Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1964 and 1981, seventy-two Japanese patients with gastric cancer associated with hepatic metastases, in whom the primary tumor had been resected, were treated in a nonrandomized manner at the Second Department of Surgery, Kyushu University Hospital. Fourteen received hepatic arterial infusion (HAI) of 5-FU and Mitomycin C (MMC) combined with systemic chemotherapy, 26 combination systemic chemotherapy of MMC, Futraful and PSK, 18 single drug (MMC) therapy, and 14 no chemotherapy. The average survival was 264 days in HAI combined with systemic chemotherapy, 208 in the combination systemic chemotherapy, 156 in the single drug therapy and 135 in those given no chemotherapy. One year survival and nine month survival rates were 21.4 per cent and 42.9 per cent in HAI combined with systemic chemotherapy, 11.5 per cent and 19.2 per cent in the combination systemic chemotherapy, 5.6 per cent and 11.1 per cent in the single drug therapy and 7.1 per cent and 14.3 per cent in the no chemotherapy group, respectively (HAI vs single drug therapy and no chemotherapy, p less than 0.01). Five of 14 patients treated with HAI combined with systemic chemotherapy showed a partial response (greater than 50 per cent reduction in tumor size), and the average survival time was 335 days, while that of nonresponders was 224 days. Six of 14 patients treated with combination infusion therapy with MMC and 5-FU survived 314 days, as compared to 201 days for patients with infusion of 5-FU alone.
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PMID:Combination of hepatic arterial infusion and systemic chemotherapy for gastric cancer with synchronous hepatic metastases. 642 97

In order to elucidate the clinico-pathologic features of gastric cancer invading to esophago-gastric junction and to discuss about rational surgical treatment, 111 cases during the 23-year period between 1957 to 1983 were selected. Of these patients, a total gastrectomy with lower esophagectomy or subtotal esophagectomy on 82 (74%), a cardiofundectomy on 26 (26%) and caudal hemipancreatectomy with splenectomy on 99 (89%) were carried out. It is severely impossible to eradicate primary tumor with an adequate margin of the esophagus and intrathoracic lymph nodes only by abdominal approach in resecting gastric carcinoma invading to esophago-gastric junction. Our experience emphasizes that a laparotomy with median sternotomy is ideal one, in addition, blunt dissection of the thoracic esophagus or right thoracotomy may be done if indicated.
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PMID:[Surgical treatment of carcinoma of the stomach invading to the esophago-gastric junction]. 647 8

The prognostic value of pretreatment information relating to prior treatment, demography, physical status, symptoms, disease involvement, pathologic, immunologic, and clinical chemistries were analyzed for a series of 322 patients with advanced gastric cancer. All patients received chemotherapy upon entry into Gastrointestinal Tumor Study Group protocols which were active between 1975 and 1978. Multivariate models were used to study relationships between prognostic factors and survival for all patients and objective tumor resonse for a subset of 137 patients with measurable disease. The initial performance status was a leading determinant of survival (P less than 0.0001). In addition, new summary measures relating to blood chemistries (P less than 0.01) and differential counts (P less than 0.001) were shown to influence patient survival. Blood chemistry parameters included SGOT, total serum protein, and total direct bilirubin while differential counts included absolute granulocytes, lymphocytes, and monocytes. Thus, the initial performance status, measurable disease status, blood chemistries, and differential counts are recommended as stratification factors in the design and analysis of trials involving patients with advanced gastric cancer. The initial performance status was examined in relation to other pretreatment data. The performance status at study entry correlated independently with the degree of weight loss (P less than 0.001), blood chemistries (P less than 0.01), differential counts (P less than 0.05), and peritoneal metastases (P less than 0.05). The measurable and nonmeasurable subgroups were compared with respect to baseline characteristics. Patients with measurable disease had more liver metastases (56 versus 35%) and less peritoneal metastases (76 versus 49%) than patients with nonmeasurable disease. Controlling for the imbalance in liver and peritoneal metastases, the presence of measurable disease was less favorable than nonmeasurable disease with respect to survival. Regarding the pathways of disease spread, there was a strong correlation (P less than 0.001) between primary tumor site within the stomach and location of metastases. Diffuse lesions were associated with the lowest frequency (25%) of liver metastases. Diffuse lesions (58%) and tumors of the pyloris (54%) were associated with the highest percentage of peritoneal metastases. Tumors of the cardia or fundus were more likely to metastasize to the liver while diffuse tumors were more likely to spread to the peritoneum. Pretreatment factors under study did not appear to be the dominant factors responsible for prolongation of survival in patients with an objective tumor response. Pretreatment factors predicted a three week advantage; however, a 22 week advantage was observed for responders over nonresponders.
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PMID:Studies in prognostic factors relating to chemotherapy for advanced gastric cancer. 675 15

Gastric cancer is the most chemotherapy-responsive adenocarcinoma of the major gastrointestinal sites. For patients with advanced disease, the response rates and survival achieved with recently designed Adriamycin-based regimens represent an improvement over the past use of 5-fluourouracil alone or combined with a chloroethylnitrosourea. Effective palliative treatment can be administered in an out-patient setting without the necessity of producing severe or life-threatening toxicity. Nevertheless, response durations are finite, as is patient survival. It is essential that Phase II trials of new drugs be continued in an attempt to identify agents with greater therapeutic activity for this disease. For the locally unresectable stage, combined modality therapy incorporating palliative resection of the primary tumor, regional radiation therapy and chemotherapy, has provided long-term disease-free survival for 15--25% of all patients. The most promising aspect of current clinical investigation is the application of the Adriamycin-based drug combinations in controlled trials of surgical adjuvant therapy.
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PMID:Current management of advanced and locally unresectable gastric carcinoma. 675 66

The present state and a future of neoadjuvant chemotherapy (NAC) was reviewed. Gastric cancer is classified as a cancer which is resistant against anti-cancer drugs. Consequently, surgery is the only method that offers hope of cure. Candidates for NAC are patients with stage IV disease, especially with T4 disease having no distant metastases. NAC is carried out for an increase of the resectability rate and the judgement of the in vivo chemosensitivity. Regimens with high fractional kill should be used, and and the tumor burden must be periodically estimated by CT scan, endoscopy and the serum levels of tumor markers. If the used regimen showed no response, a new protocol should be tried. Since a histological CR is very rare, not only primary tumor but metastases should be resected as much as possible. A completeness of the cytoreduction is a major factor for a long term survival. Surgery is carried out for the elimination of the drug-resistant cancer cells. Furthermore, early postoperative chemotherapy is very important for the improvement of survival after NAC.
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PMID:[Presence and future in neoadjuvant chemotherapy against gastric cancer]. 748 18

The prerequisite for a curative resection of metastases is their restriction to the key organs, the liver and lungs, in the sense of a limited dissemination. For long-term prognosis, the type of primary tumor as well as the radical resection of lung and liver metastases is essential. To improve the process of surgical indication and therapy of tumors, clear definitions for the terms "tumor recurrence" and "metastases" have been agreed upon. Research and clinical investigation have led to a better understanding of tumor-regulating factors, some of which are briefly described: Metastasis promoting factors include the lack of E-cadherin, which leads to a local penetration of basal membranes by tumor cells; CD44 seems to play an important role in cell-cell and cell-matrix interactions, apparently increasing the metastatic potential of tumors and reducing the long-term survival of patients. High levels of urokinase in primary tumors are also associated with a poorer prognosis, as well as plasminogen inactivator inhibitor PAI II, which plays a crucial role in tumor growth. Positive findings in bone marrow aspirates of patients with different malignancies, stained for cytokeratin 18, either are associated with higher recurrence rates in colon and breast cancer or can be correlated to the prognosis of patients with gastric cancer. Technical aspects of surgery for hepatic, pulmonary and skeletal metastases are presented and discussed with respect to curative and palliative indications.
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PMID:Surgical treatment of tumor metastases: general considerations and results. 753 64

Thirty-six patients with nonmucinous adenocarcinoma of the stomach, candidates for surgical laparotomy, were studied to evaluate the presence and extent of coagulation disorders in gastric cancer. They were staged according to TNM cancer staging (T: extent of primary tumor; N: lymph node involvement; M: presence of metastases), and a blood sample was collected before surgery. Platelets, platelet factor four (PF4), beta-thromboglobulin (BTG), activated partial thromboplastine time (APTT), prothrombin time (PT), factors five (V) and seven (VII), fibrinogen, cross-linked fibrin degradation products (XDP), fibrinopeptide-A (Fp-A), and antithrombin three (AT III) were assayed. Only fibrinogen, Fp-A, PF4, and factors V and VII were increased in more than 50% of patients. Fibrinogen and Fp-A were positively correlated with T(r = 0.29, p < p < 0.05; and r = 0.35, p < 0.05; respectively), whereas the other parameters did not show any statistically significant relationship with T, N, and M. Considering the subgroups including only the patients with pathological values, Fp-A (31 patients) was positively correlated with N (r = 0.4, p < 0.05), PF4 (25 patients) showed a positive correlation with T and N (r = 0.42, p < 0.05; r = 0.46, p < 0.05; respectively), and a significantly higher median in the presence than in the absence of metastases (median in the M+ subgroup: 42.7 ng/ml, range 38.6 to 102.8; median in the M- subgroup: 33.7, range 20.3 to 85; p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Usefulness of coagulation markers in staging of gastric cancer. 755 75

Through a period of 16 years, 108 cases of early gastric cancer (EGC) were diagnosed at Hospital Mexico, a leading teaching hospital of Costa Rica's social security system and the University of Costa Rica. It was found that in four cases, the gastric neoplasia was a second primary tumor, and in the two remaining cases, the EGC developed synchronously to another neoplasm. Two of the four metachronic EGC were preceded by a uterine cervix neoplasm on stage lla; the third one was preceded by a breast adenocarcinoma, and the fourth one by a larynx cancer in a heavy male smoker. The treatment received for the first cancer was radiation therapy only, except for the breast cancer patient in whom surgery was employed as well. One of the patients with uterine cervix cancer developed an epidermoid bronchogenic cancer 17 years after the first tumor and 8 years after her EGC. In the two male patients with synchro tumors, the EGC developed together with a squasmous cell carcinoma of esophagus, and in the remaining one the EGC appeared simultaneously with a peritoneal mesothelioma. It is important to emphasize the presence of radiation therapy in the metachronous tumors, as well as the antecedent of smoking in the patient with three primary cancers, the esophagus one, and the larynx cancer patient.
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PMID:[Early gastric cancer as a metachronic or synchronic tumor. Report of 6 cases]. 756 50

A liposome-entrapped liposome form of Adriamycin (Lip-ADM) has been demonstrated to cause less myocardial and gastrointestinal toxicity than free ADM. In the present study, Lip-ADM prepared by the remote loading method was administered to 3 patients with metastatic adenocarcinoma of the liver via a reservoir with the catheter located in the proper hepatic artery. The primary tumor was gastric cancer in 2 patients and sigmoid colon cancer in 1. Lip-ADM was administered at doses of 10, 20 or 50 mg per time. The total ADM dose was 170, 490, and 760 mg, respectively. No severe adverse effects, such as nausea, vomiting, stomatitis, alopecia or cardiotoxicity, were observed in any of the patients. Although mild leukocytopenia (2,800/microliters) was observed in 1 patient, anemia or thrombocytopenia did not occur. The survival time was respectively 6, 15, and 17 months from the start of Lip-ADM administration. A partial response was obtained in 1 patient and stable disease in 1 patient. Administration of Lip-ADM via a reservoir appears to be a useful treatment for patients with metastatic adenocarcinoma of the liver, since the low toxicity of this preparation allows an increase of the total dose of ADM.
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PMID:Intra-arterial liposomal adriamycin for metastatic adenocarcinoma of the liver. 758 1

This study analyzed intraoperative indication for splenectomy at the time of total gastrectomy, based on 249 gastric cancer patients. Data on these patients were studied with special reference to the relationship between intraoperative gross findings such as serosal invasion, tumor size, histologic patterns and nodal metastasis to the splenic hilus. Fifty-three of the 249 patients (21.3%) had a positive metastasis. The incidence of nodal metastasis to the splenic hilus was high in patients with a primary lesion in the entire stomach (26/72: 36.1%). In case of no serosal invasion of the primary lesion, there was no nodal involvement to the splenic hilus (0/42). The low incidence of nodal metastasis occurred in case of a tumor size of less than 40 mm in the largest diameter (1/60: 1.7%) and with histological findings of signet ring cell carcinoma (1/19: 5.3%). Although site and size of the primary tumor, depth of tumor penetration, and histologic findings are interdependent variables, these factors indicate probable nodal involvement to the splenic hilus and unnecessary splenectomy can be avoided.
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PMID:Indication for splenectomy combined with total gastrectomy for gastric cancer: analysis of data on 249 gastric cancer patients. 759 May 70


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