Gastric tube cancer after radical esophagectomy: comparison of two periods in a single center

Background: Recent improvements in the survival of patients after esophagectomy have led to an increasing occurrence of gastric cancer in the reconstructed gastric tube (GTC). The aim of this study was to assess generational changes in the clinicopathological characteristics and treatment of GTCs in a single center. Methods: Thirteen GTC lesions in ten patients were diagnosed and treated at Keio University Hospital between 2006 and 2014. In our previous study, we reported eight cases of GTC [1]. We compared clinicopathological characteristics and treatment of GTC, as well as overall survival achieved in this study with those in our previous study [1]. Results: In this study, median patient age at the time of GTC detection was 74 years (range 62–81 years) and the median interval between esophagectomy and GTC detection was 95 months (range 21–159 months). Nine (69 %) of 13 lesions satisfied the criteria for endoscopic resection. On comparing this study with our previous study, there were no significant differences in patient age at the time of GTC detection, the interval between esophagectomy and GTC detection, or pathological stage [1]. Compared with our previous study, the use of less invasive treatments, such as endoscopic submucosal dissection and partial gastric tube resection with sentinel lymph node dissection, generationally increased and a significant difference was observed in the type of GTC treatment [1]. However, there was no significant difference in overall survival between the studies. Conclusion: Long-term periodic endoscopy permits less invasive treatments and combinations of various treatments for effective GTC therapy.