scholarly journals Gastric Cancer in Nepal A Locally Advanced Disease

2019 ◽  
Vol 21 (3) ◽  
pp. 199-203
Author(s):  
Rabin Koirala ◽  
N. Acharya ◽  
S. Khanal ◽  
A. Rajbhandary
Keyword(s):  
Gastric Cancer ◽  
Locally Advanced ◽  
College Teaching ◽  
Albumin Level ◽  
Curative Intent ◽  
Duration Of Symptoms ◽  
Medical College ◽  
Duration Of Illness ◽  
Long Duration ◽  
Operative Findings

The goal of this study is to describe the distribution of gastric cancer by age, gender, duration of symptoms, nutritional status and staging of the disease based on operative findings and correlation between the data. This was an observational study. The study was conducted at Department of Surgery, Nepal Medical College Teaching Hospital from December 2012 to December 2017. All patients who were admitted to the department with a diagnosis of stomach cancer and underwent palliative or curative intent procedure were reviewed and analyzed. Out of the 80 patients, 51(63.7%) were male and 29 (36.3%) patients were female. The disease was commonest in the 6th and 7th decades of life. Majority of the patients were of Tibetoburmese (Mongolian) origin with 44 (55%). Majority of patients, 60 (75%) patients had long duration of illness of more than 6 months. Most of the patients had albumin level less than 3gm/dl. Gastric carcinoma is a male predominant malignancy usually of old age and commonly observed in the Tibeto-Burman group of people. Overwhelming majority diagnosed at an advanced stage and had poor prognosis.

scholarly journals Incidence of gastric cancer, its subtypes, and correlation with Helicobacter Pylori

2013 ◽  
Vol 3 (5) ◽  
pp. 403-407
Author(s):  
Shiva Raj KC ◽  
GL Amatya ◽  
A Lakhey ◽  
S Basnet ◽  
G Aryal
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Demographic Data ◽  
College Teaching ◽  
Study Data ◽  
Upper Gastrointestinal Endoscopy ◽  
Tubular Adenocarcinoma ◽  
Common Cause ◽  
Medical College ◽  
H Pylori

Background: Gastric cancer is the fourth most commonly diagnosed cancer and the second most common cause of cancer related death worldwide. It is the common cause of cancer related death in Nepal. Helicobacter Pylori has been classified as a definite carcinogen along with other factors. The aim of this study was to fi nd the incidence of gastric cancer among the patients undergoing upper gastroscopy, its various subtypes and association with Helicobacter Pylori. Materials and Methods: This is a retrospective and prospective study carried out at GRP Polyclinic and Kist Medical College Teaching Hospital. All the patients undergoing upper gastrointestinal endoscopy were included in this study. Data of all the gastric endoscopic biopsies done from June 2011 to January 2013 were collected and analyzed. All the biopsy specimens were processed routinely in histopathology laboratory. Specimens showing carcinoma were enrolled in this study and all the relevant demographic data were collected. Results: Out of 3395 biopsy cases; 49 cases (1.44%) were diagnosed as adenocarcinoma stomach. The overall mean age for carcinoma was 47.6 years with a mild male preponderance. Thirty cases (61.2%) were of intestinal type, (n=11; 22.4%) were of diffuse type and (n=8; 16.3%) were mixed type of adenocarcinoma. According to WHO classifi cation the most common subtype was tubular adenocarcinoma (n=35; 71.5%) followed by signet ring type (11 cases; 22.4%). Out of 49 cases of adenocarcinoma stomach 39 cases (79.5%) were Helicobacter Pylori positive. Conclusion: This study shows that gastric carcinoma is a male predominant neoplasm usually of old age but can occur at younger ages. It predominantly occurs in Helicobacter Pylori infected patients and H. Pylori eradication will help to decrease the incidence rate and mortality of stomach cancer. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 403-407 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7869

Downstaging capacity of neoadjuvant chemotherapy in distal versus proximal gastric carcinoma: Preliminary data from a regional tumor registry.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 120-120
Author(s):  
Benjamin Garlipp ◽  
Frank Meyer ◽  
Elke Burger ◽  
Daniela Adolf ◽  
Patrick Stuebs ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Preliminary Data ◽  
Statistical Power ◽  
Locally Advanced ◽  
Stage Iv ◽  
Curative Intent ◽  
Tumor Registry ◽  
Gastric Cancers ◽  
Tumor Stages

120 Background: Following the results of 3 randomized controlled trials, neoadjuvant chemotherapy has become standard of care for locally advanced gastric cancer in Europe. All of these trials included patients with cancers located in the gastric corpus, antrum, and pylorus (distal gastric cancers, DGC) as well as cancers of the esophagogastric junction and fundus (proximal gastric cancers, PGC). However, data suggest that DGC and PGC may be two distinct tumor entities. The aim of our study was to investigate if the capacity of neoadjuvant chemotherapy to downstage gastric cancers is different for DGC and PGC. Methods: We used data from the clinical regional tumor registry of Magdeburg which covers the northern section of the federal district of Saxony-Anhalt, Germany, to compare pretherapeutic (clinical) and postoperative (histopathological) UICC tumor stages in patients with DGC and PGC treated with neoadjuvant chemotherapy followed by surgery. Results: Of 2,460 gastric cancer patients entered into the registry between January 1993 and September 2010, 189 (7.7%) received neoadjuvant chemotherapy. Of these, 149 underwent surgery with curative intent. Pretherapeutic and postoperative UICC stages were not available for 34 of these patients. A further 42 patients had UICC stage IV documented at laparotomy; since this was likely due to peritoneal carcinomatosis which may have gone unnoticed at the start of neoadjuvant chemotherapy and thus does not reliably indicate upstaging, these patients were excluded from analysis. Of the 73 evaluable patients, 33 (45.2%) had DGC and 40 (54.8%) had PGC. UICC tumor stage decreased during therapy in 55.1% and 75.0%, remained unchanged in 16.3% and 20.8%, and increased in 28.6% and 4.2% of DGC and PGC patients, respectively (p=0.039, Fisher’s exact test). Conclusions: Despite the limited statistical power, these preliminary data suggest that DGC and PGC may differ in their response to neoadjuvant chemotherapy. With more widespread use of neoadjuvant chemotherapy in gastric cancer in recent years, we expect a steep increase in evaluable patients in the tumor registry which will allow for future multivariate analyses regarding this issue.

Phase I study of neoadjuvant chemotherapy with xeloda and oxaliplatin (G-XELOX) for locally advanced gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 149-149
Author(s):  
Hironaga Satake ◽  
Masato Kondo ◽  
Takeshi Kotake ◽  
Yoshihiro Okita ◽  
Takatsugu Ogata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Maximum Tolerated Dose ◽  
Curative Intent ◽  
Locally Advanced Gastric Cancer ◽  
Level 1 ◽  
One Year ◽  
Type 3

149 Background: Prognosis for locally advanced gastric cancer, such as clinical T4 disease, bulky nodal involvement, type 4 and large type 3 gastric cancer, remains unsatisfactory, even with D2 gastrectomy followed by adjuvant chemotherapy. Neoadjuvant chemotherapy is a promising approach, and combination chemotherapy with Xeloda and oxaliplatin (G-XELOX) is recognized as a potentially promising regimen for gastric cancer. However, the use of neoadjuvant chemotherapy consisting of G-XELOX for locally advanced gastric cancer has not been reported. The aim of this study was to evaluate the incidence of dose limiting toxicities (DLTs) during the neoadjuvant chemotherapy and to determine the maximum tolerated dose (MTD) and recommended dose of preoperative chemotherapy combined with oxaliplatin with a fixed Xeloda dose for locally advanced gastric cancer. Methods: Patients received two cycles of neoadjuvant chemotherapy with oxaliplatin on day 1, as well as Xeloda (2000 mg/m2/day, b.i.d.) for 14 days, repeatedly every 3 weeks. They then underwent gastrectomy with curative D2/3 lymph-node dissection followed by adjuvant S-1 (80 mg/m2/day, b.i.d.) for one year. A decrease of oxaliplatin dose was planned (starting at level 1, 130 mg/m2). Results: Six patients (5 male, 1 female) with a median age of 72 (range 68-79) were enrolled. MTD was not reached at level 1. Oxaliplatin 130 mg/m2 in combination with Xeloda 2000 mg/m2/day, b.i.d. could be administered with acceptable toxicity. No treatment-related death was observed. Most frequent drug-related AEs during the neoadjuvant chemotherapy period were G1 anemia, G1/2 thrombocytopenia and G1 peripheral neuropathy. One patient refused surgical resection, therefore five received resection with curative intent. Of the five patients, all achieved a pathological downstaging after neoadjuvant G-XELOX therapy. The incidence of operative morbidity was tolerable. Conclusions: Neoadjuvant chemotherapy with G-XELOX regimen was feasible by patients with locally advanced gastric cancer. Clinical trial information: UMIN000015950.

scholarly journals Prediction of Sensitivity and Efficacy of Clinical Chemotherapy Using Larval Zebrafish Patient-Derived Xenografts of Gastric Cancer

2021 ◽  
Vol 9 ◽  
Author(s):  
Jing Zhai ◽  
Jiaqi Wu ◽  
Yaohui Wang ◽  
Ruoyue Fan ◽  
Guiping Xie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Early Stage ◽  
Locally Advanced ◽  
Human Tumor ◽  
Curative Intent ◽  
Drug Dosing ◽  
Larval Zebrafish ◽  
Locally Advanced Gastric Cancer ◽  
Gastric Cancer Patients

BackgroundPerioperative chemotherapy has been accepted as one of the most common approaches for locally advanced gastric cancer. However, the efficacy of chemotherapy varies among patients, and there is no effective method to predict the chemotherapy efficacy currently. We previously established the first larval zebrafish patient-derived xenografts (zPDXs) of gastric cancer as a platform for the translational research and personalized treatment. The objective of this study was to investigate the feasibility of screening individualized chemotherapeutics using the zPDXs.MethodsWe further optimized this zPDXs platform including administration route, drug dosing, and rhythm to develop a stable and reliable protocol for chemotherapeutics screening. Using the novel platform, we investigated the chemosensitivity of 5-fluorouracil, cisplatin, docetaxel, and doxorubicin for gastric cancer patients.ResultsWe showed that the engrafted zebrafish retained the original prominent cell components of the corresponding human tumor tissues, and we successfully obtained the results of chemosensitivity of 5-fluorouracil, cisplatin, docetaxel, and doxorubicin for 28 patients with locally advanced gastric cancer. These patients underwent radical gastrectomy for curative intent and 27 cases received postoperative adjuvant chemotherapy. We revealed that the chemosensitivity obtained from zPDXs was consistent with the clinical responses in these patients (P = 0.029). More importantly, the responder drug(s) from zPDXs used or not was the only risk factor for early-stage recurrence in these 27 patients (P = 0.003).ConclusionOur study with the largest sample size so far suggests that larval zPDXs help to predict the chemotherapeutics response and to achieve precise chemotherapy for gastric cancer.

scholarly journals Surgical Management of Gastric Cancer: A Systematic Review

2021 ◽  
Vol 10 (12) ◽  
pp. 2557
Author(s):  
Lucian Mocan
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Malignant Tumors ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Surgical Care ◽  
High Volume ◽  
Resection Margins ◽  
Curative Intent ◽  
Surgical Aspects

Gastric cancer is the fifth most common cancer worldwide, and it is responsible for 7.7% of all cancer deaths. Despite advances in the field of oncology, where radiotherapy, neo and adjuvant chemotherapy may improve the outcome, the only treatment with curative intent is represented by surgery as part of a multimodal therapy. Two concepts may be adopted in appropriate cases, neoadjuvant treatment before gastrectomy (G) or primary surgical resection followed by chemotherapy. Such an approach, combined with early detection and better screening, has led to a decrease in the overall incidence of gastric cancer. Unfortunately, malignant tumors of the stomach are often diagnosed in locally advanced or metastatic stages when the median overall survival remains poor. Surgical care in these cases must be provided by a multidisciplinary team in a high-volume center. Important surgical aspects such as optimum resection margins, surgical technique, and number of harvested lymph nodes are important factors for patient outcomes. The standardization of surgical treatment of gastric cancer in accordance with the patient’s profile is of decisive importance for a better outcome. This review aims to summarize the current standards in the surgical treatment of gastric cancer.

scholarly journals Laparoscopic Management of Benign Ovarian Masses

2013 ◽  
Vol 52 (192) ◽  
Author(s):  
Rachana Saha ◽  
Chanda Karki
Keyword(s):  
Laparoscopic Surgery ◽  
College Teaching ◽  
Operative Techniques ◽  
Medical College ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Endometriotic Cyst ◽  
Operative Findings ◽  
A Prospective Study ◽  
Laparoscopic Assisted ◽  
Ovarian Masses

Introduction: Laparoscopic surgery is one of the most common procedures performed for benign ovarian masses. The aim of the study was to analyze all benign ovarian masses treated laparoscopically to assess safety, feasibility and outcome.Methods: A prospective study was carried out at Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal. All the patients undergoing laparoscopic surgery for benign ovarian masses from 1st January 2012 to 31st December 2012 were included in the study. The pre-operative findings, intra-operative findings, operative techniques and post-operative complications were analyzed.Results: Thirty-six patients were taken for the study. Two cases were excluded since intra-operatively they were tubo-ovarian masses. The most common tumor was dermoid cyst (n=13; 38.23%) and endometriotic cyst (n=14; 41.17%). Out of 34 cases, five cases of endometriotic cyst (14.70%) were converted to laparotomy due to severe adhesions and four cases of endometriotic cyst underwent deroofing surgery. Two cases underwent laparoscopic assisted vaginal hysterectomy with bilateral salphingo-oopherectomy. Successful cystectomies were carried out in 22 cases. None were malignant. Major complications were not noted while minor complications like port-site infection (n=3; 8.82%) and subcutaneous emphysema (n=1; 2.9%) were present.Conclusions: Laproscopic management of benign ovarian masses is safe and feasible.

Phase II Study of Oxaliplatin, Fluorouracil, and Folinic Acid in Locally Advanced or Metastatic Gastric Cancer Patients

2002 ◽  
Vol 20 (23) ◽  
pp. 4543-4548 ◽  
Author(s):  
C. Louvet ◽  
T. André ◽  
J.M. Tigaud ◽  
E. Gamelin ◽  
J.Y. Douillard ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Folinic Acid ◽  
Performance Status ◽  
Locally Advanced ◽  
Metastatic Gastric Cancer ◽  
Curative Intent ◽  
Suitable Alternative ◽  
Best Response ◽  
Grade 3 ◽  
Gastric Cancer Patients

PURPOSE: To evaluate the efficacy and safety of an oxaliplatin, fluorouracil (5-FU), and folinic acid (FA) combination in patients with metastatic or advanced gastric cancer (M/AGC). PATIENTS AND METHODS: Of the 54 eligible patients with measurable or assessable M/AGC, 53 received oxaliplatin 100 mg/m2 and FA 400 mg/m2 (2-hour intravenous infusion) followed by 5-FU bolus 400 mg/m2 (10-minute infusion) and then 5-FU 3,000 mg/m2 (46-hour continuous infusion) every 14 days. RESULTS: Patients (69% male, 31% female) had a median age of 61 years (range, 31 to 75 years), 89% had a performance status of 0 or 1, 70% had newly diagnosed disease, and 87% had metastatic disease. All had histologically confirmed adenocarcinoma. With a median of three involved organs, disease sites included the lymph nodes (67%), stomach (65%), and liver (61%). A median of 10 cycles per patient and 468 complete cycles were administered. Best responses in the 49 assessable patients were two complete responses and 20 partial responses, giving an overall best response rate of 44.9%. Eight patients underwent complementary treatment with curative intent (six with surgery and two with chemoradiotherapy). Median follow-up, time to progression, and overall survival were 18.6 months, 6.2 months, and 8.6 months, respectively. Grade 3/4 neutropenia, leukopenia, thrombocytopenia, and anemia occurred in 38%, 19%, 4%, and 11% of patients, respectively, and febrile neutropenia occurred in six patients (one episode each). Grade 3 peripheral neuropathy occurred in 21% of patients (oxaliplatin-specific scale). Seven patients withdrew because of treatment-related toxicity. CONCLUSION: This oxaliplatin/5-FU/FA regimen shows good efficacy and an acceptable safety profile in M/AGC patients, and may prove to be a suitable alternative regimen in this indication.

CPT-11/Cisplatin neoadjuvant therapy downstages locally advanced gastric cancer

2001 ◽  
Vol 120 (5) ◽  
pp. A129-A129
Author(s):  
E NEWMAN ◽  
S MARCUS ◽  
M POTMESIL ◽  
H HOCHSTER ◽  
H YEE ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Therapy ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Locally Advanced Gastric Cancer
Sign in / Sign up

Export Citation Format

Share Document