Gastric stump cancer. Etiology and treatment. A general review of the last 5 years

Introduction: Gastric stump cancer (GSC) is an entity described in the literature as early as the 1920s. Along the years the clinicopathological characteristic had changed. At the moment, there are no well-established guidelines regarding the optimal treatment. Material and method: We conducted a literature review of the studies published from 2014 to 2019 using the PubMed database. Results: After searching the PubMed database for the keywords: “gastric remnant cancer” AND “stump” AND “neoplasm” we identified 167 articles. Of these, 25 studies were considered relevant. Discussions: GSC develops after 2 years from the primary intervention for malignancy and after 20 years for benign lesions. The development mechanisms vary depending on the type of primary gastric lesions. GSC is considered a unique clinicopathological entity. The pattern of lymphatic drainage is different in comparison to primary gastric neoplasm. Thus an important negative prognostic factor is considered to be the N group of TNM staging. Conclusion: More studies are required to improve the understanding of development mechanisms and evolution of this pathology. Survival after gastric cancer has increased and it is possible to observe an increased percentage of patients who achieve the 5-year survival interval after surgery. Currently, there are no guidelines to select the optimal treatment with regards to surgery or chemotherapy as pathology is rare and studies which investigate the evolution and prognosis lack a significant cohort of patients. Therefore, the existent data is not substantial enough to elaborate guidelines that would define a standard surgical treatment.

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Gastric Stump Cancer: More Than Just Another Proximal Gastric Cancer and Demanding a More Suitable TNM Staging System

BioMed Research International ◽

10.1155/2013/781896 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

André Costa-Pinho ◽

J. Pinto-de-Sousa ◽

José Barbosa ◽

J. Costa-Maia

Keyword(s):

Gastric Cancer ◽

Staging System ◽

Median Number ◽

Tnm Staging ◽

Biological Behavior ◽

Gastric Stump ◽

Proximal Gastric Cancer ◽

Gastric Stump Cancer ◽

Cumulative Survival ◽

Tnm Staging System

Background. Considerable controversy persists about the biological behavior of gastric stump cancer (GSC). The aim of this study is to clarify if this cancer is just another proximal gastric cancer or if it emerges as a distinctive clinicopathologic entity.Methods. This review of a prospectively collected gastric cancer database identified 73 patients with GSC in a single institution between January 1980 and June 2012 and compared them with 328 patients with proximal gastric cancer (PGC) and 291 patients with esophagogastric junction cancer (EGJC).Results. Patients with GSC were predominantly males. Eighty-three percent of GSC penetrated the subserosal or the serosal layers. The median number of lymph nodes retrieved in GSC patients was significantly lower than in PGC patients or in EGJC patients. Cumulative survival curves were not different between GSC, PGC, or EGJC patients. Unlike that observed in PGC and in EGJC, no significant differences in cumulative survival according to the TNM staging system were observed in GSC cases.Conclusions. The outcome of patients with GSC displayed significant differences when compared to those with other proximal gastric cancers concerning the lack of survival association with the TNM staging system. Therefore a more suitable staging system should be designed for these unique cancers.

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Gastric Stump Cancer: Demanding a More Suitable Definition and TNM Staging System

10.21203/rs.3.rs-74211/v1 ◽

2020 ◽

Author(s):

Jiannan Xu ◽

Guangyao Liu ◽

Xinghan Jin ◽

Huijin Wang ◽

Lihua Zhu ◽

...

Keyword(s):

Gastric Cancer ◽

Staging System ◽

Remnant Stomach ◽

Clinicopathological Characteristics ◽

Tnm Staging ◽

Time Interval ◽

Gastric Stump ◽

Gastric Stump Cancer ◽

Tnm Staging System ◽

Suitable Definition

Abstract BackgroundThe incidence of gastric stump cancer (GSC) following resection of gastric cancer has increase. However, the definition between GSC and recurrent gastric cancer (RGC) is still being debated. This study was conducted to compare the clinicopathological characteristics and outcome for this two groups.Patients and MethodsThe investigators retrospectively reviewed patients in the Surveillance Epidemiology and End Results (SEER) databases from 1975 to 2016 to identify patients who underwent resection of gastric cancer subsequently experienced metachronous gastric cancer. GSC was defined as cancer occurring in remnant stomach of ≥10 years after gastrectomy, while RGC was defined as <10 years after gastrectomy. T-test, Pearson χ2-test and Kaplan-Meier estimator method was used in the present study.ResultsAmong the 167,747 gastric cancer patients, 1,006 (0.6%) patients were diagnosed multiple gastric cancer, 93 patients met the GSC criterion, and 282 patients met the RGC criterion. The mean time interval between the initial cancer and second cancer for GSC was 13.34 years and 4.24 years for RGC. Male gender (P=0.003), younger age (60.1 years old vs. 65.9 years old, P<0.001) developed more frequently in GSC group. The median OS in GSC group was 20.0 months compared with 16.0 months for RGC group (p=0.302). Surgery treatment or not, the median OS have statistically significant (in RGC group, 64.0 months vs. 10.0 months, P＜0.001; 33 months vs. 13 months, P=0.014 in GSC group).ConclusionIn our definition of GSC and RGC, the OS were not statistically significant and gastrectomy may be the appropriate treatment for this two groups. It may demand for a more suitable definition and TNM staging system for GSC.

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Gastric Stump Cancer: Demanding a More Suitable Definition and TNM Staging System

10.21203/rs.3.rs-121088/v1 ◽

2020 ◽

Author(s):

Jiannan Xu ◽

Guangyao Liu ◽

Xinghan Jin ◽

Huijin Wang ◽

Lihua Zhu ◽

...

Keyword(s):

Gastric Cancer ◽

Staging System ◽

Remnant Stomach ◽

Clinicopathological Characteristics ◽

Tnm Staging ◽

Time Interval ◽

Gastric Stump ◽

Gastric Stump Cancer ◽

Tnm Staging System ◽

Suitable Definition

Abstract BackgroundThe incidence of gastric stump cancer (GSC) following resection of gastric cancer has increase. However, the definition between GSC and recurrent gastric cancer (RGC) is still being debated. This study was conducted to compare the clinicopathological characteristics and outcome for this two groups.MethodsThe investigators retrospectively reviewed patients in the Surveillance Epidemiology and End Results (SEER) databases from 1975 to 2016 to identify patients who underwent resection of gastric cancer subsequently experienced metachronous gastric cancer. GSC was defined as cancer occurring in remnant stomach of ≥10 years after gastrectomy, while RGC was defined as <10 years after gastrectomy. T-test, Pearson χ2-test and Kaplan-Meier estimator method was used in the present study.ResultsAmong the 167,747 gastric cancer patients, 1,006 (0.6%) patients were diagnosed multiple gastric cancer, 93 patients met the GSC criterion, and 282 patients met the RGC criterion. The mean time interval between the initial cancer and second cancer for GSC was 13.34 years and 4.24 years for RGC. Male gender (P=0.003), younger age (60.1 years old vs. 65.9 years old, P<0.001) developed more frequently in GSC group. The median OS in GSC group was 20.0 months compared with 16.0 months for RGC group (p=0.302). Surgery treatment or not, the median OS have statistically significant (in RGC group, 64.0 months vs. 10.0 months, P＜0.001; 33 months vs. 13 months, P=0.014 in GSC group).ConclusionsIn our definition of GSC and RGC, the OS were not statistically significant and gastrectomy may be the appropriate treatment for this two groups. It may demand for a more suitable definition and TNM staging system for GSC.

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A current view on recurrent laryngeal nerve injury in total thyroidectomy

Medicina Moderna - Modern Medicine ◽

10.31689/rmm.2021.28.1.7 ◽

2021 ◽

Vol 28 (1) ◽

pp. 7-12

Author(s):

Lucian ALECU ◽

◽

Iulian SLAVU ◽

Adrian TULIN ◽

Vlad BRAGA ◽

...

Keyword(s):

Recurrent Laryngeal Nerve ◽

Total Thyroidectomy ◽

Nerve Injury ◽

Unintentional Injury ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Current View ◽

Pubmed Database ◽

Laryngeal Nerve Injury ◽

The Moment

Introduction: Recurrent laryngeal nerve damage during total thyroidectomy was, is, and probably will be in the near future the Achilles’ heel of total thyroidectomy. Material and method: To perform the research we used the PubMed database. The questions were conceived to respect the PICOS guidelines. The PRISMA checklist was used to filter the results. The search was structured following the words: „recurrent laryngeal nerve injury” AND „total thyroidectomy”. Results: A total of 60 papers were identified. We excluded 12 papers as they were duplicates. From the 48 papers left, another 4 could not be obtained. Another 3 papers from the 44 left were excluded due to the fact they were not written in English. One paper was excluded as the subject did not follow our research purpose. 40 papers were left for analysis and discussion. Conclusion: To prevent recurrent laryngeal nerve lesions, at the moment in the literature there is no consensus. Unintentional injury to the recurrent laryngeal nerve is predictable but not an avertible situation thus bilateral lesions still represent a dramatic situation across the world for the patients and the operating surgeon.

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