Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.13734
Revised: January 22, 2014
Accepted: May 28, 2014
Published online: October 14, 2014
Gastric stump carcinoma was initially reported by Balfore in 1922, and many reports of this disease have since been published. We herein review previous reports of gastric stump carcinoma with respect to epidemiology, carcinogenesis, Helicobacter pylori (H. pylori) infection, Epstein-Barr virus infection, clinicopathologic characteristics and endoscopic treatment. In particular, it is noteworthy that no prognostic differences are observed between gastric stump carcinoma and primary upper third gastric cancer. In addition, endoscopic submucosal dissection has recently been used to treat gastric stump carcinoma in the early stage. In contrast, many issues concerning gastric stump carcinoma remain to be clarified, including molecular biological characteristics and the carcinogenesis of H. pylori infection. We herein review the previous pertinent literature and summarize the characteristics of gastric stump carcinoma reported to date.
Core tip: Recent studies concerning gastric stump carcinoma were reviewed. Its carcinogenesis took more than 300 mo after distal gastrectomy for benign disease, in contrast to 100 mo for primary gastric cancer. Higher carcinogenetic risk was reported by molecular biological analysis in patients treated with Billroth II reconstruction than with Billroth I. Eradication of Helicobacter pylori in the remnant stomach improved the degree of inflammation and the pH level, and might prevent the development of carcinogenesis. Endoscopic treatment for gastric stump carcinoma has been recently reported, therefore, endoscopic surveillance should be repeated after distal gastrectomy.