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

Attempts to prevent peritoneal carcinomatosis after surgery for gastric cancer by intraperitoneal administration of anticancer drugs have not been successful, largely because the drugs are not retained in the peritoneal cavity. We have assessed the prophylactic efficacy of a delayed-release preparation--mitomycin adsorbed onto activated charcoal (M-CH). 50 patients with gastric cancer and serosal infiltration were randomly assigned intraperitoneal treatment with M-CH (50 mg mitomycin intraoperatively) or no anticancer prophylaxis (control). Survival rates for the 3 years of follow-up were significantly higher among the 24 M-CH recipients (1 was lost to follow-up) than among the 25 controls (p less than 0.01). There were significant differences in survival between the groups at 1.5 years after randomisation (difference 34.6% [95% confidence interval 8.5-60.8%]; p less than 0.01) and at 2.0, 2.5, and 3.0 years (41.7% [14.2-69.1%]; p less than 0.005). The concentration of mitomycin was significantly higher in peritoneal exudate than in plasma for 24 h after drug administration. Side-effects were slight and well tolerated. Thus, peroperative intraperitoneal treatment with M-CH seems to improve survival after gastrectomy for gastric cancer, presumably by a prophylactic effect on peritoneal recurrence.
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PMID:Prophylaxis with carbon-adsorbed mitomycin against peritoneal recurrence of gastric cancer. 135 77

Gastric cancer sometimes spread to peritoneal surfaces in the absence of lymphatic or hematogenous metastases. For the treatment of peritoneal carcinomatosis, we applied large volume intraperitoneal chemotherapy (L.V.I.C.). In L.V.I.C., drugs were administered with large volume of saline through the reservoir buried in the subcutaneous tissue of the abdominal wall. We used mitomycin C (MMC), 5-fluorouracil (5-FU) and CDDP and examined the pharmacokinetics of these drugs when they were administered by this method to the patients of peritoneal carcinomatosis. A marked pharmacokinetic advantage was observed when 5-FU and CDDP were administered. AUC of these drugs were much larger than that of MMC. In vitro sensitivity test (SDI test) was useful for the selection of adequate drugs for each patient. On this method, drugs were distributed widely in the abdominal cavity and the patients could be taken this treatment repeatedly as out-patient. L.V.I.C. seems to fulfill the need for a safe, effective and acceptable delivery system of intraperitoneal chemotherapy.
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PMID:[Large volume intraperitoneal chemotherapy as treatment for the peritoneal carcinomatosis from gastric cancer]. 155 95

The authors report four cases of intracranial hemorrhage associated with nontraumatic disseminated intravascular coagulation (DIC). Two cases demonstrated a sudden onset of intracerebral hemorrhage. The other two showed chronic subdural hematoma initially, followed by acute multiple intracranial hemorrhages or general hemorrhagic diathesis. The underlying disorders were glioblastoma multiforme, thoracoabdominal aortic aneurysm, acute promyelocytic leukemia, and stomach cancer associated with disseminated carcinomatosis of the bone marrow. All patients died eventually. When the underlying disorder has a rare incidence of DIC as in glioblastoma multiforme or thoracoabdominal aortic aneurysm, the possibility of DIC and the need for immediate initiation of replacement therapy should be recognized, although the mortality is very high because the underlying disorder cannot be eliminated quickly. When the underlying disorder has a high incidence of DIC as in acute promyelocytic leukemia or disseminated carcinomatosis of the bone marrow, it is mandatory to start replacement therapy and treatment for the underlying disorder simultaneously. DIC can be controlled when the treatment for the underlying disorder is effective.
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PMID:Intracranial hemorrhage associated with nontraumatic disseminated intravascular coagulation--report of four cases. 170 40

Meningeal carcinomatosis is a rare complication of systemic cancer, of which advanced gastric carcinomas have predominated. The present case happens to be the first reported of meningeal carcinomatosis caused by an early gastric cancer, which was first diagnosed at autopsy. Various pathological aspects of early gastric cancer, which may have influenced the outcome of the present case, are considered.
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PMID:Meningeal carcinomatosis from a clinically undiagnosed early gastric cancer. 206 18

Reported are 2 cases of an advanced gastric cancer with a "diffuse carcinomatosis of the bone marrow" (DCMB) showing a widespread osteoplastic bone metastasis. In a DCBM, a widespread invasion of cancer cells to the bone marrow occurs, causing leukoerythroblastosis, anemia, and disseminated intravascular coagulation. The local reaction in the bone, namely being osteoplastic or osteolytic, has not been discussed in previous papers. Our cases were characterized by an extremely high serum alkaline phosphatase, a "superscan" view of the bone scintigram, and a diffuse osteoplastic bone metastasis with an osteoid increase. Thus we think there are DCBM subtypes with a diffuse osteoplastic bone metastasis.
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PMID:[Two cases of advanced gastric cancer with diffuse carcinomatosis of the bone marrow showing a widespread osteoplastic bone metastasis]. 215 82

A 74-year-old man developed progressive deafness and unsteady gait two years after gastrectomy for a gastric cancer. Neurological examination revealed an alert and intelligent Japanese male in no acute distress. The optic fundi were normal. The pupils and the extraocular muscles were normal, however, horizontal nystagmus was noted in right and left gaze. He showed marked bilateral deafness, and loss of caloric response bilaterally. No muscle atrophy nor weakness was noted. His gait was wide-based and ataxic. Tandem gait was impossible. Romberg sign was present. No cerebellar ataxia was noted in the finger-to-nose or the heel-to-knee test. No adiadochokinesis was noted. Hyperextensibility was noted in the lower extremities. Deep reflexes were normal in the upper limbs, and diminished in the lower extremities. Sensation was intact. He showed the jumbling phenomenon, and the disturbance of the righting reflex in the tilt-table examination. Neuroradiological as well as laboratory studies were unremarkable except for the high titer of CEA in the CSF. Four months after his admission, malignant tumor cells were found in the CSF. It seemed likely that he had completely lost bilateral vestibular and auditory functions caused by meningeal carcinomatosis. His disturbance of gait and station was apparently similar to cerebellar ataxic gait, however, he did not have limb ataxia. The cranial CT scans failed to show cerebellar atrophy. It was our impression that his motor disturbance was in all likelihood caused by the bilateral loss of vestibular functions, i.e., vestibular ataxia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Vestibular ataxia caused by meningeal carcinomatosis]. 236 34

A new dosage form of cisplatinum (CDDP), lactic acid oligomer microspheres incorporating cisplatinum (CDDP-ms), is designed to slowly release 70% of contained CDDP. CDDP-ms's acute toxicity is as low as 57% of the toxicity of CDDP aqueous solution, and its therapeutic efficacy is statistically significantly strong as compared with that of CDDP aqueous solution, when examined with experimental peritoneal carcinomatosis induced by mouse M5076 ovarian sarcoma. Clinical trials were carried out in 10 patients with malignant ascites (gastric cancer 6, pseudomyxoma peritonei 2, colon cancer 1, pancreas cancer 1) and in one patient with pleural effusion (lung cancer). CDDP-ms at 100 mg/person in terms of CDDP was injected at bolus into the affected cavity. In the 10 patients with ascites, 7 responded completely, two partially and one did not respond. The patient with pleural effusion responded partially. The response rate was 91%. Five of the 11 patients complained of temporary nausea or vomiting. In 5 patients fever higher than 38 degrees C was seen. No other side effect such as kidney, nor liver-damage or blood cell count abnormality was noted.
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PMID:[Intracavitary microspheres incorporating cisplatinum in the treatment of malignant effusions--clinical trials]. 238 51

A new form of dosage (MMC-CH) was composed of activated carbon particles adsorbing mitomycin C. Intraperitoneal administration of MMC-CH was tested clinically for prophylactic and therapeutic effects on peritoneal carcinomatosis of gastric cancer. The criteria of MMC-CH's administration were equal or less than 70 years old, more than 40 kg in body weight, no disfunction of liver and kidney, no particular findings in electrocardiography, S2 or S3 in the grade of serosal invasion, P0, P1, P2 or P3 in the grade of peritoneal dissemination, according to the General Rules for the Gastric Cancer Study in Surgery and Pathology by the Japanese Research Society for Gastric Cancer. MMC-CH was given to 44 patients undergoing gastrectomy for gastric cancer in our department from 1985 to 1988. The 44 patients were composed of 12 patients with P0 findings (P0 patients), 8 patients with P1 findings (P1 patients), 12 patients with P2 findings (P2 patients), and 12 patients with P3 findings (P3 patients). MMC-CH at 50 mg/person in terms of mitomycin C was administered intraperitoneally before the operation wound was closed. Fifty-seven patients in our department from 1983 to 1987 for whom the same criteria were applicable and did not receive MMC-CH therapy, served as the control group. The 57 patients were composed of 23 P0 patients, 21 P1 patients, 10 P2 patients, and 3 P3 patients. There was statistically with chi 2 test no significant difference of age, sex, depth of infiltration macroscopically and microscopically defined progression of lymph-nodal metastases between the MMC-CH group and the control group. Survival rate was calculated with Kaplan-Meier's method in the overall patients in each of the MMC-CH group or the control group. The overall survival rate in the MMC-CH group was statistically significantly (p less than 0.01-0.05) higher from day 460 to day 552 and from day 736 to day 800 than that in the control group. Next, the patients were classified into two subgroups, namely the subgroup composed of P0 patients and the subgroup composed of P1, P2, and P3 patients, in order to examine each of the MMC-CH's prophylactic effects on subsequent dissemination or its therapeutic effects on established dissemination. Survival rate was calculated with Kaplan-Meier's method in the two subgroups through the same procedures used for the overall survival rate.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Intraoperative chemotherapy with intraperitoneal activated carbon particles adsorbing mitomycin C against peritoneal dissemination of gastric cancer]. 250 20

Two cases of meningeal carcinomatosis accompanying occult gastric cancer are presented. The symptomatology in meningeal carcinomatosis is characterized by rapidly progressive, multifocal CNS dysfunction but is otherwise nonspecific so that several differential diagnoses may be considered. Occurrence of carcinoma cells in the cerebrospinal fluid is diagnostic for meningeal carcinomatosis. Treatment is purely palliative.
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PMID:[Meningeal carcinomatosis in occult gastric cancer]. 280 7

Results of operation for obstructing carcinomatosis of gastrointestinal (GI), pancreatic, or biliary origin were reviewed to assess relief of symptoms, management of re-obstruction, and duration of hospitalization. A retrospective review (1977 to 1986) identified 89 patients, 59 (66%) of whom had tumors originating in the colon, and 19 (21%) in the stomach. Normal bowel function was restored for a median of 102 days in 66 patients (74%) and all but four (94%) were discharged. Forty-one (46%) patients remained unobstructed until death. Twenty-three (26%) were not relieved by operation and died a median of 33 days later (P less than .005). Forty-eight (81.4%) of the 59 colon cancer patients and ten (52.6%) of 19 with gastric cancer (P less than .05) were benefited by the operation, although comparison of duration of function was less striking (P less than .1). In-hospital mortality was 13% and complications occurred in 44%. Obstruction recurred in 38% of those relieved by the initial operation. Normal bowel function was restored in six (46%) of 13 patients undergoing a second laparotomy (median, 158 days) and in six of 13 (46%) treated with nasogastric suction. Obstruction recurred again in four of the latter six patients (median, 39 days). Hospitalization averaged 31 days (median, 25 days) for the first procedure and 41 days (median, 39 days) for patients operated for recurrent obstruction. These results justify laparotomy for intestinal obstruction in known or suspected carcinomatosis, particularly of colonic origin, if performance status is compatible with a reasonable quality of life.
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PMID:Results of surgery for obstructing carcinomatosis of gastrointestinal, pancreatic, or biliary origin. 291 33


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