Surgical resection of gastric stump cancer following proximal gastrectomy for adenocarcinoma of the esophagogastric junction

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)

COPD: Chronic obstructive pulmonary disease; EGJ: Esophagogastric junction.

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

OS: Overall survival.