AIM: To identify the lymph node metastatic pattern for gastric stump cancer; to quantify the anastomotic site invasion by tumor growth; to correlate the invasion of anastomotic site with metastasis in lymph node in general and mesenterial lymph node involvement and the survival. METHODS: One hundred and thirteen patients with gastric stump cancer were retrospectively analyzed along with their medical records, surgical specimens and histopathologic exams. RESULTS: seventy five percent of patients had tumoral invasion in the anastomotic site. In 66.7% there was invasion of the anastomotic site with metastatic lymph nodes. Nine percent had mesenterial lymph node invasion. Fatal cases occurred in 86,5% with metastatic lymph node, 64,7% with invasion of the anastomotic site and 100% with mesenterial lymph node invasion. CONCLUSIONS: Metastatic lymph node dissemination is not specific to gastric stump cancer and does not present a pattern in the lymph node dissemination. Although frequent the tumor invasion in anastomotic line, there is no significant statistical correlation with the invasion of regional or mesenterial lymph nodes. Lymph node invasion reduces survival, mainly when mesenterial lymph node dissemination is present. Tumor invasion in anastomotic line does not reduce survival.
Stump gastric cancer; Surgical treatment; Gastric cancer
