scholarly journals Direct Liver Invasion from a Gastric Adenocarcinoma as an Initial Presentation of Extranodal Tumor Spread

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Mitanshu Shah ◽  
Apsara Prasad ◽  
Dhyan Rajan ◽  
Christopher B. Tan ◽  
Mansi Shah ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Gastric Wall ◽  
Initial Presentation ◽  
Treatment Modalities ◽  
Curative Intent ◽  
Initial Manifestation ◽  
Tumor Spread ◽  
Direct Invasion ◽  
Wall Perforation

Gastric cancer often carries a poor prognosis, with an estimated 740,000 deaths from the malignancy occurring yearly worldwide (Dicken et al., 2005). The mortality of disease is largely dependent on the extent of tumor spread, as gastric cancer has a predilection to metastasize to other visceral secondaries via hematogenous and lymphatic dissemination. Direct invasion of a gastric adenocarcinoma to adjacent organs secondary to gastric wall perforation does occur; however, it is often present in the setting of advanced disease. Rarely does direct tumor invasion to adjacent organs from a gastric adenocarcinoma present as the initial manifestation of extranodal tumor spread. We present a case of a 40-year-old male with direct tumor extension to the liver as an initial presentation of extranodal tumor spread from a gastric adenocarcinoma. Clinicians should be aware of such an occurrence, as treatment modalities in direct liver extension from a gastric adenocarcinoma vary and may be directed towards palliation rather than curative intent.

Direct Liver Invasion from a Gastric Adenocarcinoma as an Initial Presentation of Extranodal Tumor Spread

2012 ◽  
Vol 107 ◽  
pp. S266-S267
Author(s):  
Mitanshu Shah ◽  
Apsara Prasad ◽  
Dhyan Rajan ◽  
Christopher Tan ◽  
Mansi Shah ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Initial Presentation ◽  
Tumor Spread

Seventh edition (2010) of gastric adenocarcinoma AJCC staging system: Is there room for improvement?

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 77-77
Author(s):  
Manali I. Patel ◽  
Kim F Rhoads ◽  
Yifei Ma ◽  
James M. Ford ◽  
Jeffrey A. Norton ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Health Planning ◽  
Gastroesophageal Junction ◽  
Staging System ◽  
Rank Test ◽  
Population Database ◽  
Curative Intent ◽  
Ajcc Staging System ◽  
Ajcc Staging

77 Background: The gastric cancer AJCC staging system recently underwent significant modifications of the T and N categories as well as stage groupings. The new system has not been validated on a US population database, but studies on Asian patients have reported no difference in survival between stages IB and IIA, as well as IIB and IIIA. Methods: California Cancer Registry data linked to Office of Statewide Health Planning and Development discharge abstracts were used to identify patients with gastric adenocarcinoma (gastroesophageal junction tumors excluded) who underwent curative-intent surgical resection from 2002 to 2006. AJCC stage was reclassified based on the 7th edition. Disease-specific survival (DSS) probabilities were calculated using the Kaplan-Meier method and compared using the log rank test. Results: Of 4,985 patients identified, 2,262 had complete pathologic data and known cause of death. Median age was 70 years and 60% were males. Median number of examined lymph nodes was 12 and 39% of patients received adjuvant chemotherapy. The 7th edition AJCC system did not distinguish outcome adequately between stages IB and IIA (P = .25), or IIB and IIIA (P = .33, Table ). By merging stage II into one category and moving T2N1 to stage IB and T2N2, T1N3 to stage IIIA, we propose a new grouping system which showed improved discriminatory ability ( Table ). Conclusions: In this first study validating the new 7th edition AJCC staging system for gastric cancer on a US population, we found stages IB and IIA, as well as IIB and IIIA to perform similarly. We propose a revised stage grouping for the AJCC system that better discriminates between outcomes. [Table: see text]

Factors associated with recurrence in lymph node-negative gastric adenocarcinoma: Results from the U.S. Gastric Cancer Collaborative.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 80-80 ◽  
Author(s):  
Linda X. Jin ◽  
Malcolm Hart Squires ◽  
George A. Poultsides ◽  
Konstantinos Ioannis Votanopoulos ◽  
Sharon M. Weber ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Gastric Adenocarcinoma ◽  
Disease Recurrence ◽  
Curative Intent ◽  
Node Negative ◽  
T Stage ◽  
Predictors Of Recurrence ◽  
Poorly Differentiated ◽  
The U.S

80 Background: Lymph node (LN) status is a predictor of recurrence after gastrectomy for gastric adenocarcinoma. Clinicopathologic predictors of recurrence in patients with node-negative disease are less well established. Methods: Patients who underwent surgery with curative intent for gastric adenocarcinoma from between 2000-2012 from participating institutions of the U.S. Gastric Cancer Collaborative were analyzed. Patients who died within 30 days of surgery were excluded. Univariate (UV) and multivariate (MV) analysis of clinicopathologic factors was associated with recurrence was performed. Results: Nine-hundred sixty-five patients from seven institutions were included in the analysis. Three-hundred forty-five (36%) had LN- disease, of whom 63 (18%) had disease recurrence after a median follow-up of 24 months. The most common patterns of recurrence were: peritoneal alone (44%), liver (22%), or combined liver/peritoneal (9%). This distribution did not differ significantly from LN+ disease. UV analysis identified tumor size, linitis plastica, diffuse histology, poor differentiation, signet ring histology, T stage ≥3, perineural invasion, and lymphvascular invasion as risk factors for recurrence (Table). On MV analysis, T stage≥3 (OR 3.6, 95% CI=1.7-7.5) and poorly differentiated histology (OR 2.4, 95% CI=1.2-4.9) were independent predictors of recurrence. Conclusions: Despite the presence of negative lymph nodes, patients with T stage ≥3 and poorly differentiated histology are at high risk of recurrence after gastrectomy for adenocarcinoma of the stomach. These factors, along with other patient and treatment-related variables, may be used to select patients who may benefit from more aggressive adjuvant therapy and to guide subsequent monitoring for disease recurrence. [Table: see text]

Madelung's Disease as the First Presentation of an Occult Gastric Adenocarcinoma

2015 ◽  
Vol 100 (9-10) ◽  
pp. 1323-1325
Author(s):  
Livia S. Smidt ◽  
Cleber D. P. Kruel ◽  
Marcio F. Chedid
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Frozen Section ◽  
Gastric Wall ◽  
Subtotal Gastrectomy ◽  
Signet Ring Cell ◽  
Pathology Report ◽  
Madelung's Disease ◽  
Madelung’S Disease ◽  
Signet Ring

Madelung's disease is a rare disorder defined as cervical benign symmetric lipomatosis. Its association to alcoholism, pulmonary pathology, and neck cancer has been reported. We first describe the occurrence of this syndrome during the course of a gastric cancer. A 65-year-old white Latino male patient was referred to our service for investigation of dyspeptic symptoms, weight loss, and small bilateral symmetric and painless cervical masses. Upper endoscopy revealed a pyloric ulcer, treated with a 3-month regimen of antibiotics and omeprazole. A new endoscopy revealed persistence of the gastric ulcer, and biopsy pathology report showed chronic inflammatory changes but no malignant cells. Two months after the biopsy, the patient was admitted to the Emergency unit for gastric obstruction. Gastric wall enlargement and distention were found at the operation. Intraoperative frozen section gastric biopsy was inconclusive. Resection was not performed and a gastroenteric anastomosis was constructed. Definitive pathology report revealed gastric adenocarcinoma with signet-ring cells. Thus, the patient underwent subtotal gastrectomy. Definitive pathology report confirmed diffuse signet-ring cell gastric cancer with duodenal invasion; 1 lymph node was positive for cancer. Postoperative course was uneventful, and adjuvant chemotherapy was performed. Gastric cancer recurred and the patient died 2 years after the operation. Madelung's disease did not show any progress during the disease-free period. Madelung's disease has been associated with head and neck cancers and now with gastric adenocarcinoma. We suggest that patients presenting with cervical lipomatosis also should be screened for occult gastric cancer and abdominal malignancy.

scholarly journals Gastric Adenocarcinoma: Is Computed Tomography (CT) Useful in Preoperative Staging?

2009 ◽  
Vol 3 ◽  
pp. CMO.S2641 ◽  
Author(s):  
Ssther Uña Cidón ◽  
Isabel Jiménez Cuenca
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Predictive Value ◽  
Gastric Wall ◽  
Preoperative Staging ◽  
Spiral Ct ◽  
Accurate Method ◽  
Lymph Node Involvement ◽  
Wall Thickening ◽  
Curative Surgery

Background and Purpose Although multiple studies testing the accuracy of CT in the preoperative staging of gastric adenocarcinoma have been carried out, their results are controversial. Whilst some authors claim that CT is an accurate method for preoperatively staging gastric cancer, others have advocated the contrary. Because of this discrepancy we have retrospectively reviewed preoperative CT findings compared with histopathological results in patients with gastric adenocarcinoma. Patients and Methods Seventy-two patients diagnosed with gastric cancer who underwent potentially curative surgery and preoperative staging CT of quality were included in the study. The size, gastric wall thickening, presence of lymphadenopathy, adjacent organ invasion and location of the gastric mass was recorded. Early tumors (T1 and T2) and more advanced tumors (T3 and T4) were grouped together. CT staging was correlated with the final histopathological stage (TNM). The global results were expressed as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results Seventy-two cases were included with fifty-five being male and a median age of 67 years (range 33–91). CT correctly identified the location of the tumor in 56 (53% antropyloric, 18% subcardial). Median time from CT scan to surgery was fourteen days (range 2–49). In T detection: T1/T2 and T3/T4 with sensitivity of 70% and 61%. Lymph node involvement: Sensitivity 49%. Overstaged in 47% Understaged in 75%. Specificity of 53%. Nine patients with colon-mesocolon (5 patients) and pancreas (4 patients) invasion. Sensitivity 44% and specificity 96%. Conclusion Spiral CT is not an accurate method in predicting preoperative stages in gastric cancer.

The effect of postoperative morbidity on survival after resection for gastric adenocarcinoma: Results from the U.S. Gastric Cancer Collaborative.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 5-5
Author(s):  
Linda X. Jin ◽  
Lindsey E. Moses ◽  
Yan Yan ◽  
Malcolm Hart Squires ◽  
Sharon M. Weber ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Therapy ◽  
Gastric Adenocarcinoma ◽  
Negative Impact ◽  
Perioperative Complications ◽  
Disease Free Survival ◽  
Oncologic Outcomes ◽  
Rank Test ◽  
Curative Intent ◽  
The U.S

5 Background: The negative impact of postoperative complications (POCs) on survival is well documented for many cancer types, but has not been well described in gastric cancer. Here, we evaluated the effect of POCs on survival after surgery for gastric cancer in a cohort of patients from a multi-institutional database. Methods: Patients who underwent surgery with curative intent for gastric adenocarcinoma between 2000-2012 from participating institutions of the U.S. Gastric Cancer Collaborative were analyzed. Patients who died within 30 days of surgery were excluded. Ninety-day postoperative complication data were collected. Survival probabilities were estimated by Kaplan-Meier analysis and compared using the log-rank test. Results: A total of 853 patients from seven institutions met inclusion criteria. Median follow-up was 32 months. The overall complication rate was 40% (n=344). The most frequent complications were: infectious (25%, including surgical site infection [8%]), and anastomotic leak (6%). 7% of patients underwent reoperation during the same hospitalization. Five-year overall survival (OS) for patients without perioperative complications was 54%, compared with 39% for patients with POCs (p=0.001). Disease free survival (DFS) at five years was 61% for patients without POCs compared to 49% in patients with POCs (p=0.002). Patients without POCs were significantly more likely to receive adjuvant therapy (55% vs 42%; p<0.001). Conclusions: In a large, multi-institutional cohort, POCs were associated with decreased survival in patients undergoing surgery for gastric adenocarcinoma. This may be due, in part, to the negative impact of complications on the receipt of adjuvant therapy. Efforts aimed at reducing perioperative morbidity are important not only for short-term surgical outcomes, but also for enhancing long-term oncologic outcomes in patients with gastric cancer. [Table: see text]

scholarly journals Early Gastric Cancer Associated With Gastric Sarcoidosis

2015 ◽  
Vol 100 (5) ◽  
pp. 949-953 ◽  
Author(s):  
Takeshi Matsubara ◽  
Noriyuki Hirahara ◽  
Ryoji Hyakudomi ◽  
Yusuke Fujii ◽  
Shunsuke Kaji ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Gastric Wall ◽  
Cancer Invasion ◽  
Tumor Spread ◽  
Surgical Specimen ◽  
Elevated Lesion ◽  
Gastric Corpus ◽  
Well Differentiated ◽  
Depth Of Cancer Invasion

Sarcoidosis is a multisystemic disorder that is characterized by the formation of noncaseating granulomas. Although sarcoidosis can affect any organ, gastrointestinal tract involvement in sarcoidosis is very rare, and gastric cancer associated with gastric sarcoidosis has hardly been reported. A 64-year-old female with a 10-year history of the medical treatment of gastric sarcoidosis received a routine follow-up gastrointestinal endoscopy and an irregular-shaped, elevated lesion was detected in the gastric corpus. The gastric mucosal surface was nodular and ulcerated throughout the stomach. The gastric lumen was narrow, and the gastric wall was stiff and nondistensible, resembling linitis plastica. The biopsies of the elevated lesion in the gastric corpus revealed well-differentiated adenocarcinoma. An endoscopic ultrasonography was then performed, but it failed to assess precisely the depth of cancer invasion because of sarcoidosis-related gastritis and fibrosis of the gastric wall. The patient underwent a laparoscopic total gastrectomy under the diagnosis of gastric cancer associated with gastric sarcoidosis. Histologic examination of the surgical specimen demonstrated well-differentiated adenocarcinoma in the gastric corpus, and the histologic mapping of cancer cells revealed that the tumor spread within the mucosal layer of the stomach. No lymph node metastasis was found. The patient's postoperative course was uneventful. We experienced a rare case of early gastric cancer associated with gastric sarcoidosis, which identified the troublesome issue that the assessment of depth of cancer invasion is difficult, because patients with longstanding gastric sarcoidosis may involve various degrees of fibrosis of the gastric wall.

Helical CT Findings of Gastric Wall Thickening by Peptic Ulcer: Compared with Gastric Adenocarcinoma with Ulcer

2000 ◽  
Vol 42 (2) ◽  
pp. 281
Author(s):  
Won Jung Jung ◽  
Jong Chul Choi ◽  
Keum Soo Seo ◽  
Bon Sik Koo ◽  
Byeong Ho Park ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastric Adenocarcinoma ◽  
Gastric Wall ◽  
Helical Ct ◽  
Wall Thickening ◽  
Ct Findings

BIOPSY OF THE SIGNALING LYMPH NODES IN GASTRIC CANCER - CURRENT STATUS OF THE PROBLEM AND PROSPECTS

2018 ◽  
Vol 64 (3) ◽  
pp. 335-344
Author(s):  
Aleksey Karachun ◽  
Yuriy Pelipas ◽  
Oleg Tkachenko ◽  
D. Asadchaya
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Stomach Cancer ◽  
Current Status ◽  
Regional Lymph Nodes ◽  
Systematic Analysis ◽  
Tumor Spread ◽  
Special Value

The concept of biopsy of sentinel lymph node as the first lymph node in the pathway of lymphogenous tumor spread has been actively discussed over the past decades and has already taken its rightful place in breast and melanoma surgery. The goal of this method is to exclude vain lymphadenectomy in patients without solid tumor metastases in regional lymph nodes. In the era of minimally invasive and organ-saving operations interventions it seems obvious an idea to introduce a biopsy of sentinel lymph node in surgery of early gastric cancer. Meanwhile the complexity of lymphatic system of the stomach and the presence of so-called skip metastases are factors limiting the introduction of a biopsy of sentinel lymph node in stomach cancer. This article presents a systematic analysis of biopsy technology of signaling lymph node as well as its safety and oncological adequacy. Based on literature data it seems to us that the special value of biopsy of sentinel lymph nodes in the future will be in the selection of personalized surgical tactics for stomach cancer.

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