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

For classification of perigastric lymph node metastases in gastric cancer, only topographical aspects are taken into consideration at present. As a numerical classification for lymph node metastases was proposed recently, the current problem is that of determining the number of dissectable perigastric lymph nodes and also assessing the quality of nodal dissection. The perigastric lymph nodes of 10 adults without gastric disease were therefore evaluated microscopically by a serial section technique. On average a total of 36.2 +/- 15.2 perigastric lymph nodes were found, e.g. 14.9 +/- 14.1 lymph nodes on the greater and 7.4 +/- 4.8 on the lesser curvature. These figures are similar to those in fetuses and newborn infants, but they exceed the numbers of perigastric lymph nodes reported in the literature for adults with or without gastric cancer. This difference could be attributable to our use of the serial section technique, because the so-called "micro-lymph nodes" with a diameter of less than 1.5 mm are consequently included in this study. Our results support the assumption, that pathologic processes do not result in any real increase of regional lymph nodes, but in an activation and enlargement of fetal lymph node reserve.
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PMID:Number and size of perigastric lymph nodes in human adults without gastric cancer. 192 12

Four hundred and eighty five gastric cancer patients underwent gastrectomy in the past 6 years and of those 332 patients (68.2%) were found to have only serosal involvement (se) or adjacent organ invasion (sei). Simple gastrectomy (SG) was carried out in 144 cases while radical gastrectomy (RG), which included systemic lymphadenectomy, was performed in 188 cases. This type of operation was chosen by the operators arbitrarily except in the presence of non-curative factors such as multiple liver metastasis, peritoneal seeding and distant metastasis, in which case SG was always used to relieve gastrointestinal obstruction or bleeding. The operative mortality of SG was 2.7% and that of RG was 3.2%. On average, 15.8 lymph nodes were taken out per patient in SG and 33.6 lymph nodes in RG. The chance of nodal metastasis was higher in sei than in se. According to the Japanese General Rules of Gastric Cancer Study, we found that for gastric cancer with serosal involvement: (1) the long term result of RG was superior to SG in both stage 3 and 4 patients, (2) when absolute curative resection was achieved, the result was the best in stage 3 patients, (3) no patient in stage 4 who underwent absolute non-curative resection survived for more than 42 months, therefore this result was the worst. RG is recommended for advanced gastric cancer patients with serosal involvement whenever the patient's condition permits and in absence of the unresectable non-curative factors.
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PMID:[Gastrectomy for advanced gastric carcinoma with serosal involvement]. 199 Jan 53

Adenocarcinoma of the stomach having invasion limited to the muscularis propria with or without lymph node metastasis, termed PM (proper muscle) gastric cancer by Japanese investigators, has a prognosis superior to that of carcinoma extending to the serosa and approaching that of early gastric cancer in Japan. To evaluate the occurrence and significance of PM gastric cancer in the United States, we analyzed 272 gastric carcinomas resected at our institution between 1964 and 1983. Forty-two PM cancers (15%) were identified. Improved 5-year survival rate was noted for PM cancer when compared with survival rate for 215 neoplasms exhibiting serosal invasion (29% versus 7%, P less than 0.001). In univariate analysis, a survival advantage was also associated with absence of lymph node metastasis, intestinal-type histopathology of the Lauren classification, the expanding pattern of the Ming classification, and polypoid or fungating gross configuration of tumor. In multivariate analysis, depth of tumor invasion remained significantly associated with improved 5-year survival rate independently of other variables, including lymph node metastasis. Using continuous survival curves, the prognostic significance of PM cancer prevailed throughout the 5-year postgastrectomy interval. Our data indicate that PM gastric cancer occurs in the United States and need not be considered "advanced" gastric carcinoma; depth of tumor invasion should be recognized as a nodal metastasis-independent prognosticator of gastric cancer survival.
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PMID:Adenocarcinoma of the stomach with invasion limited to the muscularis propria. 200 74

A retrospective study of early gastric cancer (60 patients) was performed to evaluate its diagnosis and treatment. Ninety-five per cent of patients presented with nonspecific gastrointestinal symptoms and 53.3% had been treated for presumed benign disease for up to 48 months before diagnosis. Fiberoptic endoscopy detected these lesions more accurately than radiologic examination. The disease-free 5-year survival rate after resection was 76.4%. Survival showed no significant correlation with sex, tumor site, macroscopic appearance, extent of gastric resection, or histopathologic type. Tumors larger than 1.5 cm in diameter, invasion of submucosa, or lymph node metastasis resulted in significantly lower survival rates. Three of eight patients with nodal metastasis survived 5 or more years, including one who had second-echelon deposits. A high index of suspicion may permit more frequent detection. Extended lymphadenectomy (R2) is recommended to achieve the highest possible cure rate.
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PMID:Early gastric cancer. Twenty-eight-year experience. 200 14

The expression of Ki-67 antigen in 71 patients with advanced gastric cancer was studied by immunohistochemical technique. Immunohistochemical staining with Ki-67 produced clear labeling of a portion of tumor cell nuclei, and the nucleoli stained intensely. The Ki-67 labeling rates of the 71 specimens ranged from 7.7 to 70.5% (mean: 29.2%; standard deviation: 12.9%). There was no significant association between Ki-67 labeling rates and macroscopic type, peritoneal metastasis, or serosal invasion. The tumors showing high Ki-67 labeling rates (greater than 25%) are more likely to have liver metastasis and lymph node involvement. Larger tumors, with a diameter greater than 6 cm, more frequently showed high Ki-67 labelling rate than those with a diameter less than 6 cm. When the Ki-67 labeling rate and 9 clinicopathologic parameters, as conventional prognostic factors, were entered simultaneously into the regression model, nodal status and Ki-67 labeling rate emerged as independent prognostic factors. These results indicate that the in situ determination of the growth fraction by Ki-67 antibody may be a reliable prognostic marker of advanced gastric cancer.
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PMID:Assessment of tumor cell kinetics by monoclonal antibody Ki-67. 207 97

The patterns of recurrence and the prognosis of 24 gastric cancer patients with peritoneal seeding and/or serosal invasion, who underwent gastrectomy followed by intraperitoneal hyperthermic perfusion (IPHP), were studied in comparison with 23 gastric cancer patients given surgery alone (controls). With respect to 22 patients with peritoneal seeding, all of 8 patients in the control group died of re-accumulation of ascitic effusion, whereas of 14 patients in the IPHP group, 3 died of peritoneal recurrence, 2 of intraperitoneal tumors, 1 from pleural metastasis, and 1 of liver metastasis. The remaining 7 cases are alive without a sign of recurrence. Again, with respect to 25 patients with large serosal penetration of cancer, 7 of 15 patients in the controls died of peritoneal recurrence, whereas this was never observed in the IPHP group. As to the relation of histology and prognosis, while the poorly differentiated adenocarcinoma and signet ring cell carcinoma had poor prognosis in the controls, the same patterns in the IPHP group proved not to be so unfavorable. Since a few given IPHP resulted in hepatic metastasis and/or nodal involvement, adjuvant treatment will be required. The survival rate for the IPHP group was significantly better at p = 3.43 x 10(-2) than in controls.
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PMID:[Clinical evaluation of recurrent patterns of gastric cancer after intraperitoneal hyperthermic perfusion]. 211 94

The infiltration of dendritic cells determined in 210 patients with gastric carcinoma was investigated from the standpoint of tumor invasion, lymph node metastasis, and prognosis. Dendritic cell infiltration was graded as "slight" and "marked." The 39% frequency in the marked infiltration group at the mucosal stage did not change in proportion to invasion into the deeper layers. The 5-year survival rate was 60.4% in patients with marked infiltration and 38.8% in those with slight infiltration, which was statistically different (P less than 0.01). The difference in survival rates was only statistically significant in those with cancer emerging from the serosa (P less than 0.001). There was a similar incidence of lymph node metastasis between the marked and slight infiltration groups in each grade of tumor invasion. However, marked infiltration of dendritic cells prevented widespread nodal involvement beyond the primary node in cases of advanced carcinoma (P less than 0.05). These findings indicate that infiltrating dendritic cells do not prevent the spread of tumor invasion but do prevent nodal involvement; therefore, for patients with a gastric cancer emerging from the serosa, the prognosis will be good.
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PMID:Infiltration of dendritic cells in relation to tumor invasion and lymph node metastasis in human gastric cancer. 222

Paraffin-embedded tumor samples from 493 patients with gastric cancer were analyzed by DNA flow cytometry, and proliferative activities of 155 tumors were measured by bromodeoxyuridine (BrdU) labeling, Ki-67 monoclonal antibody (Mab), and anti-p105 Mab. The results were correlated with clinicopathological findings and patients prognoses. Of the 493 patients, 183 (37%), 225 (46%), and 85 (17%) showed diploid, single DNA a neuploid, and DNA-multiploid. The relative risk of death was three-fold higher in DNA-multiploid tumors than in DNA-diploid tumors. BrdU labeling indices also proved to be an independent prognostic factor. Multiploid tumors had the highest median BrdU LI associated with the most frequent lymph node metastases and hepatic metastases. When the DNA histogram and all the clinicopathological parameters were entered simultaneously into the Cox regression model, DNA ploidy, hepatic metastasis, peritoneal dissemination, BrdU LI, and nodal status emerged as independent prognostic parameters. These results indicate that DNA ploidy and proliferative activities may be useful prognostic factors for the patients with gastric cancer.
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PMID:[Quantitative estimation of malignancy of gastric cancer by DNA ploidy and proliferative activities]. 223 66

The personal experience on the gastric cancer prognosis is reported. Particularly it is outlined that survival is strictly dependent on the wall invasion and lymph-node metastasis. Moreover in cancers with the same wall invasion the prognosis changes very much in relation to lymph-nodal status.
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PMID:[Gastric cancer: prognosis in relation to parietal infiltration and lymphatic metastasis]. 228 64

The prognostic significance of proliferative activity in 167 gastric carcinomas was studied by means of an in vitro labeling method with bromodeoxyuridine (BrdU), using specimens obtained by endoscopic biopsy, and the results were correlated with conventional prognostic factors. The BrdU labeling indicates (BrdU LI) varied from 2.1 to 45%. When the in vitro BrdU LI were plotted against in vivo BrdU LI, a significant correlation was found between in vitro and in vivo BrdU LI (P less than .01). These results show that the in vitro BrdU LI of specimens obtained by endoscopic biopsy indicate accurate proliferative activities of gastric cancers. The BrdU LI were closely correlated with nodal status, vessel invasion, and tumor size. With regard to the correlation of BrdU LI and prognosis, patients whose tumors had a high BrdU LI (BrdU greater than LI less than 10%). When the BrdU LI and all the pathologic findings were entered simultaneously into the regression model, nodal status, tumor size, serosal involvement, and BrdU LI emerged as independent prognostic parameters. The present studies demonstrated the usefulness of the in vitro BrdU-labeling method to estimate the malignancy of gastric cancer preoperatively, and this method may be useful in designing the operative procedure and multimodal therapy for individual patients.
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PMID:Relation of proliferative activity to survival in patients with gastric carcinoma. 229 93


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