Gastric cancer in the reconstructed gastric tube after radical esophagectomy: a single-center experience

Surg Today. 2011 Jul;41(7):966-9. doi: 10.1007/s00595-010-4402-1. Epub 2011 Jul 12.

Abstract

Purpose: Metachronous gastric carcinoma arising in a gastric tube used for esophageal reconstruction has been occasionally encountered in long-term survivors of esophageal cancer. This study investigated 10 cases of gastric tube cancer in order to clarify the characteristics and the outcome of these patients.

Methods: Four hundred and seventy-one patients underwent a radical esophagectomy at Kyushu University Hospital between 1989 and 2003. There were 10 cases of gastric tube cancer after an esophagectomy.

Results: The interval between the esophagectomy and the development of the gastric tube cancer ranged from 1.1 to 7 years. There was no peak for the incidence of gastric tube cancer. In 6 of 10 cases of gastric tube cancer, endoscopic or surgical resection were performed for the treatment; however, chemotherapy was administered to the other 4 cases for several reasons. The prognosis of patients who underwent resection was better than that of the other patients.

Conclusions: Frequent endoscopic examinations are therefore important even several years after performing an esophagectomy, since the risk of gastric tube cancer is higher than the risk of a recurrence of esophageal cancer several years after an esophagectomy. Only an early diagnosis permits a less invasive and appropriate approach for the treatment of gastric tube cancer.

MeSH terms

  • Aged
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / adverse effects*
  • Esophagectomy / methods
  • Female
  • Humans
  • Incidence
  • Japan
  • Male
  • Middle Aged
  • Postoperative Period
  • Prognosis
  • Risk Factors
  • Stomach Neoplasms / etiology*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Survival Analysis
  • Time Factors
  • Treatment Outcome