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

Adenocarcinoma of the stomach remains a significant cause of mortality worldwide. The majority of patients present with stage III or IV disease, negating surgery as a curative option. Numerous drugs have been tested over the past 2 decades in single-agent and combination chemotherapy trials. Given by intravenous bolus, mitomycin has induced responses as high as 63% and as low as 24% in patients with various gastrointestinal malignancies. Mitomycin has also demonstrated efficacy when given in combination with doxorubicin and in the three-drug regimen FAM (5-fluorouracil/doxorubicin/mitomycin). FAM has been explored in multiple phase II and III trials and has become the standard with which many new combinations are compared. Compared with other doxorubicin-containing regimens, it has demonstrated the longest median survival (29.5 weeks) and the lowest incidence of severe toxicity. The addition of semustine or leucovorin to FAM has yielded responses comparable with those attained by FAM alone. In Japan, where treatment of gastric cancer has been more successful, possibly due to earlier diagnosis and more aggressive surgical approaches, mitomycin has been given intraperitoneally during surgery and postoperatively in combination with fluorinated pyrimidines or other agents. Mitomycin will undoubtedly play a role in the development of new approaches to the treatment of gastric cancer.
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PMID:Mitomycin therapy in gastric cancer. 848 60

Adenocarcinoma of the small intestine is uncommon. Due to this paucity and the lack of specificity of symptoms, patients are usually seen late in the course of their illness, when curative therapy, mainly represented by extensive surgical resection, is unlikely. The authors report a case of primary well-differentiated tubular adenocarcinoma (T4N0M0) arising in the duodenal limb of a reconstructed Billroth I gastroduodenostomy, 9 years after a distal gastrectomy for signet-ring cell carcinoma of the stomach (T4N0M0). Evidence for excluding the possibility of a recurrence of the primary gastric cancer was based on the different histologic pattern, the long disease-free interval, and other features of the second neoplasm. Relatively early diagnosis of the neoplasm, followed by curative surgical therapy was made possible by the early onset of the obstructive symptoms and the favorable anatomical location of the tumor.
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PMID:Primary tubular adenocarcinoma arising in the duodenal limb of reconstructed gastroduodenostomy for signet-ring cell carcinoma of the stomach. 857 40

Adenocarcinoma of the stomach distal to the cardia remains one of the most common cancers in the world. The interest in the aetiology of this disease has been rekindled because of recent epidemiological and molecular studies linking this cancer to H. pylori and certain dietary factors. The authors provide an updated review of the aetiology of gastric cancer. This review seeks to summarize the disease, to propose pathways of carcinogenesis and to suggest ways in which the "traditional" risk factors may be interpreted on the basis of evolving knowledge.
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PMID:Gastric cancer distal to the cardia--prevention or cure? 943 57

To determine the current status in various aspects of gastric cancer in Thai patients, we retrospectively reviewed the records of 119 patients with histologically proven gastric cancer in King Chulalongkorn Memorial Hospital during the five-year period from 1994 to 1998. There were 72 males (60.5%) and 47 females (39.5%) with ages ranging from 22 to 91 years (mean age 60.2+/-15.1 years). Among these, 20 patients (16.8%) were younger than 40 years. The duration of symptoms prior to first presentation averaged 20 weeks and dyspepsia and weight loss were the most common complaints. Lesion location was lower third in 40.3 per cent, middle third in 31.9 per cent, upper third in 15.1 per cent and entire stomach in 3.4 per cent of patients. Adenocarcinoma was the most common histological finding (91.6%), followed by lymphoma and leiomyosarcoma (3.4% each). Helicobacter pylori infection was detected in 17 of 25 (68%). The TMN staging was as follows: stage II, 5.9 per cent; stage III, 9.2 per cent; and stage IV, 68.9 per cent. (the stage was unknown in 16%). The overall 1-year, 2-year and 5-year survival rates were 51.6 per cent, 17.5 per cent and 4.4 per cent, respectively. Management was surgical treatment in 58.9 per cent (total gastrectomy 14.5%, subtotal gastrectomy 33.3% and palliative bypass surgery in 11.1%). Systemic chemotherapy was the primary modality of therapy in 16.8 per cent and was adjuvant therapy in 18.5 per cent. The median survival time of resectable cases was 1.00+/-0.53 years, significantly longer than that of unresectable cases (0.11+/-0.03 years) (p=0.0025). However, the administration of chemotherapy did not improve the survival rate. It is concluded that, in Thailand, gastric cancer continues to be an important health problem and is generally associated with a poor prognosis.
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PMID:Current status of gastric cancer in Thai patients. 1146 Sep 56

BACKGROUND: Adenocarcinoma of the esophagus and cardia is a challenging disease for the surgeon. Delay in diagnosis, nodal involvement, and incompleteness of resection have an adverse effect on long-term prognosis. Efforts are currently oriented to identify patients who may benefit from extensive resection.METHODS: Between November 1992 and May 1998, 218 patients with histologically proven adenocarcinoma of the distal esophagus or cardia were referred to our Department. In 6 patients (10.2%) cancer was discovered during endoscopic surveillance for Barrett's metaplasia. Overall, 147 patients (67%) underwent resection. An Ivor-Lewis approach was used in 121 patients; of these, 51 underwent an extended mediastinal lymph node dissection.RESULTS: Median cumulative survival was 25.9 +/- 3.1 months in patients undergoing resection, and 7 +/- 1.3 months in patients having palliation ( P < 0.01). Survival was significantly higher in patients with negative nodes than in those with lymph node metastases (54 +/- 12.9 versus 17 +/- 2.8 months; P < 0.01). Six of the 51 patients (11.8%) undergoing extended lym-phadenectomy had metastatic upper mediastinal nodes. Additional serial sections and immunohistochemistry were performed in 46 patients. In 6 of 18 patients (33.3%) with negative nodes at conventional hematoxylin-eosin examination, immunohistochemistry demonstrated micrometastases in the lesser curvature, paracardial, peripancreatic, or lower mediastinal nodes. Three of these patients had recurrent disease within the first year of follow-up.CONCLUSIONS: Early diagnosis remains the prerequisite for curative treatment of adenocarcinoma of the esophagus and cardia. Endoscopic surveillance appears to be warranted in patients with Barrett's metaplasia. When a curative resection is attempted, extended lymphadenectomy improves tumor staging and may prevent local recurrences. Serial sections and immunohistochemistry provide additional accuracy in the staging of the disease and may prove useful to select patients for adjuvant therapy.
Gastric Cancer 1999 Aug
PMID:Results of surgical therapy in patients with adenocarcinoma of the esophagus and cardia. 1195 79

Peritoneal carcinosis often occurs during the evolution of many neoplasias either abdominal or extra-abdominal. The free time survival of the patients affected by carcinosis is poor (about 6 months) as regards gastric and colorectal cancer. In the last ten-year period a combined surgical technique aiming at the total removal of parietal and visceral peritoneal lesions (peritonectomy) and at the perfusion of peritoneal cavity with chemo-drugs in hyper-thermia had developed. This method is based on the presence of the peritoneal-plasmatic barrier that holds back high molecular weight drugs, keeping from passing at the systemic circulation; in this way it is possible to use higher and more concentrate chemo-drug doses in a very limited area than in the systemic chemotherapy. The association between chemotherapy and hyperthermia produces a synergic effect: hyperthermia, infarct, makes chemo-drugs more effective and selective, improving their capability of penetration in tumoral masses; heat has furthermore an intrinsic anti-neoplastic action, being altered the reparation mechanisms of the tumoral cells. A WEB research on Medline site has been conducted choosing especially those articles referable at the 1999-2000 period. The selected articles have been briefly analysed in the "Clinical experience" section. Authors' experiences have been divided, as far as possible, on the basis of the tumors treatable with cytoreduction and HAPP: 1) Colon-rectal Cancer; 2) Pseudomyxoma peritonei/Appendicular Adenocarcinoma; 3) Gastric Cancer; 4) Ovarian Cancer; 5) Peritoneal Mesothelioma. The determinant variables in the analysis of the results are basically three: 1) Selection of the patients, 2) Characteristics of the surgical operation, 3) Characteristics of the HAPP. Colon-rectal carcinoma: the survival time of the recurrent disease, obtained by some authors like P.H. Sugarbaker, is surely remarkable (50% at 5 years in the patients where a complete cytoreduction was possible to perform), but the result obtained in patients affected by peritoneal carcinosis, subjected to this technique at the first clinical presentation (100% at 5 years) is much more interesting. For this type of neoplasia, it is important to underline that not all the authors report the same results, with a median survival time lower than that of the American author. Pseudomyxoma peritonei: about this rare neoplasia, the "golden standard" treatment consists on cytoreduction of all visceral and peritoneal macroscopical lesions, with a homogeneous distribution of the data obtained by most authors: median survival time included among 70% and 90% at 5 years. Gastric cancer: there is a considerable difference between the data of Japanese authors and others. In the treatment of peritoneal carcinosis the results are, on average, rather poor; better results have been obtained using this technique as an adjuvant presidium for the prevention of the onset of peritoneal carcinosis. Ovarian cancer: the results about the recurrent ovarian cancer are good; in the future, it will be useful to start a phase III study to render effective the use of this technique in the ovarian cancer at the beginning of its clinical story. Peritoneal mesothelioma: till now, a standardized alternative, approaching this neoplasia, does not exist; the results are encouraging, with good median and free time survival.
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PMID:[Cytoreductive surgery and intraperitoneal hyperthermic-antiblastic therapy (HAPP) in peritoneal carcinomatosis]. 1237 Jun 61

The endoscopic examination of a 66-year-old male patient revealed a protruding lesion close to a reddish IIc area in the antrum of the stomach. The protruding lesion and reddish area were resected completely with endoscopic mucosal resection using an insulation-tip diathermic knife (IT-EMR). Histological examination of the protruding lesion revealed proliferation of fibroblasts and infiltration of inflammatory cells, and it was diagnosed as an inflammatory fibroid polyp (IFP). Adenocarcinoma in the IIc area was present adjacent to the IFP. This may be the first report of gastric cancer concomitant with gastric IFP treated by endoscopic mucosal resection.
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PMID:Gastric cancer concomitant with inflammatory fibroid polyp treated with endoscopic mucosal resection using an insulation-tip diathermic knife. 1270 91

Adenocarcinoma of the stomach is advanced enough in some patients to preclude curative treatment, but many gastric cancer patients have what appears to be localized disease that is amenable to surgical resection, which is the only truly effective treatment. Long-term results of what appear to be "curative resections" are relatively poor, however, and new management tools such as sentinel lymph node biopsy, recently promising adjunctive therapies (such as radiochemotherapy), and the organization of the order of treatment combinations do require further study with an eye to improving outcomes. However, there appears to be little hope for a dramatic improvement in treatment results from these innovations for patients with established gastric cancer. Fortunately, gastric cancer in the United States has gone from being the number one cause of cancer death in our population 50 years ago to that of being the number eight cause of cancer death at this time. This intriguing major decrease in the incidence of this disease must be considered secondary to one or more changes in our own environment that we hope will be exploitable in the future. As with cancers of all types and in all sites, a prevention strategy may prove more effective than the treatment strategies that are outlined here. The management strategies outlined are hopefully only temporary ones until we are able to develop a better handle on primary prevention.
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PMID:Gastric Adenocarcinoma. 1501 29

Adenocarcinoma of the stomach represents upwards of 95% of all gastric malignancy. Calcifications in untreated gastric cancer are rare, but typically represent mucin-producing tumor. We report the radiology and pathology of a patient who presented with gastric wall calcifications on CT and a mucin-producing adenocarcinoma at pathologic examination of a gastric biopsy specimen.
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PMID:Radiology-Pathology Conference: Calcified untreated gastric cancer. 1553 Nov 42

An excessive duodenal reflux induced by surgery has been widely accepted to cause gastric carcinogenesis in the remnant stomach. As one of causative factors for malignancy, N-nitroso compounds produced by enteric bacteria have been postulated. However, there is no concrete information to prove this hypothesis. This study was undertaken to elucidate the factors underlying the remnant stomach carcinogenesis, by giving thiazolidine-4-carboxylic acid (thioproline; TPRO) to the rats with duodenal reflux as a nitrite scavenger. Operated 39 animals were used, divided into 2 groups; one with a diet containing 0.5% TPRO (n=18), and the other with a diet without TPRO (n=21). Adenocarcinoma developed in 16 rats out of 21 (76.2%) of untreated rats, whereas adenocarcinoma was detected in 1 rat of the TPRO-treated rats (5.6%). TPRO thus prevented the development of gastric cancer in the remnant stomach, thereby suggesting a concern of nitroso compounds to the carcinogenesis.
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PMID:Thioproline prevents carcinogenesis in the remnant stomach induced by duodenal reflux. 1605 25


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