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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of gastric mass survey during the 11-year period 1968-1978 were evaluated. The detection rate of gastric cancer was relatively high (0.22%) and that of early gastric cancer was surprisingly good (0.10%). The five-year survival rate (67%) accordingly was much higher than in Japanese out-patients in general. Gastric mass survey therefore is useful for the early diagnosis of gastric cancer. Although some questions of a practical nature remain to be solved, improvement and extension of surveys seem ot promise a reduction in the death rate from gastric cancer.
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PMID:Evaluation of gastric mass survey. 746 39

Because endoscopists are concerned about misidentifying a gastric neoplasm as a benign gastric ulceration (GU), routine endoscopic biopsy and documentation of GU healing has been recommended. With the decreasing incidence of gastric cancer in the United States, the increased use of nonsteroidal anti-inflammatory drugs, and the concern over medical care costs, this practice standard has been questioned. To study the utility of endoscopic GU follow-up, we reviewed all cases of GU in the Duke GI-Trac database over a 7-year period. We found 1,189 patients diagnosed with GU who underwent 1,698 upper endoscopies. Of these, 130 patients underwent serial esophagogastroduodenoscopy until GU healing was documented. We identified 19 cases of gastric neoplasm. Endoscopic impression correlated with histology as follows: positive predictive value, 36%; negative predictive value, 99.3%; specificity, 90%; and sensitivity, 84%. Two of the three cases of GU in which the endoscopist's impression was benign but histology revealed malignancy occurred in the setting of an acute gastrointestinal bleed. We conclude that more than 99% of the time an endoscopist's initial impression that a GU is benign is correct. Using the Medicare reimbursement scheme, approximately $150,000 would be spent to detect one early gastric cancer. Our results further question the utility of serial endoscopic evaluation of GUs until healing.
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PMID:Endoscopic discrimination of gastric ulcers. 925 41

We describe a case in which bilateral chylothorax was the initial presenting manifestation of a gastric cancer (scirrhous type). A 58-year-old woman was admitted because of acute right subclavian vein thrombosis. Following admission, she complained of dyspnea on effort and on the 14th hospital day chest X-ray examination revealed bilateral pleural effusion. Biochemical tests of the pleural fluid detected chyle, and cytological examinations revealed mucinous adenocarcinoma bilaterally. An upper gastrointestinal examination revealed gastric cancer (scirrhous type). Carcinoma of the stomach has very rarely been described as the cause of chylothorax, but our findings indicate the need to rule out a gastric neoplasm in patients with chylothorax of no clear cause.
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PMID:[Bilateral chylothorax as initial manifestation of gastric cancer]. 1151 97

The reduced incidence of gastric cancer, due to a better patients surveillance and more accurate understanding of prophylactic measure, has allowed a detection of early stages as well as cancers with different origin cells. Either the difficulty of differential diagnosis or the various surgical and integrated approaches, make these neoplasm hard to enroll in standard treatment protocols. Our experience consists of 5 clinical cases with four different histology: lymphoma, leiomioma, carcinoid and gastrinoma. A rare case of secondary involvement of the stomach by an adrenal adenocarcinoma is also described. Lymphomas benefit of the surgical therapy only in early stages (IE, IIE), eventually associated to chemio- and radiotherapy, in relationship with local diffusion of the disease; gastric resection is more supported than gastrectomy. Polychemotherapy, with or without radiotherapy, is used for advanced stages (IIIE and IVE), leaving to surgery the role of controlling hemorrhagic or occlusion compliances. GIST have a different therapeutic approach: surgery represents the only choice since chemio- and radiotherapy have no benefits for the biological characteristics of such neoplasm. Surgery is the ideal choice for the carcinoids with some indications for chemio radiotherapy in the palliative surgery or in the relapsing. We emphasize the rarity of the secondary gastric neoplasm coming from the suprarenal glands. We analyze our diagnostic and therapeutic protocols, comparing them with the current literature.
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PMID:[Direct experience in the treatment of unusual, primary, and secondary malignant tumors of the stomach]. 1155 72

Lymphadenectomy including second-echelon lymph nodes (D2 resection) for gastric cancer has not been widely adopted partly as a result of a reported increase in operative morbidity and mortality. In the present study we examined the operative risk of D2 resection in a public teaching hospital. From 1995 to 1998, 57 patients underwent exploratory laparotomy for gastric neoplasm: nine with curative D2 resection (Group I), 17 with curative but less than D2 resection (Group II), 16 with palliative resection (Group III), and 15 with no resection (Group IV). Among the four groups, patients with curative D2 resection (Group I) were older and had increased operative time and estimated blood loss, but their need for blood transfusion, the operative morbidity and mortality, and the mean hospital stay were not increased. In contrast, those patients with palliative resection (Group III) had the highest morbidity among all groups, the only fatality, and prolonged hospital stay. Therefore, curative D2 resection can be performed safely even with significant resident involvement. The advanced patient age or the extensive dissection does not increase its surgical risk. Hence, D2 dissection should be considered whenever curative resection is feasible because it allows accurate staging with the added benefit of possible improvement in patient survival.
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PMID:Extended lymphadenectomy for gastric cancer: results in a teaching hospital. 1195 48

The differentiation between primary gastric cancer and a metastatic breast tumor to the stomach is important for planning of treatment and to spare the patient unnecessary surgery. We report a rare case of breast cancer with metastasis to the stomach. The diagnosis was established by histologic and immunohistochemical analyses of biopsies of the stomach lesion using gross cystic disease fluid protein-15, cytokeratin, carcinoembryonic antigen, and epithelial membrane antigen. Positivity for gross cystic disease fluid protein-15 with negative staining for carcinoembryonic antigen supported the diagnosis of a breast cancer metastasis. The patient was treated with systemic chemotherapy without surgery and is still alive 2 years after initial referral for a gastric neoplasm.
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PMID:Breast cancer masquerading as a primary gastric carcinoma. 1212 29

The volume-rendering technique uses computed tomography data to produce simulated images of conventional barium and endoscopic studies of the stomach. Various gastric lesions are detected on volume-rendered images, and submucosal tumors are easily differentiated from mucosal lesions by means of the overlying bridging fold. Lesions that are only manifested by a change of mucosal color (early gastric cancer type 2b) or a loss of mucosal detail (gastritis) are difficult to detect from volume-rendered images, however. In cases of gastric neoplasm and varix, both the extraluminal pathologies of the lesion and the relation between the intraluminal and extraluminal components can be evaluated simultaneously.
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PMID:Computed tomography gastrography with volume-rendering technique: correlation with double-contrast barium study and conventional gastroscopy. 1270 2

The levels of urokinase (uPA) and tissue type (tPA) plasminogen activators and their type 1 inhibitor (PAI-1) were determined by immunoassay in tumor cytosols and samples of histologically unaltered adjacent mucosa in gastric cancer patients. Gastric tumor revealed enhanced uPA and PAI-1 matched by decreased tPA in intact mucosa. The expression of uPA and PAI-1 was particularly was high at the later stages of the disease. The concentrations of uPA in tumor tissue increased with age. No significant correlation was established between levels of plasminogen activation system components, on the one hand, and histopathological grading of tumor, on the other.
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PMID:[Urokinase and tissue type plasminogen activators and their type-1 inhibitor (PAI-1) in gastric cancer]. 1278 98

The fact that the first symptoms of gastric cancer occur when therapy, even surgical, is limited to palliative objectives, was the starting point of the present study. A clinical study was carried out in a group of 158 patients with gastric cancer admitted to the Surgical Clinic II of Cluj-Napoca in the past 10 years. The most frequent location of the gastric neoplasm was the antrum-pylorus, though there were also extended tumours that invaded the neighbouring organs. Secondary processes were evidenced in over 70% of the patients studied. This fact, together with the associated conditions, made us limit the gastric resection even for the cases in which we considered total extensive gastrectomy to be the best solution. The methods of restoration of the gastric passage were esophago-jejunostomy on the Y loop in the first place, followed by gastro-jejunostomosis with the other techniques of gastric reconstruction. Palliative procedures such as gastro-enteroanastomosis or nutritional gastro-jejunostomy were sometimes necessary. Good postoperative results were obtained in 69% of the patients, which emphasizes once again the importance of this study.
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PMID:[The place of surgery in the complex treatment of gastric cancer]. 1499 70

The aim of the present study was to compare the efficacy of chemotherapy and support treatment in patients with advanced non-resectable gastric cancer in a systematic review and meta-analysis of randomized clinical trials that included a comparison of chemotherapy and support care treatment in patients diagnosed with gastric adenocarcinoma, regardless of their age, gender or place of treatment. The search strategy was based on the criteria of the Cochrane Base, using the following key words: 1) randomized clinical trials and antineoplastic combined therapy or gastrointestinal neoplasm, 2) stomach neoplasm and drug therapy, 3) clinical trial and multi-modality therapy, 4) stomach neoplasm and drug therapy or quality of life, 5) double-blind method or clinical trial. The search was carried out using the Cochrane, Medline and Lilacs databases. Five studies fulfilled the inclusion criteria, for a total of 390 participants, 208 (53%) receiving chemotherapy, 182 (47%) receiving support care treatment and 6 losses (1.6%). The 1-year survival rate was 8% for support care and 20% for chemotherapy (RR = 2.14, 95% CI = 1.00-4.57, P = 0.05); 30% of the patients in the chemotherapy group and 12% in the support care group attained a 6-month symptom-free period (RR = 2.33, 95% CI = 1.41-3.87, P < 0.01). Quality of life evaluated after 4 months was significantly better for the chemotherapy patients (34%; RR = 2.07, 95% CI = 1.31-3.28, P < 0.01) with tumor mass reduction (RR = 3.32, 95% CI = 0.77-14.24, P = 0.1). Chemotherapy increased the 1-year survival rate of the patients and provided a longer symptom-free period of 6 months and an improvement in quality of life.
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PMID:Chemotherapy versus support cancer treatment in advanced gastric cancer: a meta-analysis. 1661 65


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