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

We report a case of advanced gastric cancer complicated by disseminated intravascular coagulation successfully treated with chemotherapy consisting of 5-fluorouracil and cisplatin. The patient was a 53-year-old woman who complained of loss of appetite, weight loss, and low back pain. Based on the laboratory data, a diagnosis of disseminated intravascular coagulation was made. Gastroscopy revealed gastric carcinoma (Borrmann type 3) that was continuously bleeding, and chest computed tomography showed a solitary lung metastasis and bilateral pleural effusion. Bone scintigraphy revealed multiple bone metastases. Accordingly, we made a diagnosis of stage IV gastric cancer complicated by disseminated intravascular coagulation. We selected the 5-fluorouracil and cisplatin combination chemotherapy for treatment and obtained the patient's consent. After two cycles of the 5-fluorouracil and cisplatin therapy, the bleeding symptoms improved and the disseminated intravascular coagulation process was successfully controlled. We concluded that disseminated intravascular coagulation caused by gastric cancer may be improved when the primary cancer and its metastases are brought under control by treatment with FP combination chemotherapy.
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PMID:Advanced gastric cancer associated with DIC successfully treated with 5-FU and cisplatin: a case report. 1194 41

BACKGROUND: Some patients with stage IV gastric cancer have a long survival. Host immune response and proteolytic activity in the primary tumor may be associated with outcome in these patients. The purpose of this study was to assess prognostic factors in patients with stage IV far advanced gastric cancer.METHODS: Findings in 26 patients who underwent resection of stage IV gastric cancer were retrospectively analyzed for clinicopathological variables, and for the immunohistochemical expression of human leukocyte antigen (HLA)-DR as an index of host immune response and for expression of urokinase type-plasminogen activator (u-PA) as an index of proteolytic activity in the tumor.RESULTS: Of the 13 clinicopathological and immunohistochemical variables tested by univariate analysis surgical curability, lymph node metastasis, HLA-DR expression, and u-PA expression had a significant influence on survival after surgery. Multivariate analysis showed that surgical curability, HLA-DR expression, and u-PA expression independently influenced survival. Patients positive for HLA-DR expression [HLA-DR (+)] and regative for u-PA expression [u-PA (-)] had the best survival: 25-month median survival and 25% 5-year survival rate. Patients who were HLA-DR (+) and u-PA (+), or HLA-DR (-) and u-PA (-) had a median survival of 10 months, a 1-year survival rate of 46.2%, and a 2-year survival rate of 7.7%. HLA-DR (-) and u-PA (+) patients had the worst survival: 4.5-month median survival and 0% 1-year survival.CONCLUSIONS: These findings suggest that host immune response and proteolytic activity in the primary tumor may determine malignant potential, and that the combination of positive-HLA-DR and negative-u-PA expression in cancer cells may be a predictor of prolonged survival in stage IV gastric cancer patients.
Gastric Cancer 1998 Dec
PMID:Expression of HLA-DR and urokinase-type plasminogen activator in stage IV gastric cancer. 1195 46

BACKGROUND: The prognosis of stage IV gastric cancer is poor with the 5-year survival rate still being about 10%.METHODS: We classified 130 patients with stage IV gastric cancer into four groups: peritoneal metastasis, liver metastasis, lymph node metastasis, and multiple factor groups, according to the factors that determined stage IV in each patient and compared survival in the four groups. We also performed univariate and multivariate analyses of various prognostic clinicopathological factors. The 5-year survival rate in the patients with stage IV gastric cancer was 7.4%.RESULTS: No significant differences were observed in survival among the four groups. Univariate analysis showed significant differences in survival among the categories of lymphatic invasion ( P = 0.0045), venous invasion ( P = 0.0024), peritoneal metastasis ( P = 0.0019), postoperative chemotherapy ( P = 0.0385), curability ( P = 0.0001), and lymph node dissection ( P = 0.0001). In the curability B group, survival was prolonged in the postoperative chemotherapy group. Multivariate analysis revealed the highest relative hazard (RH) for lymph node dissection (RH, 2.261), followed, in descending order, by curability (RH, 1.905), peritoneal metastasis (RH, 1.896), lymphatic invasion (RH, 1.736), and venous invasion (RH, 1.481).CONCLUSION: As prognostic factors in stage IV gastric cancer, the tumor factors of peritoneal metastasis and vessel invasion, and the treatment factors of curability and lymph node dissection may be important, and active treatment appears to improve survival.
Gastric Cancer 2000 Sep 29
PMID:Prognostic factors in stage IV gastric cancer: univariate and multivariate analyses. 1198 14

Recently, with the improvement of the prognosis of esophageal cancer, subsequent gastric cancer has increased. However, the standard surgical treatment for such patients has not been established as of yet. Since the patient's physical condition is relatively poor after Ivor-Lewis esophagectomy, it is important that surgical strategies must be decided according to both physical and cancerous conditions. Hence, various surgical procedures have been reported to date. The authors experienced two cases with cancer occurring in the reconstructed gastric tube after Ivor-Lewis esophagectomy. One was subsequent primary gastric cancer, and the other was metastatic gastric cancer. Distal resection of the gastric tube including the dissection of the right gastroepiploic vessels was carried out in both cases. Vascular reconstruction by utilizing microsurgery technique was attempted for each case, but failed in one case. After surgery, four sessions of endoscopic examinations were carried out. In the early period, we could identify mucosal ischemic change in the remnant gastric tube in the case without successful vascular reconstruction. On the contrary, no ischemic change was revealed in the other with successful vascular reconstruction. Hence, we came to the conclusion that vascular reconstruction must be added to the cases, which undergo distal resection of the reconstructed gastric tube with regional vascular dissection.
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PMID:Endoscopic comparison of two cases: distal resection of reconstructed gastric tube. 1850 65

A phase II trial was performed to determine the antitumour efficacy and tolerance of combined paclitaxel and cisplatin with or without hematopoetic growth factor support in patients with advanced gastric cancer. Forty-five patients with histologically confirmed metastatic gastric cancer were entered in this trial. Treatment consisted of 2-weekly courses of paclitaxel 160 mg per m2 and cisplatin 60 mg per m2 both given on day 1. Depending on absolute neutrophil counts on the days of scheduled chemotherapeutic drug administration (1000-2000 per microl), a 5-day course of human granulocyte colony-stimulating factor 5 microg x kg(-1) per day was given subcutaneously; in addition, if haemoglobin was <12.0 mg dl(-1), erythropoietin 10 000 IU was administered subcutaneously three times per week. The confirmed overall response rate (intent-to-treat) was 44%, including five complete (11%) and 15 partial remissions (33%). Twelve patients had stable disease (27%), 11 (24%) progressed while on chemotherapy, and two patients were not evaluable. The median time to response was 3 months, the median time to progression 7.0 months, and the median survival time was 11.2 months with 12 patients currently alive. Haematologic toxicity was common, though WHO grade 4 neutropenia occurred in only five patients (11%). Apart from total alopecia in 16 patients (36%), severe non-haematologic adverse reactions included grade 3 peripheral neuropathy in six (13%) and anaphylaxis in two patients. In addition, there was one patient each who experienced grade 3 emesis, diarrhea, and infection, respectively. Our data suggest that the combination of paclitaxel and cisplatin with or without G-CSF and/or erythropoietin has promising therapeutic activity in patients with advanced gastric cancer.
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PMID:Effective combination chemotherapy with paclitaxel and cisplatin with or without human granulocyte colony-stimulating factor and/or erythropoietin in patients with advanced gastric cancer. 1208 76

The appearence of distant metastases or local recurrence is assumed to render gastric cancer incurable. However, experience with colorectal cancer has shown that patients with recurrent disease may have a chance for cure, if recurrent or metastatic disease can be completely resected. Since improved imaging allows detection of ever smaller tumour deposits, we have reviewed the pertinent literature to determine the current surgical options for recurrent or metastatic gastric cancer. Metastatic disease or local recurrence is rarely resectable. Tumour recurrence in the remnant stomach after partial gastrectomy can be treated by secondary total gastrectomy and may occasionally result in long-term survival. Other types of local recurrence are generally not amenable to complete resection. The same is true for distant metastases. If, however, distant metasases are technically resectable, 5 year survival of approximately 20% has been documented. Solitary and late appearing metachronous tumours are associated with an improved prognosis. As a consequence resection of distant metastases should be considered, because the risk of metastasectomy is generally low and there is no alternative treatment with a chance for cure.
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PMID:Surgical therapy for loco-regional recurrence and distant metastasis of gastric cancer. 1258 80

To identify genes whose alterations lead to gastric cancer, gene expression profiles have been obtained from 22 gastric cancer tissues and their surrounding gastric mucosa tissues. A total of 16 genes were differentially expressed in more than 50% of gastric cancer tissues compared with surrounding gastric mucosa tissues. Genes such as HMG-Y, fibroblast collagenase inhibitor, and osteopontin are among those that are overexpressed in over 50% of the gastric cancer tissues. Dihydrodiol dehydrogenase, ribonuclease A, and glutathione peroxidase are among those genes that are underexpressed in over 50% of the gastric cancer tissues. We identified genes that are associated with clinical phenotypes of patients with gastric cancers. Alpha-II spectrin, Na/K-ATPase and KIAA0111 are those that are enhanced in intestinal type of gastric cancer. Gene such as platelet-endothelial tetraspan antigen 3 was enhanced in highly metastatic gastric cancer tissues.
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PMID:Identification of genes differentially expressed between gastric cancers and normal gastric mucosa with cDNA microarrays. 1212 92

This review focused on the clinical trials in patients with gastric cancer in Japan. Oral fluoropyrimidines have been extensively used in Japan. Through the decades, these oral fluoropyrimidines have been examined in a variety of combinations. Most of the reports are about randomized phase II trials using overall response rate as a primary endpoint, and are a few phase III trials were conducted. S-1 (TS-1), a novel oral fluoropyrimidine, has demonstrated promising activity in phase II trials. Ongoing phase III trials on S-1 would be defining this as standard chemotherapy for metastatic gastric cancer.
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PMID:[Chemotherapy of gastric cancer--a review of clinical trials in Japan]. 1235 38

A forty-year-old female consulted a hospital complaining of epigastralgia. She underwent endoscopy, which showed irregular shaped ulceration with fold convergence; the biopsy specimen revealed poorly differentiated adenocarcinoma. She underwent subtotal gastrectomy and lymph node dissection. Histological findings revealed the signet-ring-cell cancer confined to the mucosa and no lymph node metastasis. The serum carcinoembryonic antigen was elevated 2 years and 11 months after operation. Bone scintigraphy demonstrated multiple accumulation and bone biopsy of the sacrum revealed the metastatic gastric cancer. She underwent chemotherapy and radiation, however, later complained of nausea, vomiting, and diminished visual acuity. Brain computed tomography revealed multiple brain metastasis. She died 3 years and 6 months after her operation. We reviewed the 39 reported cases of early gastric cancer with bone metastasis in Japan, which suggests that signet-ring-cell carcinoma and poorly differentiated carcinoma have a possibility of bone metastasis even though the early gastric cancer is confined to the mucosa.
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PMID:Early gastric cancer giving rise to bone and brain metastases--a review of the Japanese literature. 1239 85

We report a case of effective weekly paclitaxel (TXL) administration for metastatic gastric cancer. TXL (80 mg/m2) was infused over 1 hour after short premedication on an outpatient basis. Administration was continued for 3 weeks followed by 1 week rest. A 74-year-old man was diagnosed with recurrence 49 months after surgery for gastric cancer. He was treated with 5-fluorouracil and cisplatin, and thrombocytopenia (grade 3) and creatinin elevation (grade 1) were observed and assessed as progressive disease 2 months after the treatment. We attempted weekly TXL administration and after 5 courses assessed the patient as having a partial response. The treatment is ongoing. The toxic event was leukopenia (grade 2), with no episode of thrombocytopenia. The patient did not complain of nausea or vomiting, and his quality of life was fair during the treatment. Weekly TXL administration is a useful treatment for metastatic gastric cancer.
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PMID:[A case of effective weekly paclitaxel administration for metastatic gastric cancer]. 1246 5


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