ReviewGastric stump carcinoma – Epidemiology and current concepts in pathogenesis and treatment
Section snippets
Aim of the article and introduction
Gastric stump carcinoma (GSC) is defined as a carcinoma occurring in the gastric remnant at least 5 years after surgery for benign peptic ulcer disease.1, 2 Despite the fact that conservative medical therapy displaced partial gastrectomy for the treatment of ulcer, the incidence of gastric stump carcinoma is not declining, because of the long latency period.3, 4, 5 This implies that more cases of gastric stump carcinoma will be encountered in the future. In addition, even today there are
Methods
The electronic literature search was conducted in the MEDLINE database. The literature on all topics concerning GSC was reviewed. The references reported in these studies were used to complete the literature search. One main focus of the literature search was studies dealing with the different ways of lymph node metastasation, because of its special relevance for treatment. Furthermore, all studies covering the topics of epidemiology, aetiology, pathology, treatment and prognosis in GSC were
Epidemiology
This rising number of GSC cases and the association to the operated stomach was at first described in the 1950s.9 The proportion of GSC ranges from 1.1% to 7% of all gastric carcinomas.7, 10, 11, 12 In recent years, the incidence of GSC has been increasing, because of the long latency period and the frequent performance of partial gastrectomy in the previous decades.3 In retrospective studies with long follow-up times, an increase in the incidence ratio of gastric stump cancer was detected in
Conclusion
The incidence of GSC has not yet declined because of the long time interval until the development of GSC in the operated stomach; the incidence may even rise in the years to come as surgery was frequently performed until the early 1980's. Several studies reported an increased frequency of gastric stump carcinoma after partial gastrectomy.7, 8 Fifteen to twenty years after distal gastrectomy, the risk of GSC steeply rises and the average latency period until manifestation of carcinoma in the
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