Ma FH, Xue LY, Chen YT, Li WK, Li Y, Kang WZ, Xie YB, Zhong YX, Xu Q, Tian YT. Surgical resection of gastric stump cancer following proximal gastrectomy for adenocarcinoma of the esophagogastric junction. World J Gastrointest Oncol 2019; 11(5): 416-423 [PMID: 31139311 DOI: 10.4251/wjgo.v11.i5.416]
Corresponding Author of This Article
Yan-Tao Tian, MD, Professor, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Beijing 100021, China. tyt67@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. May 15, 2019; 11(5): 416-423 Published online May 15, 2019. doi: 10.4251/wjgo.v11.i5.416
Table 1 Clinical characteristics of patients
Characteristics
Number of patients (%)
Sex
Male
31 (88.6)
Female
4 (11.4)
Age (yr)
60 ± 11 (33-83)
ASA
I-II
25 (71.4)
III-IV
10 (28.6)
Comorbidity
Any comorbidity
7 (20)
Hypertension
2 (5.7)
Diabetes
1 (2.9)
COPD
1 (2.9)
Coronary artery disease
2 (5.7)
Cerebral vascular disease
1 (2.9)
Family history of gastric cancer
4 (11.8)
Siewert type of initial EGJ adenocarcinoma
SiewertI
2 (5.7)
Siewert II
29 (82.9)
Siewert III
4 (11.4)
Adjuvant therapy after initial operation
Received
17 (48.6)
Not received
4 (11.4)
Unknown
14 (40)
Tumor location
Anastomotic site
14 (40)
Nonanastomotic site
21 (60)
Interval (yr)
4.9 ± 3.2 (0.7-12)
Interval
< 5 yr
21 (60)
≥ 5 yr, < 10 yr
10 (28.6)
≥ 10 yr
4 (11.4)
Table 2 Surgical characteristics and short-term outcomes
Surgical characteristics
Number of patients (%)
Operation type
Total gastrectomy
27 (77.1)
Partial gastrectomy
8 (22.9)
Additional organ resection
Yes
5 (14.3)
Yes
5 (14.3)
Estimated blood loss (mL)
513 ± 383
Operation time (min)
343 ± 132
Blood transfusion
No
9 (25.7)
Yes
26 (74.3)
Postoperative complications
Any complication
6 (17.1)
Leakage
4 (11.4)
Hemorrhage
1 (2.9)
Ileus
1 (2.9)
Wound infection
1 (2.9)
Postoperative hospital stay (d)
18.4 ± 12.1
Table 3 Histopathological characteristics
Pathological characteristics
Number of patients (%)
Histology
Adenocarcinoma
26 (74.3)
Adenocarcinoma with signet ring cell
9 (25.7)
Pathologic grade
Poor
21 (60.0)
Moderate
11 (31.4)
Well
3 (8.6)
T stage
T1a-1b
6(17.1)
T2
3 (8.6)
T3
9 (25.7)
T4a
11 (31.5)
T4b
6 (17.1)
Number of dissected lymph nodes
11.1 ± 7.4
Number of lymph node metastasis
2.9 ± 4.2
N stage
N0
16 (45.7)
N1/N2/N3
19 (54.3)
Table 4 Univariate and Multivariate analyses of clinicopathologic factors associated with overall survival
5-yr OS (%)
Univariate
Multivariate
Hazard ratio
P value
Hazard ratio
P value
Sex: Male vs female
49.4 vs 66.7
3.352 (0.420-26.755)
0.229
-
-
Age: < 65 yr vs ≥ 65 yr
63.5 vs 44.7
0.597 (0.199-1.796)
0.354
-
-
Tumor location: Anastomotic vs nonanastomotic
57.7 vs 56.2
0.868 (0.265-2.846)
0.816
-
-
Interval: < 5 yr vs ≥ 5 yr
56.8 vs 55.4
0.665 (0.213-2.074)
0.479
-
-
Operation type: Completion gastrectomy vs segmental resection
56.2 vs 68.6
2.112 (0.464-9.614)
0.323
-
-
Histology: Adenocarcinoma vs adenocarcinoma with signet ring cell
65.6 vs 0
0.368 (0.104-1.306)
0.108
0.376 (0.098-1.44)
0.154
Pathologic grade: Poor vs moderate/well
49.7 vs 65.3
1.232 (0.401-3.786)
0.715
-
-
T stage: T1-3 vs T4
77.0 vs 30.6
0.144 (0.039-0.534)
0.001
0.166 (0.041-0.672)
0.012
N stage: N0 vs N+
73.8 vs 39.2
0.216 (0.058-0.807)
0.013
0.432 (0.103-1.822)
0.253
Citation: Ma FH, Xue LY, Chen YT, Li WK, Li Y, Kang WZ, Xie YB, Zhong YX, Xu Q, Tian YT. Surgical resection of gastric stump cancer following proximal gastrectomy for adenocarcinoma of the esophagogastric junction. World J Gastrointest Oncol 2019; 11(5): 416-423