Clinical Features And Prognostic Factors Of Gastric Stump Cancer

Objective：To investigate the clinical and pathological features of gastric remnant and factorsinitial gastrointestinal anastomosis with transverse position on the relationshipbetween affect and influence the prognosis of survival.Methods：1. Data source:2002January-2012year during December, No.1Hospital of JilinUniversity treated with gastric stump cancer diagnosis standard parallel operationtreatment in47cases of patients,45patients with complete data2. Study on patients with primary operation situation, clinicalmanifestation,histological type, age and initial operation of gastric stump cancerincidence relations, and according to gender, time interval, tumor location, TNMstaging,treatment methods, methods of anastomosis grouping and survival analysis3. Statistical methods: using SPSS17.0statistical software. Count data using chisquare test or Fisher’s exact probability of2, according to the Kaplan-Meiermethod todraw the survival curves, Log-rank test was used to compare thesurvival ratedifferences, analysis with the COX regression model for multivariateResults：1.41male patients,6female patients with GSC, male: female was6.8:1.initialsurgery colon before gastrojejunostomy to gastric remnant interval averaged29.12±11.61years after the initial surgery of the colon to the remnant gastricgastrojejunostomy interval averaged32.64±9.50years.The difference was notstatistically significant (P <0.05).2. Before colonic anastomosis tumors involving the proportion of theanastomosis was29.4%, the proportion of the colonic anastomosis tumors involvingthe anastomosis was67.9%, after colonic anastomosis than before colonic anastomosis tumors occur in the stoma, the difference was statistically significant (P<0.05).3. Lymph node metastasis before colonic anastomosis was21.6%, lymph nodemetastasis after colonic anastomosis was31.4%; pre-colonic anastomosis patients, theincidence of lymph node metastasis in46.2%of patients after colorectal anastomosis,the incidence of lymph node metastasis (76.9%),the difference was statisticallysignificant (P <0.05).4. The age for the first partial gastrectomy was negatively correlated with thetime interval (rs=-0.678).The first time the older gastric surgery, postoperative gastricremnant shorter time interval,the difference was statistically significant (P <0.01).5. Before colon anastomosis resection was88.2%, the radical resection rate was76.5%; after colonic anastomosis resection rate was57.1%, the radical resection ratewas46.4%,the difference was significant (P <0.05).6. Before the colon anastomosis combined organ resection was13.3%, combinedorgan resection after colonic anastomosis was20.8%, the difference was significant(P<0.05).7. The survival rates of the patients with gastric stump cancer were significantlysignificant by PTNM stages,treatment methods and anastomosis. but sex, timeinterval and tumor location do not affact the survival rates of the patients with gastricstump cancer.Conclusion：1. In patients with pathological staging and radical degree under the sameinitialoperation, when the older, incidence of gastric remnant carcinoma afteroperation of shorter intervals. The first operation of colonic anteriorgastrojejunostomythan colon anastomosis after low transfer rate of gastric stump cancer short timeinterval, lymph node, but the survival rate was significantly higher than the latter.2. The colon is consistent with multiple tumor in the colon anastomosis and thecombined organ resection rate is high.