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

Although the standard operation for early cancer of gastric cardia is proximal gastrectomy followed by jejunal interposition, we recently reported a simple and useful technique for proximal gastrectomy with gastric tube reconstruction. The operative procedures included resection of the proximal two-thirds of the stomach, followed by anastomosis between the esophagus and gastric tube, using a circular stapler (Proximate ILS 25; Ethicon, Cincinnati, OH, USA). The gastric tube was about 20 cm long and 4 cm wide. The patient a 76-year-old man had no reflux symptoms such as heartburn, retrosternal pain, and regurgitation. Endoscopy showed no evidence of reflux esophagitis, including mucosal redness, erosion, and ulceration. Ambulatory 24-h pH monitoring indicated that the pH of the lower esophagus was between 6 and 8 when the patient was upright and between 5 and 7 when he was in the supine position. There were nine reflux episodes during the day, and no reflux episode while he was asleep. The duration of each reflux episode was less than 1 min, and the total reflux time was 1 min in the 12-h day (0.1%). These data indicate that reconstruction by gastric tube may prevent esophageal reflux in patients who have undergone proximal gastrectomy for early cancer of the gastric cardia.
Gastric Cancer 1998 Dec
PMID:Long-term survival after perforation of advanced gastric cancer: Case report and review of the literature. 1195 48

Skeletal muscle is an uncommon site of hematogenous metastasis of gastric carcinoma. We report here a rare case of gastric carcinoma with multiple intramuscular metastases. Our patient had advanced gastric carcinoma and complained of left gluteal induration with tenderness. Because magnetic resonance imaging (MRI) revealed that the gluteal tumor showed iso-signal intensity on T1-weighted images and high signal intensity on T2-weighted images, with reticulated texture around the tumor, and the patient had advanced gastric carcinoma, we speculated that the tumor was an intramuscular metastatic tumor from primary gastric carcinoma. There were also multiple intramuscular metastatic lesions in both gluteal muscles on the MRI findings that were not detected by physical examination. Therefore, the patient underwent total gastrectomy with combined resection of spleen, with subsequent chemotherapy. Three months after the operation, we excised the gluteal tumor to alleviate the gluteal pain. Histological examinations confirmed that the gluteal tumor was a metastasis from primary gastric carcinoma.
Gastric Cancer 2002
PMID:Intramuscular metastasis from gastric cancer. 1211 87

This is a 12-year follow-up study on screening with a mixture of 2% hydrochloric acid and 18% alcohol for upper digestive tract cancer in a Chinese high-risk population. A public screening for upper digestive tract cancer was conducted from November 1979 to May 1984 by giving a mixture of 2% hydrochloric acid and 18% alcohol to 7280 subjects in high-risk population in Yaocun village, Linxian County, Henan province. The subjects were given 15 ml of this mixture in the morning or at noon before lunch when fasting. Five minutes later, irritative reactions (retrosternal discomfort, warmth, pain or pyrosis) was felt in subjects suffering from oesophageal cancer, oesophagitis, gastritis, mucosal dysplasia or ulcer (positive group). Those with normal oesophageal or gastric mucosa felt nothing (negative group). The overall positive rate was 23.2% (1689/7280). In oesophageal or gastric cancer subjects, the positive rate of these symptoms was 88.7%. In subjects with mucosal dysplasia, it was 71.2%. A total of 26 upper digestive tract cancer patients were found. As a result of 12 years' follow-up, 271 persons with upper digestive tract cancer among the 1689 positive group subjects have been discovered, giving an annual morbidity rate of 1.34%. Among the 5591 negative group subjects, 136 persons have been found to suffer from this cancer, giving an annual morbidity rate of 0.2%. This illustrated that the annual morbidity rate of upper digestive tract cancer in the positive group was 6.65 times of that of the negative group ( <0.0001). In conclusion, screening of upper digestive tract cancer with dilute hydrochloric acid in alcohol is simple, safe, non-traumatic, effective and readily acceptable in a high-risk area in China. It may be feasible in other parts of the world, especially the developing countries.
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PMID:Screening of upper digestive tract cancer with dilute hydrochloric acid and alcohol in a Chinese high-risk population--a follow-up study of 12 years. 1239 50

Since 1990, laparoscopic surgery for gastrointestinal disease has been accepted worldwide because it is minimally invasive, associated with less pain, and results in early recovery. For the surgical management of gastroesophageal reflux and perforated peptic ulcer, laparoscopic procedures are recognized as the standard. Laparoscopic gastrectomies for cancer have developed since 1991. Laparoscopic wedge resection and intragastric mucosal resection are performed for the treatment of early gastric cancer without the risk of lymph node metastasis. For early gastric cancer with the risk of perigastric lymph node metastasis, laparoscopy-assisted Billroth-I gastrectomy with D1 lymph node dissection has been successfully performed. Thus, laparoscopic approaches play an important role in the management of gastroduodenal disease.
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PMID:[Laparoscopic surgery for gastroduodenal disease]. 1241 41

Presentation of a multicentric retrospective french study concerning 4,655 cases of gastric cancer operated between 1980 and 1996. The mean age was 67.4 years old with a male predominance of 63.1%. Pains was the predominant presenting symptom (60%) followed by alteration of the general condition (44%) and anaemia (20%). 35.5% of tumors were of distal, 18.8% of middle and 18.6% of proximal localisation. As regard cancer stages, 40% were of stage I,-II and 60% of stages III,-IV. Subtotal gastrectomy was realised in 44%, total radical gastrectomy in 42.1% and other surgical procedures in 14% of cases (proximal gastric resection or atypical resection). D1 lymphadenectomy was associated in 58.4% and D2 in 41.6%. Morbidity was of 23% and mortality of 11.9% which passed from 19% during the first (1980,-85) to 8% in the last interval of time (1990,-96). The 5 years survival was 41% in case of gastric resection. In univariate analysis the 5 years relative survival was better in female patients (44% at 5 years), in patients younger than 50 years old (46%), when pain was the only clinical symptom (52.7%), in middle and distal third localisation (47%), in case of subtotal distal resection (47%) and in less advanced stages (79% at 5 years for stage I cancer). In multivariate analysis the 5 years survival was essentially correlated to the stage of the tumor and no real prognosis improvement was shown during the period of the study.
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PMID:Gastric cancer: the French survey. 1242 Jun 8

Gastric cancer continues to be the second cause of cancer-related mortality in the world. Surgery is the only potentially curative therapy, although the adverse effects of surgery are considerable and include digestive symptoms, loss of appetite and malnutrition. Our study included 45 patients subjected to gastrectomy who were under treatment at our unit during 2000. The data given here refer to their first visit following surgery. The most frequent complications were diarrhoea (31%), pain (29%) and early dumping (24%). Other complications found were late dumping, nausea/vomiting and dysphagia. Anorexia appeared in 49% and 29% presented a negative attitude towards food. These complications give rise to insufficient food intake, leading to malnutrition, mainly marasmic in nature. Only 7% of the patients were normonourished, with 86% presenting slight or moderate malnutrition and 7% severe malnutrition. The mean Body Mass Index (BMI) of these patients was 20 +/- 3 kg/m2. The most frequent analytical alterations were anaemia with ferropenia and b12 deficit, and a reduction in the levels of zinc and retinol transporting protein. Many patients had impaired quality of life; 43% did not leave home and only 13% were able to work. Three groups were established depending on the time that had passed since the gastrectomy was performed before the first nutritional assessment (less than 3 months, from three months to a year, and over one year), without significant differences being found in any of the parameters studied. In this article we include recommendations for the nutritional handling and treatment of patients following gastrectomy.
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PMID:[Nutritional evaluation in patients with total gastrectomy]. 1242 99

Hereditary hemorrhagic telangiectasia (HHT) is associated with arteriovenous malformation in multiple organs. The association of HHT with primary malignancy has rarely been reported. We describe the case of a 68-year-old man with gastric carcinoma who presented with abdominal fullness and cramping pain. Radiographic examination showed multiple pulmonary nodules and an osteolytic cervical spine lesion. The initial diagnosis of gastric cancer with multiple metastases was revised after meticulous imaging studies revealed these lesions to be vascular malformations in the lungs and vertebra. This case demonstrates that HHT may coexist with a primary malignancy and mimic multiple metastases.
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PMID:Hereditary hemorrhagic telangiectasia mimicking metastases in a patient with gastric carcinoma. 1251 49

We retrospectively evaluated the efficacy of chemotherapy regarding symptom control, toxicity and discharge rate in 39 patients with gastric or colorectal cancer. Treatment consisted of TS-1 (n = 16), TS-1 + CPT-11 (n = 8), CDDP + CPT-11 (n = 5), paclitaxel (n = 8) and MTX + 5-FU (n = 4) for gastric cancer and 5-FU + l-leucovirin (n = 6), 5-FU + CPT-11 (n = 5), MMC + CPT-11 (n = 8) and 5-FU protracted continuous infusion (n = 5) for colorectal cancer. The rates of symptom improvement were the following: pain 60% (10/15), general fatigue 56% (5/9) and abdominal fullness 53% (8/15). 87% (34/39) of the patients were discharged from hospital and continued chemotherapy as outpatients grade 3 toxicities were the following: anemia 10.3%, nausea and/or vomiting 7.7%, diarrhea 5.1%. There was no treatment related death. The rates of outpatient based treatment duration improvement were the following: gastric cancer: 47.6%, colorectal cancer: 72%. These data suggest that these treatments for gastric and colorectal cancer are safe and improve the patients' QOL.
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PMID:[Effectiveness of chemotherapy for outpatients with gastric or colorectal cancer]. 1253 32

Cisplatin is an active palliative chemotherapy agent in advanced upper gastrointestinal cancer, but it is associated with significant non-haematological toxicity. Substitution of cisplatin by carboplatin in combination chemotherapy regimens may reduce these adverse effects. These two phase II studies evaluated the efficacy and toxicity of the combination of mitomycin C (MMC) 7 mg/m2 q 6 weekly, carboplatin area under the concentration-time curve 5 mg/ml/min q 3 weekly and protracted venous infusion 5-fluorouracil (5FU) 300 mg/m2/day (McarboF) in advanced upper gastrointestinal cancer. Between October 1998 and June 2000, 31 patients were enrolled in the studies, 23 patients in the oesophago-gastric study and eight patients in the pancreatic study. Although non-haematological toxicity was modest, both protocols were closed prematurely because of excessive haematological toxicity and frequent treatment delays. The overall incidence of grade 3/4 neutropenia and thrombocytopenia was 39 and 52%, respectively. The McarboF combination showed significant activity with an overall response rate of 52% in advanced oesophago-gastric cancer. Palliative benefit was also evident with improvement in symptoms of pain and weight loss in over 79 and 50% of patients in the oesophago-gastric study and pancreatic study, respectively. Median overall survival times were 10.6 and 6.6 months for patients with oesophago-gastric and pancreatic cancer, respectively. The McarboF regimen showed promising activity in advanced upper gastrointestinal cancer, with modest non-haematological side-effects. This combination merits further evaluation with modification of the dose and schedule of carboplatin and MMC in order to reduce the severity of haematological toxicity.
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PMID:Mitomycin C, carboplatin and protracted venous infusion 5-fluorouracil in advanced oesophago-gastric and pancreatic cancer: results of two phase II studies. 1280 Oct 44

Over the past 10 years laparoscopy has been used for the staging of gastric cancer. It has also been used over the past decade for cancer resections, mainly stage I. In addition, it can be used for palliation in advanced stages. We have reviewed the main papers published in the English literature with a view to assessing the validity of laparoscopy in the staging of gastric cancer and in curative resections for cancer. Several studies published in the last 5 years have demonstrated the utility of laparoscopy in the staging of gastric cancer--mainly T3 and T4--and of cancer of the oesophagogastric junction. Laparoscopy can reduce the numbers of useless laparotomies performed and may be useful in selecting patients for neoadjuvant therapy. A number of studies have demonstrated the feasibility of laparoscopic gastric resections, mainly in stage I cancer. The advantages it affords consist above all in less postoperative pain and a quicker recovery. Laparoscopy, then, is useful in the staging of gastric cancer and in cancer of the oesophagogastric junction, mainly because it brings down the number of pointless laparotomies. More debatable is the issue of gastric resection for cancer, because of the low prevalence of early gastric cancer in Western countries.
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PMID:[Laparoscopic surgery of the stomach: state of the art]. 1472 20


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