Topic Highlight
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2014; 20(38): 13734-13740
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.13734
Gastric cancer arising from the remnant stomach after distal gastrectomy: A review
Shinsuke Takeno, Tatsuya Hashimoto, Kenji Maki, Ryosuke Shibata, Hironari Shiwaku, Ippei Yamana, Risako Yamashita, Yuichi Yamashita
Shinsuke Takeno, Tatsuya Hashimoto, Kenji Maki, Ryosuke Shibata, Hironari Shiwaku, Ippei Yamana, Risako Yamashita, Yuichi Yamashita, Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka 814-0180, Japan
Author contributions: Takeno S designed and wrote this review article; Hashimoto T, Maki K, Shibata R, Shiwaku H, Yamana I and Yamashita R collected the references and analyzed those datas in each section “Epidemiology”, “Effects of Reconstruction during Distal Gastrectomy on Carcinogenesis in the Remnant Stomach”, “Helicobacter pylori Infection”, “Epstein-Barr Virus Infection in the Remnant Stomach”, “Clinicopathological Characteristics” and “Endoscopic Treatment”; Yamashita Y directed and proofread this review article.
Correspondence to: Shinsuke Takeno, MD, PhD, Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Nanakuma 7-45-1, Johnan-ku, Fukuoka 814-0180, Japan. takeno@fukuoka-u.ac.jp
Telephone: +81-92-8011011 Fax: +81-92-8639759
Received: October 25, 2013
Revised: January 22, 2014
Accepted: May 28, 2014
Published online: October 14, 2014
Processing time: 356 Days and 6.4 Hours
Abstract

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.

Keywords: Remnant gastric cancer; Distal gastrectomy; Carcinogenesis; Helicobacter pylori; Endoscopic submucosal dissection

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.