Comparative study of the pathological characteristics of gastric stump carcinoma and carcinoma of the upper third of the stomach

Background: Gastric stump cancer is often described as a tumor with a poor prognosis and low resectability rates. Objectives: To compare the pathological characteristics of gastric stump cancer patients with those of patients with proximal gastric cancer. Methods: This retrospective study was based on the demographic and pathological data of patients diagnosed with gastric cancer and treated at Assaf Harofeh Medical Center during an 11 year period. The patients were divided into two groups: those undergoing proximal gastrectomy for proximal gastric cancer and those undergoing total gastrectomy for gastric stump cancer. Results: Patients with gastric stump cancer were predominantly male, older (P = 0.202, not significant), and had a lower T stage with less signet-ring type histology, fewer harvested and fewer involved lymph nodes (P =0.03, statistically significant) and less vascular/lymphatic involvement than patients with proximal gastric cancer. Conclusions: The lower incidence of involved lymph nodes and lymphovascular invasion in gastric stump cancer as compared to proximal gastric cancer in this study may imply that the prognosis of gastric stump cancer may be better than that of proximal gastric cancer. However, to verify this assumption a study comparing patient survival is required.