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Gastric stump cancer. Etiology and treatment. A general review of the last 5 years

Introduction: Gastric stump cancer (GSC) is an entity described in the literature as early as the 1920s. Along the years the clinicopathological characteristic had changed. At the moment, there are no well-established guidelines regarding the optimal treatment. 
Material and method: We conducted a literature review of the studies published from 2014 to 2019 using the PubMed database. 
Results: After searching the PubMed database for the keywords: “gastric remnant cancer” AND “stump” AND “neoplasm” we identified 167 articles. Of these, 25 studies were considered relevant. 
Discussions: GSC develops after 2 years from the primary intervention for malignancy and after 20 years for benign lesions. The development mechanisms vary depending on the type of primary gastric lesions. GSC is considered a unique clinicopathological entity. The pattern of lymphatic drainage is different in comparison to primary gastric neoplasm. Thus an important negative prognostic factor is considered to be the N group of TNM staging. 
Conclusion: More studies are required to improve the understanding of development mechanisms and evolution of this pathology. Survival after gastric cancer has increased and it is possible to observe an increased percentage of patients who achieve the 5-year survival interval after surgery. Currently, there are no guidelines to select the optimal treatment with regards to surgery or chemotherapy as pathology is rare and studies which investigate the evolution and prognosis lack a significant cohort of patients. Therefore, the existent data is not substantial enough to elaborate guidelines that would define a standard surgical treatment. 
 