Clinicopathological features of patients with gastric stump carcinoma after a distal gastrectomy HU Xiang，TIAN Da-yu，CAO Liang, et al. Department of General Surgery, the First Affiliated Hospital, Dalian Medical University, Dalian 116011, China Corresponding author: HU Xiang, E-mail: tiandayu_2000@163.com Abstract Objective To discuss the clinicopathologic feature and the effect of surgical treatment in gastric stump carcinoma (GSC). Methods Eighty-nine patients who undergone operation for GSC (42 patients with primary diseases were benign, 47 patients with primary diseases were malignant) between 1993 and 2003 in the Department of General Surgery of the First Affiliated Hospital of Dalian Medical University were studied. Clinicopathologic feature, the 5?year survival rate after operation and prognostic factors were analyzed retrospectively. Results GSC occurs more frequently in anastomotic site and the majority of histological types was poorly-differentiated cancer. In metastasis of lymph node of GSC, the rate of lymph node metastasis in No.1,2,3,4,10,11,12 stations was 30.5%～61.0%, and that in No. 14 station was 25%. The percentage of lymph node metastasis in jejunal mesentery was 27.3%～50.4%. Patients performed Billroth?Ⅰreconstruction were found high rate of lymph node metastasis in No.10,11,12 stations. Patients performed Billroth?Ⅱreconstruction showed that the rate of lymph node metastasis in jejunal mesentery was up to 50.4%. In the organ invasion of GSC , the percentage of pancreatic invasion and hepatoduodenal ligament invasion was 66.7% and 33.3%, respectively, for patients with Billroth?Ⅰ reconstruction. The percentage of transverse colon invasion and pancreatic invasion was 25.0%～28.5% and 71.4%～75.0%, respectively, for patients with Billroth?Ⅱreconstruction. The overall 5?year survival rate for patients with GSC secondary to benign diseases was 38.1%, that in patients with GSC secondary to malignant diseases was 10.4%. The overall 5?year survival rate for radical A and B in GSC secondary to benign diseases and malignant diseases was 53.6% and 22.2% respectively with statistically significant difference (P< 0.05). Conclusion GSC has a particular pattern in lymph node metastasis and direct organs invasion. Surgical resection is considered an effective therapeutic strategy for GSC.