Principles of surgical treatment of gastric stump carcinoma JI Jia-fu. Department of Surgical, Peking Vniersity School of Oncology, Beijing Institute for Cancer Research, Beijing 100142, China Abstract Gastric stump carcinoma (GSC) is an uncommon tumour; however, the incidence is not declining, so the tumour entity will be encountered in the years to come. Due to low diagnosis rate of early stage, GSC still has a poor prognosis. It is important for us to understand treatment principle. The treatment of choice for GSC should be the total removal of the gastric remnant including at least D2 lymphadenectomy. The pattern of lymph node metastases in GSC may differ from primary gastric carcinoma, as lymph node metastases have been reported in the jejunal mesentery and the lower mediastinum. Therefore, GSC may require a modified lymphadenectomy to include all important lymph node stations. After radical remnant gastrectomy, GSC has a prognosis not different from primary proximal gastric carcinoma.