arianna
authors.initials: A
authors.lastname: Coniglio
authors.forename: Fausto
authors.initials: F
authors.lastname: Rosa
authors.forename: Paolo
authors.initials: P
authors.lastname: Morgani
authors.forename: Daniele
authors.initials: D
authors.lastname: Marrelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Marchet
authors.forename: Luca
authors.initials: L
authors.lastname: Cozzaglio
authors.forename: Simone
authors.initials: S
authors.lastname: Giacopuzzi
authors.forename: Guido Alberto Massimo
authors.initials: GA
authors.lastname: Tiberio
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Doglietto
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vittimberga
authors.forename: Franco
authors.initials: F
authors.lastname: Roviello
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D018530:Gastric Stump / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D011230:Precancerous Conditions / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate