Top

Published in:

01-06-2010

Surveillance and treatment for second primary cancer in the gastric tube after radical esophagectomy

Authors: Takeo Bamba, Shin-ichi Kosugi, Manabu Takeuchi, Masaaki Kobayashi, Tatsuo Kanda, Atsushi Matsuki, Katsuyoshi Hatakeyama

Published in: Surgical Endoscopy | Issue 6/2010

Abstract

Background

Recent improvement in the survival of patients after esophagectomy for esophageal cancer has led to increasing occurrence of second primary cancer in the pulled-up stomach as gastric tube cancer (GTC). However, a treatment strategy for GTC including surveillance has not been established. The aims of this study are to clarify the incidence and clinicopathological characteristics of GTC and to assess the treatment results of endoscopic resection.

Methods

Twenty-five patients with 29 GTC lesions treated between 1989 and 2007 were analyzed retrospectively.

Results

The median interval between esophagectomy and GTC detection was 86 months, and the 10-year cumulative incidence rate of GTC was 8.6%. Of 18 asymptomatic GTCs, 17 lesions (94.4%) were detected by periodic endoscopy and 15 (88.2%) of them were treated endoscopically. Of all 29 GTCs, endoscopic submucosal dissection (ESD) was performed in 10 GTCs with a completely curative resection rate of 90%, which was significantly higher than that of 7 GTCs treated with endoscopic mucosal resection (EMR) (14.3%, P = 0.004). In these 17 GTCs, no cancer recurrence developed during a median follow-up period of 24 months, and the 3-year survival rate was 80.8%.

Conclusions

For patients after esophagectomy with gastric pull-up, long-term follow-up including periodic endoscopy is necessary to detect a potentially curable GTC. ESD is a feasible and safe procedure for GTC, with oncologically favorable features.

Poon RT, Law SY, Chu KM, Branicki FJ, Wong J (1998) Multiple primary cancers in esophageal squamous cell carcinoma: incidence and implications. Ann Thorac Surg 65:1529–1534CrossRefPubMed

Nagasawa S, Onda M, Sasajima K, Takubo K, Miyashita M (2000) Multiple primary malignant neoplasms in patients with esophageal cancer. Dis Esophagus 13:226–230CrossRefPubMed

Okamoto N, Ozawa S, Kitagawa Y, Shimizu Y, Kitajima M (2004) Metachronous gastric carcinoma from a gastric tube after radical surgery for esophageal carcinoma. Ann Thorac Surg 77:1189–1192CrossRefPubMed

Kokawa A, Yamaguchi H, Tachimori Y, Kato H, Watanabe H, Nakanishi Y (2001) Other primary cancers occurring after treatment of superficial oesophageal cancer. Br J Surg 88:439–443CrossRefPubMed

Earlam R, Cunha-Melo JR (1980) Oesophageal squamous cell carcinoma: I. A critical review of surgery. Br J Surg 67:381–390CrossRefPubMed

Sugiura T, Kato H, Tachimori Y, Igaki H, Yamaguchi H, Nakanishi Y (2002) Second primary carcinoma in the gastric tube constructed as an esophageal substitute after esophagectomy. J Am Coll Surg 194:578–583CrossRefPubMed

Kise Y, Kijima H, Shimada H, Tanaka H, Kenmochi T, Chino O, Tajima T, Makuuchi H (2003) Gastric tube cancer after esophagectomy for esophageal squamous cell cancer and its relevance to Helicobacter pylori. Hepatogastroenterology 50:408–411PubMed

Kuwabara S, Nishimaki T, Kanda T, Nakagawa S, Suzuki T, Hatakeyama K (2002) Second primary cancer developing in the reconstructed gastric tube after esophagectomy for esophageal cancer: clinicopathological analyses of 14 cases. Acta Med Biol 50:91–96

Suzuki H, Kitamura M, Saito R, Motoyama S, Ogawa J (2001) Cancer of the gastric tube reconstructed through the posterior mediastinal route after radical surgery for esophageal cancer. Jpn J Thorac Cardiovasc Surg 49:466–469CrossRefPubMed

10.

Motoyama S, Saito R, Okuyama M, Maruyama K, Ogawa J (2006) Treating gastric tube cancer with distal gastrectomy preserving the gastroepiploic artery. Ann Thorac Surg 81:751–753CrossRefPubMed

11.

Sobin LH, Wittekind CH (2002) TNM classification of malignant tumors, 6th edn. Wiley, New York

12.

Dixon MF, Genta RM, Yardley JH, Correa P (1996) Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 20:1161–1181CrossRefPubMed

13.

Japan Esophageal Society (2008) Japanese classification of esophageal cancer, 10th edn. Kanehara, Tokyo

14.

Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma, 2nd English edn. Gastric Cancer 1:10–24CrossRefPubMed

15.

Japanese Gastric Cancer Association (2004) Treatment guideline for gastric cancer in Japan (in Japanese), 2nd edn. Kanehara, Tokyo

16.

Makuuchi H, Kise Y, Shimada H, Chino O, Tanaka H (1999) Endoscopic mucosal resection for early gastric cancer. Semin Surg Oncol 17:108–116CrossRefPubMed

17.

Oyama T, Kikuchi Y, Shimaya S, Tomori A, Hotta K, Miyata Y, Yamada S (2002) Endoscopic mucosal resection using a hooking knife (hooking EMR). Stomach Intest 37:1155–1161

18.

Gotoda T, Yamamoto H, Soetikno RM (2006) Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 41:929–942CrossRefPubMed

19.

Atmani A, Topart P, Vandenbroucke F, Louzi A, Ferrand L, Lozac’h P (2006) Metachronous cancer of gastroplasty after esophagectomy. Dis Esophagus 19:512–515CrossRefPubMed

20.

Shigemitsu K, Naomoto Y, Shirakawa Y, Haisa M, Gunduz M, Tanaka N (2002) Five cases of early gastric cancer in the reconstructed gastric tube after radical resection for esophageal cancer. Jpn J Clin Oncol 32:425–429CrossRefPubMed

21.

Morita M, Kuwano H, Ohno S, Sugimachi K, Seo Y, Tomoda H, Furusawa M, Nakashima T (1994) Multiple occurrence of carcinoma in the upper aerodigestive tract associated with esophageal cancer: reference to smoking, drinking and family history. Int J Cancer 58:207–210CrossRefPubMed

22.

Marugame T, Matsuda T, Kamo K, Katanoda K, Ajiki W, Sobue T, Japan Cancer Surveillance Research Group (2007) Cancer incidence and incidence rates in Japan in 2001 based on the data from 10 population-based cancer registries. Jpn J Clin Oncol 37:884–891CrossRefPubMed

23.

Dixon MF, Mapstone NP, Neville PM, Moayyedi P, Axon AT (2002) Bile reflux gastritis and intestinal metaplasia at the cardia. Gut 51:351–355CrossRefPubMed

24.

Takeo H, Matsukuma S (2007) Gastric tube cancer: immunohistochemical study of 10 lesions in six patients. J Gastroenterol Hepatol 22:23–29CrossRefPubMed

25.

Katsoulis IE, Robotis I, Kouraklis G, Yannopoulos P (2005) Duodenogastric reflux after esophagectomy and gastric pull-up: the effect of the route of reconstruction. World J Surg 29:174–181CrossRefPubMed

26.

Palmes D, Weilinghoff M, Colombo-Benkmann M, Senninger N, Bruewer M (2007) Effect of pyloric drainage procedures on gastric passage and bile reflux after esophagectomy with gastric conduit reconstruction. Langenbecks Arch Surg 392:135–141CrossRefPubMed

27.

Correa P, Houghton J (2007) Carcinogenesis of Helicobacter pylori. Gastroenterology 133:659–672CrossRefPubMed

28.

Shimizu T, Akamatsu T, Sugiyama A, Ota H, Katsuyama T (1996) Helicobacter pylori and the surface mucous gel layer of the human stomach. Helicobacter 1:207–218CrossRefPubMed

29.

Koide N, Yazawa K, Koike S, Adachi W, Amano J (1997) Oesophageal cancer associated with other primary cancers: a study of 31 patients. J Gastroenterol Hepatol 12:690–694CrossRefPubMed

30.

Ono H, Kondo H, Gotoda T, Shirao K, Yamaguchi H, Saito D, Hosokawa K, Shimoda T, Yoshida S (2001) Endoscopic mucosal resection for treatment of early gastric cancer. Gut 48:225–229CrossRefPubMed

31.

Soetikno RM, Gotoda T, Nakanishi Y, Soehendra N (2003) Endoscopic mucosal resection. Gastrointest Endosc 57:567–579CrossRefPubMed

32.

Koyanagi K, Ozawa S, Ando N, Shih CH, Nakamura E, Takeuchi H, Hayashi K, Kitajima M (1998) Case report: metachronous early gastric carcinoma in a reconstructed gastric tube after radical operation for oesophageal carcinoma. J Gastroenterol Hepatol 13:311–315CrossRefPubMed

33.

Kunisaki C, Akiyama H, Nomura M, Matsuda G, Otsuka Y, Ono HA, Takagawa R, Nagahori Y, Takahashi M, Kito F, Moriwaki Y, Nakano A, Shimada H (2006) Lymph node status in patients with submucosal gastric cancer. Ann Surg Oncol 13:1364–1371CrossRefPubMed

34.

Kurihara N, Kubota T, Otani Y, Ohgami M, Kumai K, Sugiura H, Kitajima M (1998) Lymph node metastasis of early gastric cancer with submucosal invasion. Br J Surg 85:835–839CrossRefPubMed

35.

Pointner R, Wetscher GJ, Gadenstätter M, Bodner E, Hinder RA (1994) Gastric remnant cancer has a better prognosis than primary gastric cancer. Arch Surg 129:615–619PubMed

Title: Surveillance and treatment for second primary cancer in the gastric tube after radical esophagectomy
Authors: Takeo Bamba
Shin-ichi Kosugi
Manabu Takeuchi
Masaaki Kobayashi
Tatsuo Kanda
Atsushi Matsuki
Katsuyoshi Hatakeyama
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 6/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-009-0766-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surveillance and treatment for second primary cancer in the gastric tube after radical esophagectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2010

Outweighing the benefits and weakness of endoscopic submucosal dissection for early gastric cancer in the west

Dietetic-led management of patients undergoing laparoscopic gastric banding: early results

A population-based analysis of emergent vs. elective hospital admissions for an intrathoracic stomach

Comparison of endoscopic ultrasonography (EUS), positron emission tomography (PET), and computed tomography (CT) in the preoperative locoregional staging of resectable esophageal cancer

Tensile strength and adhesion formation of mesh fixation systems used in laparoscopic incisional hernia repair

Laparoscopic conversion of Roux-en-Y gastric bypass to biliopancreatic diversion