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Abstract
Introduction. The study of gastric stump cancer (GSC) is gaining increasing relevance due to the growing number of patients with a history of gastric resection and their high subsequent risk of developing carcinoma.
Aim. To compare the immediate and long-term treatment outcomes of patients with GSC versus those with unresected gastric cancer (GC).
Materials and methods. The study included 124 patients treated at the Republican Clinical Oncology Dispensary named after prof. M.Z. Sigal from 2011 to 2024. All patients were divided into two groups: the study group (n=54) comprised patients with GSC who underwent gastric stump extirpation (n=49) or resection (n=5); the comparison group (n=70) comprised patients with primary GC, selected via paired matching.
Results. Immediate outcomes were worse in the main group versus the comparison group. There was a higher incidence of Clavien-Dindo grade ≥III complications (18.5% vs. 4.3%, p=0.029), a higher re-laparotomy rate (16.7% vs. 2.9%, p=0.01), a longer median operative time (27.5 minutes longer, p<0.001), greater intraoperative blood loss (p<0.001), and a longer postoperative hospital stay (p=0.009). The median overall survival (OS) was 74 months (95% CI: 24–∞) in the GSC group and 72 months (95% CI: 42–∞) in the GC group. The 5-year OS rates were 56% (95% CI: 39.2–69.8) and 57.7% (95% CI: 41.7–70.8), respectively (p=0.988). Independent factors influencing OS in GSC patients included ASA class 3–4 (p=0.034) and the presence of regional lymph node metastases (p=0.032).
Conclusion. Despite similar long-term survival rates when clinical and pathological data are initially comparable, surgical treatment for GSC represents a more complex intervention associated with significantly worse immediate postoperative outcomes compared to surgery for primary gastric cancer.
References
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