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)

The histories of 429 patients who underwent surgery for primary gastric cancer at our ward from January 1970 to December 1985, were reviewed. All patients underwent surgery: potentially curative surgery, 54.8%, non-curative resection, 18.2%; palliative surgery, 27%. Nodal status was as follows: N0, 28%; N1, 17.7%; N2, 44.5%; N3, 9.8%. The incidence of N0 cases was significantly increased in Stage T1 and T2 disease compared to Stage T3 and T4 lesions (p < 0.001). In Stage T3 and T4 patients the incidence of distant metastases increased if lymph node involvement was also present (p < 0.005). In patients without nodal metastases 5-year survival was 70% (median survival: 60+ months) whereas, in patients with lymph node involvement survival was 32% (median survival: 24 months) (p < 0.001). Our data suggest that elective extensive lymph node dissection (R2) is indicated in all patients because survival is improved by this procedure. We recommend R3 lymph node dissection only in macroscopic N3 node involvement patients.
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PMID:Extension of lymph node dissection and survival in primary gastric cancer. 147 3

To investigate the relationship between "systemic" antitumor immunity and "local" antitumor immunity with respect to the histopathological stage of gastric cancer, interleukin-2 stimulated mixed lymphocyte tumor extract reactions (ILS-MLTR) of peripheral blood lymphocytes (PBL) and regional node lymphocytes (RNL) were evaluated in 59 gastric cancer patients. ILS-MLTRs of both PBL and RNL decreased with the advance of cancer stage, but ILS-MLTRs of PBL were always lower than those of RNL. Positive correlations in MLTR between PBL and RNL were found in patients with depth of invasion to muscularis propria and serosa and peritoneal dissemination. Inverse correlations between PBL and RNL were noted in patients with stage IV and distant nodal involvement. These results suggest that variations in the anticancer immunities might be effectively managed by an immunotherapy which is designed according to the responsiveness in the immune parameter ILS-MLTR.
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PMID:Relationships for recombinant interleukin-2-stimulated mixed lymphocyte tumor extract reaction between peripheral blood lymphocytes and regional node lymphocytes in gastric cancer patients. 153 72

Early gastric cancer is a unique form of gastric carcinoma with an excellent prognosis. Now recognized worldwide, this tumor is most commonly diagnosed in Japan secondary to aggressive screening practices. Early detection is dependent on a low threshold for esophagogastroduodenoscopy with biopsies, because specific symptoms and physical findings or diagnostic laboratory tests are rarely present with early gastric cancer. Once the disease is diagnosed, subtotal gastrectomy achieves survival rates equivalent to those of age-matched controls. Consideration of total gastrectomy is warranted with proximal tumor location or multicentric carcinoma. Radical lymphadenectomy should be undertaken in patients with regional nodal metastasis. After operative resection, patient outcome is usually excellent. Large submucosal tumors with an aneuploid DNA pattern and nodal involvement denote a more ominous outlook. Close patient follow-up is necessary to detect both the uncommon recurrence and the more common nongastric malignancy.
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PMID:Early gastric cancer. 154

The value of extended lymph node dissection for gastric cancer has not been clearly defined. The incidence, staging, and, possibly, the biology of gastric carcinoma in Japanese and Western confound the evaluations of radical lymph node dissection. Surgeons and pathologists must be familiar with the unified international gastric cancer staging system, and careful attention should be given to accurate identification and rigorous examination of regional lymph nodal groups.
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PMID:Extended lymph node dissection for gastric cancer. Is it of value? 154 2

The concentrations of urinary type plasminogen activator (u-PA), plasminogen activator inhibitor 1 (PAI-1), and PAI-2 were measured in gastric cancer tissues and adjacent healthy mucosal tissues. Levels of u-PA, PAI-1 and PAI-2 were higher in cancer than in control tissues. PAI-1 levels were higher together with the progression of cancer however there were no differences in u-PA or PAI-2 levels. Tumors with higher PAI-1 and lower PAI-2 levels tend to metastasize to remote lymph nodes. When the numbers of involved lymph nodes were analyzed, tumors with the large number of metastatic lymph nodes showed higher PAI-1 and lower PAI-2 level. No difference was shown in u-PA levels among these groups. These tendencies were more significant in patients with progressed gastric cancer. These results suggest that tumor with higher PAI-2 levels tend to localize or have less tendency to metastasize to lymph nodes. On the other hand PAI-1 was generally higher in tumor with invasion into nearby tissue or with nodal metastasis.
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PMID:Possible role of plasminogen activator inhibitor 2 in the prevention of the metastasis of gastric cancer tissues. 163 63

The in vivo function of NK cells is still uncertain, and there are various contradictory reports on NK cells in gastrointestinal cancer. In the present study the activity and proportion of NK cells (Leu 11 + cells) in peripheral blood were assessed in 71 patients with gastric cancer, and analysed with respect to the clinical and histopathological factors, such as the clinical stage, tumor size, degree of invasion, metastasis, histology, etc. There were no differences in the proportions and activities of NK cells between normal volunteers and gastric cancer patients. A low NK cell activity was associated with early gastric cancers (carcinoma in the mucosa or submucosa) less than 2 cm in diameter, large advanced tumors (invasion beyond the muscularis propria) greater than 8 cm in diameter, and metastasis of adjacent regional (perigastric) nodes. Liver metastasis did not affect the NK cell activity, however a high NK activity was found in patients with peritoneal dissemination. The NK activity did not correlate with the proportion of Leu 11 + cells in normal volunteers or in patients with early gastric cancer, however the activity and proportion of NK cells correlated with each other in patients with advanced gastric cancer. These results suggest that the preoperative evaluation of circulating NK cells in gastric cancer patients may be beneficial to assess the extent of nodal metastasis, the degree of tumor invasion, and peritoneal dissemination.
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PMID:The clinical status and histopathological factors affecting natural killer cells of peripheral blood lymphocytes in patients with gastric cancer. 166 68

To see if there was an association between the number of lymph node metastases and the macroscopic findings of the tumour (such as size, location, and gross appearance), the nuclear DNA content was cytophotometrically analysed in biopsy specimens taken at preoperative endoscopy from 84 cases of gastric cancer. The DNA ploidy patterns were classified into type D, type A1, and type A2, according to the stem lines and the degree of scatter of the cells. Lymph nodes were positive in 2 of 20 (10%) in type D and 10 of 30 (33%) in type A1; these were both significantly lower than that in type A2 (24 of 34, 71%). Knowing the degree of nodes metastases or the microscopic lymphatic spread before the operation is almost impossible at present; the nuclear DNA content is closely associated with metastatic content of the nodes, so the cytophotometric determination of the DNA ploidy patterns from biopsy specimens may be useful in predicting the nodal state.
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PMID:Preoperative prediction of nodal state in gastric cancer by nuclear DNA content. 167 81

Esophageal and gastric cancers are highly virulent tumors with an especially poor prognosis. They are rather common tumors in the United States with an anticipated annual incidence of approximately 32,000 new patients in 1991. Adenocarcinomas of the proximal stomach and lower esophagus are rapidly increasing in incidence; the reasons for this remain unclear. Endoscopic ultrasonography has offered a new dimension to staging especially of the primary tumor but also shows promise for more accurate identification of nodal metastasis. While stage remains the single most important prognostic variable, biological studies investigating tumor markers are a high priority; aneuploidy and HER-2/neu amplification or overexpression may predict poor outcome in gastric cancer. Esophageal and gastric cancers have a high local and distant failure rate when treated with conventional therapy. New developments in chemotherapy in the neoadjuvant and postoperative setting are under intense investigation in an attempt to improve prognosis for these diseases.
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PMID:Therapy of upper gastrointestinal tract cancers. 174 44

We have studied the incidence and prognosis of N4 node (para-aortic lymph node) metastases in gastric cancer in 434 patients who had been referred to our department for surgical treatment during the period between 1978 and 1988. N4 nodal involvement was found in 76 (17.5%) of 434 patients who had received a laparotomy with resection, and in 42 (10.5%) of 400 patients who had "curative" resection. When the surgeon assessed that the patients had metastasis in para-aortic lymph nodes, the para-aortic lymph nodes lying above and below the left renal vein were completely removed (R4 gastrectomy). During this period, 42 patients with N4 nodal involvement underwent "curative" resection by R4 gastrectomy. Their treatment results were compared with those of 32 patients who underwent subtotal or total gastrectomy (R2 or R3 gastrectomy) without resection of metastases of para-aortic lymph nodes ("palliative" resection). The operating time and the operative mortality rate were similar in both groups (R4 vs R2 or R3 gastrectomy). The patients who had undergone "curative" resection (R4 gastrectomy) had a significantly higher five-year survival rate than those who had received "palliative" resection. The R4 gastrectomy is a rational and useful surgical procedure for treating patients with N4 nodal involvement.
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PMID:Surgical treatment of advanced gastric cancer with metastasis in para-aortic lymph node. 177 20

Adjuvant immunochemotherapy using the antitumour polysaccharide sizofiran (SPG), an extract from the culture broth of Schizophyllum commune Fries, was prescribed randomly for 386 Japanese patients with resectable gastric cancer. Although the overall survival probability for 5 years did not differ between the SPG and control groups, in 264 patients with curatively resected cancer, the probability to 5 year survival and to recurrence in the sizofiran-administered patients was better than in the controls. In the multivariate analysis, four of six prognostic factors correlated with the prognosis of the 264 patients who underwent curative surgery, that is, nodal involvement (chi 2 = 21.426, P = less than 0.0001), age distribution (chi 2 = 9.262, P = 0.010), sizofiran administration (chi 2 = 6.507, P = 0.011), and primary tumour size (chi 2 = 9.345, P = 0.025). Thus, patients with a curatively resected gastric cancer had a better prognosis when sizofiran was prescribed in combination with antitumour drugs.
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PMID:Clinical outcome of postoperative adjuvant immunochemotherapy with sizofiran for patients with resectable gastric cancer: a randomised controlled study. 183 19


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