Table of Contents
1
UI - 11405085
AU - Piso P; Werner U; Benten D; Bektas H; Meuer U; Klempnauer J
TI -
Early gastric cancer--excellent prognosis after curative resection in 87
patients irrespective of submucosal infiltration, lymph-node metastases
or tumor size.
SO - Langenbecks Arch Surg 2001 Feb;386(1):26-30
AD - Klinik fur Viszeral- und Transplantationschirurgie, Zentrum Chirurgie,
Medizinische Hochschule Hannover, Carl Neuberg Strasse 1, 30625
Hannover, Germany. piso.pompiliu@mh-hannover.de
BACKGROUND AND AIMS: Despite a decreasing incidence of primary gastric
carcinoma over the last decade, the incidence of early gastric cancer
has remained unchanged. Some aspects of the surgical treatment (e.g.,
extent of resection, lymphadenectomy) are still controversially
1999, 87 patients were operated upon due to primary early gastric
adenocarcinoma. All patients data were analyzed retrospectively.
RESULTS: Of 626 patients with primary gastric carcinoma, 87 (13.9%) had
an early carcinoma (54 men, 33 women; median age 61 years). In all
patients, curative (R0-) gastrectomy could be performed, total in 62
patients (71.4%) and subtotal in 25 patients (28.6%). Postoperative
morbidity was 23% and mortality 4.5%. Mucosal tumors were found in 34
(39.1%) and submucosal in 53 (60.9%) patients. Multicentricity was
present in eight cases (9.1%). Twelve patients (13.8%) had lymph-node
metastases. The 5-year survival rate was 88.8%. The submucosal
infiltration, the lymph-node infiltration, the histological type, and
the tumor size had no statistically significant impact on prognosis.
CONCLUSION: Radical resection of early gastric cancer cured most of the
patients, irrespective of lymph-node metastases or tumor size.
Multicentricity, increasing incidence of proximal cancers, and low
mortality suggest that total gastrectomy may be indicated. Patients with
early gastric cancer may benefit from D2-lymphadenectomy, but this has
to be assessed in further randomized studies, in particular for those
with small mucosal tumors.
2
UI - 11552474
AU - Zucchetti F; Negro F; Matera D; Cagossi M
TI -
Gastric cancer in the elderly.
SO - Ann Ital Chir 2001 Mar-Apr;72(2):181-6
AD - Istituto di Clinica Chirurgica Generale, Universita Cattolica del Sacro
Cuore, Roma.
Nowadays an increased number of elderly patients undergo surgery for
gastric cancer. The old age by itself does not seem to represent a
prohibitive risk factor anymore. Two groups of patients operated on of
gastric cancer at our surgical unit (Group A = 378 patients younger or
as old as 65 years and Group B = 330 patients older than 65 year) were
compared. There were not statistically significant differences between
the two groups in terms of number of performed radical exereses (57.7%
vs. 42.3% respectively), kind of resective operation (total gastrectomy
or subtotal gastrectomy) and extent of lymphadenectomy (D2-D3 type:
64.7% vs 63.8% respectively). The location of tumor, the distribution by
stage and the long term survival of radically resected cases were not
statistically different in the two groups of patients. Five-year
survival after radical resection was 56.8% and 54.0% respectively. We
conclude that elderly patients in good clinical conditions affected by
gastric cancer should undergo radical resection with lymphadenectomy
such extensive as D2-D3 type.
3
UI - 11686031
AU - Aiba K
TI -
Upper gastrointestinal tumors.
SO - Cancer Chemother Biol Response Modif 2001;19():535-45
AD - Japanese Foundation for Cancer Research, Cancer Chemotherapy Center,
Kami-Ikebukuro 1-37-1, Toshima-ku, Tokyo 170-8455, Japan.
4
UI - 11816133
AU - Markus B; Pinter G
TI -
[Partial versus total gastrectomy in the surgical treatment of stomach
cancer]
SO - Magy Seb 2001 Dec;54(6):361-7
AD - Vas Megye es Szombathely Megyei Jogu Varos Markusovszky Korhaza,
Egyetemi Oktatokorhaz, Altalanos Sebeszeti Osztaly, 9700 Szombathely,
Markusovszky u. 3.
The authors discuss some aspects of radical gastrectomy. They analyse
whether there is any progress in their results in the treatment of
stomach cancer in the past 5 years. They describe some aspects of total
gastrectomy with regards to the need for splenectomy. During 36 years
(01.07.1952-30.06.1962 and 1974-1999) 1614 patients were treated for
stomach cancer. In the last two 5 year long periods (1990-1994 and
1995-1999) the number of radical operations was 106 and 114. In the
second period we used laparoscopic exploration in some patients. We
carried out total gastrectomies with modern suturing devices (AutoSuture
Premium Plus CEEA, Proximate ILS Straight Intraluminal Stapler Endo
Surgery, TA Premium) without compromising the principles of radicality
using Rochard-Aesculap retractor in most patients. We tried to avoid
splenectomy when possible. In the past 5 years we carried out
lymphadenectomy according to the Japanese classification, excising group
I and II lymph nodes. The resectability rate rose in the last 6 years
compared to the previous ten year period (55.3%, 36.1%, 48.4%, 64.3%).
The ratio of total gastrectomies increased from 8.6% (10 out of 106
resections) to 42.9% (49 out of 114 resections) in the two 5 year
periods. Mortality for partial and total gastrectomy were 4.6% (65/3)
and 6.1% (49/3). They could preserve the spleen in 32.6% of the cases.
We found that laparoscopic exploration rarely influenced the operation.
Partial resection in intestinal type stomach cancer should be performed,
if a margin of 6 cm can be achieved. If the patient is in good general
health, total gastrectomy should be performed unless the size, type and
lymph node involvement of the cancer indicated otherwise. We think that
increased resectability is related to both increased capabilities and
better diagnostic tools. It is important to preserve the spleen where
oncology principals allow.
5
UI - 11484287
AU - Belchev B; Belchev N
TI -
[Surgical treatment outlook for gastric carcinoma (a 10-year
retrospective study)]
SO - Khirurgiia (Sofiia) 2000;56(2):38-9
After analyzing clinical material of 159 patients with gastric cancer
into Surgical department of the Regional hospital in Dobrich, the
authors signified the tendency of later coming for surgery of
predominant patients. The part of 66.8% patients coming in 3rd and 4th
stage of disease is disturbing. The subtotal resection and gastrectomy
like a method of choice are 40.4% with a something more true survival
chances.
6
UI - 11484290
AU - Gaydarsky R; Tasev V; Draganov K; Yonkov A; Bulanov D
TI -
[Carcinoma of the stomach - our experience with surgical treatment]
SO - Khirurgiia (Sofiia) 2000;56(2):5-9
Carcinoma of the stomach is among the commonest malignancies of the
gastrointestinal tract regardless of the permanent tendency of its
diffusion to decrease, observed in the last 25-30 years. The readily
accessible methods of diagnosing the disease contribute greatly to its
early detection. However, owing to diverse causes, in over 70 per cent
of cases the diagnosis is usually made as late as in the advanced III-IV
stages. The latter circumstance preordains largely the unfavourable
long-term results of the treatment undertaken where surgery plays a
major role. It is the purpose of this study to analyze the surgical
strategy and tactics currently used in the management of gastric
carcinoma. Over a 5-year period (Jan 1995 through Dec 1999), in the
Chair of General and Operative Surgery of the Medical University--Sofia
a total of 184 gastric carcinoma patients, including 116 men (63.1%) and
68 women (36.9%) with age ranging from 23 to 80 years, undergo
operation. Diagnosing is based on past history, physical, laboratory and
x-ray data, but first and foremost on evidence from FGS and histological
assessment of biopsy material (carried out in all patients). With a view
to precise preoperative staging of the lesion, roentgenoscopy +
roentgenography of lungs, USD and CAT of the abdominal organs are also
done. The following intervention are performed: gastrectomy 18 (9.8%),
upper pole resection 43 (23.4%), subtotal resection of stomach 4 (2.2%),
prosthetic replacement of cardia 8 (4.3%), derivations 22 (11.9%), and
explorative laparotomies. Combined subtotal gastric resections of
gastrectomies are necessitated in 73 patients (39.7%) because of
carcinomatous infiltration of contiguous organs and/or presence of liver
metastases. Morbidity involves 29 patients (15.7%) with lethality
amounting to 16 (8.7%). The long-term postoperative results are
discussed under a separate heading. Operative treatment of gastric
carcinoma patients is the only chance of survival. The scope of
indication for more aggressive surgical interventions, including
combined resections and gastrectomies, are broadened leading in turn to
a considerable reduction of the proportion of explorative laparotomies.
7
UI - 11852408
AU - Huntsman D; Carneiro F; Lewis F; MacLeod P; Hayashi A; Monaghan K; Maung
TI -
R; Seruca R; Jackson C; Caldas C
[Prophylactic gastrectomy in patients with deleterious E-cadherin gene
mutation]
SO - Gastroenterol Clin Biol 2001 Oct;25(10):931-2
AD - Hopital Europeen Georges-Pompidou, Paris, France.
8
UI - 11902529
AU - Du MQ; Isaccson PG
TI -
Gastric MALT lymphoma: from aetiology to treatment.
SO - Lancet Oncol 2002 Feb;3(2):97-104
AD - Department of Histopathology, Royal Free and University College Medical
School, University College London, UK. m.du@ucl.ac.uk
The development of gastric mucosa-associated lymphoid tissue (MALT)
lymphoma is dependent on Helicobacter pylori infection. Bacterial
colonisation of the gastric mucosa triggers lymphoid infiltration and
the formation of acquired MALT. The bacterial infection induces and
sustains an actively proliferating B-cell population through direct
(autoantigen) and indirect (intratumoral T cells specific for H. pylori)
immunological stimulation. Moreover, the bacterial infection provokes a
neutrophilic response, which causes the release of oxygen free radicals.
These reactive species may promote the acquisition of genetic
abnormalities and malignant transformation of reactive B cells. A
transformed clone carrying the translocation t(1;18)(q21;q21) forms a
MALT lymphoma, the growth of which is independent of H. pylori and will
not respond to bacterial eradication. Malignant clones without
t(11;18)(q21;q21), but with other genetic abnormalities, such as trisomy
3 or microsatellite instability, depend critically on immune stimulation
mediated by H. pylori for their clonal expansion. In the early stages,
the tumour can be successfully treated by eradication of the bacterium,
whereas at later stages the tumour may escape its growth dependency
through acquisition of additional genetic abnormalities such as
t(1;14)(p22;q32) and t(1;2)(p22,p12) involving the BCL-10 gene. Finally,
further genetic abnormalities, such as inactivation of the tumour
suppressor genes, p53 and p16, can lead to high-grade transformation.
Detection of these abnormalities may help with the clinical management
of patients with gastric MALT lymphoma.
9
UI - 11865370
AU - Nogueira C; Silva AS; Santos JN; Silva AG; Ferreira J; Matos E; Vilaca H
TI -
Early gastric cancer: ten years of experience.
SO - World J Surg 2002 Mar;26(3):330-4
AD - Surgery Department, Surgery 1, Hospital Geral de Santo Antonio, Largo
Prof. Abel Salazar, 4000 Oporto, Portugal. carlosnog2001@yahoo.com
Gastric cancer is a disease in which the main treatment is surgical
extirpation. The modifications introduced in the surgical treatment over
the last decades were accompanied by a clear increase of survival, which
reaches global values of 61% at 5 years in Japan. One of the reasons
that contribute to this improvement is early diagnosis of the lesions.
In the period between January 1, 1990 and December 31, 1999 662 patients
with gastric adenocarcinoma were treated in the Service of Surgery 1 of
our hospital; 110 were refused surgical treatment. Of the resected
patients, 91 (21.4%) were classified as early gastric cancer according
to the definition of the Japanese Society of Digestive Endoscopy. There
were 30 women and 61 men, with a median age of 60.2 +/- 15 years; 3
patients had a preoperative diagnosis of gastric ulcer; 2 others were
operated without recent histology; and 1 patient was urgently resected
for a bleeding ulcer. In all the remaining patients biopsy confirmed the
presence of cancer (89%) or serious dysplasia (4.6%). The lesions had
been distributed essentially in the medium 1/3 (48.3%) and distal 1/3 of
the stomach. Subtotal gastrectomy was accomplished in 48 patients, total
gastrectomy in 40, total desgastrogastrectomy in 3, and in 9 patients
the surgery involved the spleen (8 patients) and the spleen and tail of
the pancreas in 1 patient. Lymphadenectomy was not performed in 5
patients, lymph nodes by the first lymph node barrier were removed in 25
patients and by the second barrier in 61 patients (67%). Median tumor
size was 26 +/- 1.8 mm. The lesion reached the mucosa in 46 patients and
the mucosa and submucosa in 45. In 6 patients the removed lymph nodes
were microscopically invaded (6.7%). Five patients died (5.7%). The
median follow-up of the patients is 41 +/- 26 months; 7 patients died
(8.1%) during this period; 4 died unequivocally of disease progression.
The median survival of patients was 85% at 5 years and 80% at 10 years.
In our series, survival was affected by the presence of invaded lymph
nodes, not by the penetration in depth of the lesion or the size of the
tumor.
10
UI - 11865371
AU - Hoksch B; Ablassmaier B; Zieren J; Muller JM
TI -
Quality of life after gastrectomy: Longmire's reconstruction alone
compared with additional pouch reconstruction.
SO - World J Surg 2002 Mar;26(3):335-41
AD - University Department of Surgery, Charite/Humboldt-University,
Schumannstrasse 20/21, D-10117 Berlin, Germany.
The optimal reconstruction protocol after total gastrectomy is still a
matter of debate. Pouch reconstructions are developed to create a larger
reservoir for food, to provide a barrier against intestinoesophageal
reflux, and to lengthen the food transit time. Preservation of the
duodenal passage should result in better physiologic regulation of the
ingested food. Controlled randomized clinical studies must be conducted
to assess the quality of life after gastrectomy and various types of
reconstruction. In the present trial, which compared Longmire's
reconstruction without a pouch and Longmire's reconstruction with a
pouch of varying sizes, we evaluated the quality of life for 41 patients
during the first postoperative year. The quality of life was examined by
an EORTC questionnaire and an organ-specific module. There were no
statistically proven benefits for pouch reconstruction in comparison
with Longmire's reconstruction alone. Some benefits are shown for the
large pouch but it was only a trend. This is especially so with regard
to diarrhea and food consumption. A definitive answer to the question
about the value of a pouch reconstruction after gastrectomy has not yet
been attained. It is possible that there will be significant differences
between reconstruction groups during the long-term follow-up.
11
UI - 11869332
AU - Kun L; Yun-Jie W; Qing-Shu C; Dao-Xi W; Zhen-Yuan Z
TI -
Emergency re-operation for postoperative hemorrhage following partial
esophagectomy for carcinoma of the esophagus and cardia of the stomach.
SO - Dis Esophagus 2001;14(3-4):251-3
AD - Department of Thoracic Surgery, The 4th Military Medical University,
Tang Du Hospital, Xian, PR, China. liukun@fmmu.edu.cn
The clinical records of 12 cases of emergency re-operation for
management of postoperative hemorrhage (POH) following partial
esophagectomy and esophago-gastrostomy or colonic interposition for a
group of 3690 cases of carcinoma of the esophagus (CE) and cardia of the
studied. There were 10 survivors and two deaths, giving a mortality rate
of 16.6% (2/12). It was concluded that an emergency re-operation was a
cardinal surgical procedure to save the patient's life if a serious POH
had developed. The POH could be prevented by a careful, conscientious
and strict hemostasis during the primary operation. The criteria for the
diagnosis are presented.
12
UI - 11054376
AU - Fischbach W; Dragosics B; Kolve-Goebeler ME; Ohmann C; Greiner A; Yang
TI -
Q; Bohm S; Verreet P; Horstmann O; Busch M; Duhmke E; Muller-Hermelink
HK; Wilms K; Allinger S; Bauer P; Bauer S; Bender A; Brandstatter G;
Chott A; Dittrich C; Erhart K; Eysselt D; Ellersdorfer H; Ferlitsch A;
Fridrik MA; Gartner A; Hausmaninger M; Hinterberger W; Hugel K; Ilsinger
P; Jonaus K; Judmaier G; Karner J; Kerstan E; Knoflach P; Lenz K;
Kandutsch A; Lobmeyer M; Michlmeier H; Mach H; Marosi C; Ohlinger W;
Oprean H; Pointer H; Pont J; Salabon H; Samec HJ; Ulsperger A; Wimmer A;
Wewalka F
Primary gastric B-cell lymphoma: results of a prospective multicenter
study. The German-Austrian Gastrointestinal Lymphoma Study Group.
SO - Gastroenterology 2000 Nov;119(5):1191-202
AD - Medizinische Klinik II, Klinikum Aschaffenburg, Aschaffenburg, Germany.
BACKGROUND & AIMS: Appropriate management of primary gastric lymphoma is
controversial. This prospective, multicenter study aimed to evaluate the
accuracy of endoscopic biopsy diagnosis and clinical staging procedures
and assess a treatment strategy based on Helicobacter pylori status and
tumor stage and grade. METHODS: Of 266 patients with primary gastric
B-cell lymphoma, 236 with stages EI (n = 151) or EII (n = 85) were
included in an intention-to-treat analysis. Patients with H.
pylori-positive stage EI low-grade lymphoma underwent eradication
therapy. Nonresponders and patients with stage EII low-grade lymphoma
underwent gastric surgery. Depending on the residual tumor status and
predefined risk factors, patients received either radiotherapy or no
further treatment. Patients with high-grade lymphoma underwent surgery
and chemotherapy at stages EI/EII, complemented by radiation in case of
incomplete resection. RESULTS: Endoscopic-bioptic typing and grading and
clinical staging were accurate to 73% and 70%, respectively, based on
the histopathology of resected specimens. The overall 2-year survival
rates for low-grade lymphoma did not differ in the risk-adjusted
treatment groups, ranging from 89% to 96%. In high-grade lymphoma,
patients with complete resection or microscopic tumor residuals had
significantly better survival rates (88% for EI and 83% for EII) than
those with macroscopic tumor residues (53%; P < 0.001). CONCLUSIONS:
There is a considerable need for improvement in clinical diagnostic and
staging procedures, especially with a view toward nonsurgical treatment.
With the exception of eradication therapy in H. pylori-positive
low-grade lymphoma of stage EI and the subgroup of locally advanced
high-grade lymphoma, resection remains the treatment of choice. However,
because there is an increasing trend toward stomach-conserving therapy,
a randomized trial comparing cure of disease and quality of life with
surgical and conservative treatment is needed.
13
UI - 11762812
AU - Mackay HJ; McInnes A; Paul J; Raby N; Lofts FJ; McDonald AC; Soukop M;
TI -
Fullarton GM; Harris AL; Garcia-Vargas J; Evans TR
A phase II study of epirubicin, cisplatin and raltitrexed combination
chemotherapy (ECT) in patients with advanced oesophageal and gastric
adenocarcinoma.
SO - Ann Oncol 2001 Oct;12(10):1407-10
AD - CRC Department of Medical Oncology Beatson Oncology Centre, Western
Infirmary, Glasgow, UK. hjmklz@udcf.gla.ac.uk
BACKGROUND: The aim of this study was to evaluate the efficacy of the
combination of epirubicin, cisplatin and ralitrexed (Tomudex). ECT, in
patients with advanced oesophageal or gastric adenocarcinoma. Efficacy
was assessed primarily as response rate and secondarily in terms of
toxicity, time to progression and survival. PATIENTS AND METHODS:
Twenty-one patients with histologically and/or cytologically proven
unresectable (7) or metastatic (14) gastro-oesophageal adenocarcinoma,
who had bi-dimensionally measurable disease, with ECOG performance
status < or = 2. with adequate haematological, hepatic and renal
function received first-line chemotherapy with epirubicin (50 mg/m2).
cisplatin (60 mg/m2) and Tomudex (2.5 mg/m2), ECT, at three-weekly
intervals. Treatment consisted of three cycles of chemotherapy, with a
further three cycles if there was disease response or stabilisation.
RESULTS: ECT is an active regimen in the treatment of advanced
gastro-oesophageal adenocarcinoma with an overall intention-to-treat
response rate of 29% (95% confidence intervals (CI): 11%-52%). In
addition, 4 (19%) patients had stable disease. Median time to
progression was 19 weeks (95% CI: 7-31 weeks). Median overall survival
was 18 weeks (95% CI: 11-24 weeks). Seventeen patients failed to
complete the six cycles of treatment due to disease progression (5).
toxicity (3), non-toxic death (1 pulmonary embolism, 1 cardiac), severe
allergy to epirubicin (1), patient decision (1) and five patients after
the study was discontinued early due to toxicity. There were three toxic
deaths: two due to sepsis complicating neutropaenia and one due to
cardiorespiratory failure following drug induced enteritis. Nine
patients experienced grade 3 or 4 neutropaenia, two patients experienced
grade 3 or 4 nausea and vomiting and one patient had grade 4 diarrhoea.
CONCLUSIONS: The combination of epirubicin, cisplatin and tomudex is
active against advanced gastro-oesophageal adenocarcinoma but the
toxicity suggests that further evaluation in a randomised comparison to
ECF is not appropriate.
14
UI - 11872061
AU - Gillison EW; Powell J; McConkey CC; Spychal RT
TI -
Surgical workload and outcome after resection for carcinoma of the
oesophagus and cardia.
SO - Br J Surg 2002 Mar;89(3):344-8
AD - Department of Surgery, City Hospital, Cancer Research Campaign Clinical
Trials Unit, University of Birmingham, Birmingham, UK.
BACKGROUND: Performing cancer surgery in high-volume centres may lead to
improved outcomes. This study explored the relationship between annual
workload and outcome following resection for carcinoma of the oesophagus
and cardia. METHODS: The study was a retrospective case-note review of
1125 patients who had surgery for cardio-oesophageal cancer in the West
Midlands region of England. Outcome measures were 30-day mortality and
long-term survival. RESULTS: The overall 30-day mortality rate was 10.0
per cent with a median survival of 14 months and a 5-year survival rate
of 17.2 per cent. Increasing age, advanced stage of disease and
emergency resection independently affected outcome adversely. Forty-one
infrequent operators (fewer than four resections per year) performed 146
resections (13.0 per cent), 18 intermediate operators (between four and
11 resections per year) performed 488 resections (43.4 per cent) and
five frequent operators (12 or more resections per year) performed 491
resections (43.6 per cent). The 30-day mortality rate was greatest in
the infrequent group (15.1 per cent) compared with both the intermediate
group (6.6 per cent; adjusted odds 0.40, P = 0.004) and the frequent
group (11.8 per cent; odds 0.73, P = 0.28). There were no differences in
survival rates between the groups, and no difference in outcome between
high- and low-volume hospitals. CONCLUSION: In this unselected
population-based series there was little evidence of a trend of
improving 30-day mortality rate with increasing workload, or between
workload and long-term survival.
15
UI - 11798956
AU - Chen J; Wang S; Xu H
TI -
[Curative effect of radical gastrectomy combined with peritoneal lavage
with thermal hypoosmotic solution in treatment of gastric cancer]
SO - Zhonghua Yi Xue Za Zhi 2001 Jun 25;81(12):730-2
AD - China Medical University Cancer Institute, Shenyang 110001, China.
OBJECTIVE: To evaluate the curative effect and indications of radical
gastrectomy combined with peritoneal lavage with thermal hypoosmotic
solution, double distilled water (DDW) or DDW plus chlorhexidine
acetate, in treatment of gastric cancer. METHODS: Five hundred cases of
underwent radical gastrectomy and peritoneal lavage for 10 minutes with
400 ml of DDW at 43 degrees C, group B, with 89 cases who underwent
radical gastrectomy and peritoneal lavage for ten minutes with 4 000 ml
of DDW plus 0.6 g chlorhexidine acetate, and group C, with 213 cases who
underwent radical gastrectorny and peritoneal lavage for four minutes
with 4 000 ml of normal saline at normal temperature as controls.
RESULTS: The group A and group B (called lavage group as a whole) had
almost the same curative effects. The one-year survival rates and
three-year survival rates were similar among the cases in different
stages in no matter what group. The five-year survival rate was 63.8% in
the lavage group and 51.2% in the control group, most of the cases with
a good effect being at the mid-stage (II and III A stages). CONCLUSION:
Peritoneal lavage, helpful in killing the exfoliated cancer cells in
peritoneal cavity of patients with gastric cancer at II and III A
stages, should be conducted in the treatment of gastric cancer by
radical gastrectomy before closing the abdomen.
16
UI - 11819768
AU - Miehlke S; Kirsch C; Dragosics B; Gschwantler M; Oberhuber G; Antos D;
TI -
Dite P; Lauter J; Labenz J; Leodolter A; Malfertheiner P; Neubauer A;
Ehninger G; Stolte M; Bayerdorffer E
Helicobacter pylori and gastric cancer:current status of the Austrain
Czech German gastric cancer prevention trial (PRISMA Study).
SO - World J Gastroenterol 2001 Apr;7(2):243-7
AD - Medical Department I, Technical University Hospital Carl Gustav Carus,
Fetscherstrabetae 74, D 01307 Dresden, Germany.
AIM: To test the hypothesis that Helicobacter pylori eradication alone
can reduce the incidence of gastric cancer in a subgroup of individuals
with an increased risk for this fatal disease. METHODS: It is a
prospective, randomized, double blind, placebo controlled multinational
multicenter trial. Men between 55 and 65 years of age with a gastric
cancer phenotype of Helicobacter pylori gastritis are randomized to
receive a 7 day course of omeprazole 2 X 20mg, clarithromycin 2 X 500mg,
and amoxicillin 2 X 1g for 7 days, or omeprazole 2 X 20mg plus placebo.
Follow-up endoscopy is scheduled 3 months after therapy, and thereafter
in one-year intervals. Predefined study endpoints are gastric cancer,
precancerous lesions (dysplasia, adenoma), other cancers, and death.
patients (18.3%) had a corpus dominant type of H. pylori gastritis, and
167 of those were randomized (58.8%). In the active treatment group (r =
86), H. pylori infection infection was cured in 88.9% of patients.
Currently, the cumulative follow-up time is 3046 months (253.38 patient
years, median follow up 16 months). So far, none of the patients
developed gastric cancer or any precancerous lesion. Three (1.8%)
patients reached study endpoints other than gastric cancer. CONCLUSION:
Among men between 55 and 65 years of age, the gastric cancer phenotype
of H. pylori gastritis appears to be more common than expected. Further
follow up and continuing recruitment are necessary to fulfil the main
aim of the study.
17
UI - 11922582
AU - Hamajima N; Matuo K; Watanabe Y; Suzuki T; Nakamura T; Matsuura A; Yamao
TI -
K; Ohashi K; Tominaga S
A pilot study to evaluate stomach cancer risk reduction by Helicobacter
pylori eradication.
SO - Am J Gastroenterol 2002 Mar;97(3):764-5
18
UI - 11159898
AU - Kurtz RC; Zhang ZF
TI -
Gastric cardia cancer and dietary fiber.
SO - Gastroenterology 2001 Feb;120(2):568-70
19
UI - 11665692
AU - Fishman V; Friedel D
TI -
Inverse association between intake of cereal fiber and risk of gastric
cardia cancer.
SO - Gastroenterology 2001 Oct;121(4):1024-5
20
UI - 11956303
AU - Ikeda N; Shimada Y; Ohtsu A; Boku N; Tsuji Y; Saito H; Koizumi W; Iwase
TI -
H; Yoshida S; Fukuda H
A phase II study of doxifluridine in elderly patients with advanced
gastric cancer: the Japan Clinical Oncology Group Study (JCOG 9410).
SO - Jpn J Clin Oncol 2002 Mar;32(3):90-4
AD - Department of Internal Medicine, Mitoyo General Hospital, Mitoyo-gun,
Kagawa, Japan.
BACKGROUND: A previous phase II study of doxifluridine in non-elderly
patients with advanced gastric cancer demonstrated a favorable survival
with mild toxicity, despite a low response rate. The objectives of this
study were to evaluate efficacy and feasibility of this agent for
elderly patients. METHODS: This study protocol required elderly
patients, aged 76-80 years, with advanced gastric cancer and having no
prior chemotherapy. Doxifluridine, at a dose of 1400 mg/m(2)/day, was
administered for four consecutive days followed by a 10-day rest.
registered. The study was then closed because of poor accrual. Toxicity
was moderate; three patients suffered from grade 3 anemia and one
patient each had grade 3 thrombocytopenia, nausea/vomiting and grade 4
diarrhea. There was one partial response, seven with no change and 10
with progressive disease, yielding a response rate of 5.6%. The median
progression-free survival and median survival time for the 18 patients
were 55 and 164 days, respectively, with a 1-year survival rate of 5.6%.
CONCLUSIONS: Although the number of patients was too small to draw any
definitive conclusions, this study failed to demonstrate the survival
advantage of doxifluridine.
21
UI - 2016625
AU - Wils JA; Klein HO; Wagener DJ; Bleiberg H; Reis H; Korsten F; Conroy T;
TI -
Fickers M; Leyvraz S; Buyse M; et al
Sequential high-dose methotrexate and fluorouracil combined with
doxorubicin--a step ahead in the treatment of advanced gastric cancer: a
trial of the European Organization for Research and Treatment of Cancer
Gastrointestinal Tract Cooperative Group.
SO - J Clin Oncol 1991 May;9(5):827-31
AD - Laurentius Hospital, Roermond, The Netherlands.
In a prospective phase III multicenter trial, 213 patients with advanced
measurable or nonmeasurable gastric cancer were randomized to receive
methotrexate (MTX), fluorouracil (5-FU), and Adriamycin (doxorubicin;
Farmitalia Carlo Erba, Milan, Italy) (FAMTX) or 5-FU, Adriamycin, and
mitomycin (FAM). The results show a significantly superior response rate
(41% v 9% [P less than .0001]), and survival (median, 42 weeks v 29
weeks [P = .004]) for FAMTX. There was a cumulative thrombocytopenia in
FAM and not in FAMTX. The FAMTX protocol should be the reference
treatment in future clinical trials that seek to improve the therapeutic
outcome in advanced gastric cancer.
22
UI - 8996151
AU - Webb A; Cunningham D; Scarffe JH; Harper P; Norman A; Joffe JK; Hughes
TI -
M; Mansi J; Findlay M; Hill A; Oates J; Nicolson M; Hickish T; O'Brien
M; Iveson T; Watson M; Underhill C; Wardley A; Meehan M
Randomized trial comparing epirubicin, cisplatin, and fluorouracil
versus fluorouracil, doxorubicin, and methotrexate in advanced
esophagogastric cancer.
SO - J Clin Oncol 1997 Jan;15(1):261-7
AD - Cancer Research Campaign (CRC) Section of Medicine, Royal Marsden
Hospital, Sutton, Surrey, United Kingdom.
PURPOSE: We report the results of a prospectively randomized study that
compared the combination of epirubicin, cisplatin, and protracted venous
infusion fluorouracil (5-FU) (ECF regimen) with the standard combination
of 5-FU, doxorubicin, and methotrexate (FAMTX) in previously untreated
patients with advanced esophagogastric cancer. PATIENTS AND METHODS: Two
hundred seventy-four patients with adenocarcinoma or undifferentiated
carcinoma were randomized and analyzed for survival, tumor response,
toxicity, and quality of life (QL). RESULTS: The overall response rate
was 45% (95% confidence interval [CI], 36% to 54%) with ECF and 21% (95%
CI, 13% to 29%) with FAMTX (P = .0002). Toxicity was tolerable and there
were only three toxic deaths. The FAMTX regimen caused more hematologic
toxicity and serious infections, but ECF caused more emesis and
alopecia. The median survival duration was 8.9 months with ECF and 5.7
months with FAMTX (P = .0009); at 1 year, 36% (95% CI, 27% to 45%) of
ECF and 21% (95% CI, 14% to 29%) of FAMTX patients were alive. The
median failure-free survival duration was 7.4 months with ECF and 3.4
months with FAMTX (P = .00006). The global QL scores were better for ECF
at 24 weeks, but the remaining QL data showed no differences between
either arm of the study. Hospital-based cost analysis on a subset of
patients was similar for each arm and translated into an increment cost
of $975 per life-year gained. CONCLUSION: The ECF regimen results in a
survival and response advantage, tolerable toxicity, better QL and
cost-effectiveness compared with FAMTX chemotherapy. This regimen should
now be considered the standard treatment for advanced esophagogastric
cancer.
23
UI - 11099333
AU - Ajani JA
TI -
Standard chemotherapy for gastric carcinoma: is it a myth?
SO - J Clin Oncol 2000 Dec 1;18(23):4001-3
24
UI - 11352971
AU - Tebbutt NC; Norman A; Hill M; Cunningham D
TI -
Standard chemotherapy for gastric carcinoma: is it a myth?
SO - J Clin Oncol 2001 May 15;19(10):2765-7
25
UI - 11775185
AU - Tomita R; Fujisaki S; Tanjoh K; Fukuzawa M
TI -
Operative technique on nearly total gastrectomy reconstructed by
interposition of a jejunal J pouch with preservation of vagal nerve,
lower esophageal sphincter, and pyloric sphincter for early gastric
cancer.
SO - World J Surg 2001 Dec;25(12):1524-31
AD - Department of Surgery, Nippon Dental University, Tokyo, Japan.
Nearly total gastrectomy preserving the vagal nerve, the lower
esophageal sphincter (LES), and the pyloric sphincter was developed as a
function-preserving surgical technique to improve postgastrectomy
disorders. In this paper, application criteria and technique are
outlined, and postoperative quality of life was clinically investigated.
Ten subjects who underwent this surgical operation (group A: 7 male and
3 female subjects at age 48 to 68 years with a mean age of 58.3 years)
were interviewed to inquire about reflux esophagitis, dumping syndrome,
and microgastria. Group A was compared with 20 cases of conventional
total gastrectomy with D2 lymphadenectomy, excision of the lower
esophageal sphincter (LES), total vagotomy, and single jejunal
interposition (group B: 16 male and 4 female subjects at age 48 to 72
years with a mean age of 63.9 years). Included were cases with early
cancer (M or SM1 of N0) localizing at the middle third and lower
stomach, which was not applicable to endoscopic excision of gastric
mucosa or partial gastric excision in M cancer, 2 cm or farther from the
margin of the cancer to the esophagogastric mucosa cephalad junction and
3.5 cm or farther from the margin of the cancer to the pyloric caudad
sphincter; in SM1 cancer, 4 cm or farther from the oral-side margin of
the cancer to esophagogastric mucosa junction and 5.5 cm or farther from
the anal-side margin of the cancer to the pyloric sphincter. In excision
with lymph nodes, hepatic and celiac branches bifurcating from anterior
and posterior trunks of the vagal nerve were preserved. To preserve LES,
the esophagus was severed at the His angle at right angle to the
longitudinal axis of the esophagus. The antrum was severed at 1.5 cm
from the pyloric sphincter, preserving the arteria supraduodenalis. An
alternative gaster was created as a 15-cm jejunal pouch with a 5-cm
jejunal conduit for orthodromic peristaltic movement, using an automatic
suture instrument to complete side-to-side anastomosis of folded jejunum
with 1- to 1.5-cm long upper end of the pouch not anastomosed. The
abdominal esophagus was mechanically anastomosed with a jejunal J pouch,
and anastomosis of the pyloric antrum with a jejunal conduit was
manually completed by stratum anastomosis. In group A, food ingestion
per time could be taken the same as that of a healthy person, with no
reflux esophagitis and dumping syndrome being noticed. Reflux
esophagitis developed more significantly in group B than in group A (p <
0.05). In food ingestion per time, group B was significantly delayed
compared with group A (p < 0.05). The present results suggested that the
surgical technique proposed is a function-preserving gastric surgery
appropriate to prevent postgastrectomy disorder of subjects.
26
UI - 11789278
AU - Yin G; Zhang W; Li G
TI -
[Therapeutic effect of weikangfu on gastric precancerous disorder with
spleen deficiency syndrome and its effect of gastric mucosal zinc,
copper, cyclic adenosine monophosphate, superoxide dismutase, lipid
peroxide and 3H-TdR lymphocyte conversion test]
SO - Zhongguo Zhong Xi Yi Jie He Za Zhi 2000 Mar;20(3):176-9
AD - Wuxi Third People's Hospital, Jiangsu (214041).
OBJECTIVE: To observe the clinical therapeutic effect of Weikangfu
granule (WKF) on intestinal metaplasia (IM), atypical proliferation
(ATP) and its therapeutic mechanism. METHODS: Sixty-one patients
(treated group) were diagnosed by integrated TCM and western medicine
(WM), and treated according to Syndrome Differentiation, the amount of
WKF was adjusted according to various Syndromes. The control group
consisted of 54 patients, took Weisu granule without considering their
Syndromes. Besides, 15 healthy subjects comprised of the control group.
Gastroscopy was conducted both before and after the treatment, mucosal
sample was taken from antral region of stomach for pathological changes,
for IM classification through histochemical staining and for
determination of gastric mucosal Zn, Cu, cAMP, SOD, serum LPO and 3H-TdR
lymphocyte conversion test (LCT). RESULTS: (1) The symptomatic and
pathologic therapeutic effect of the treated group were markedly better
than those of the control group (P < 0.05, P < 0.01). (2) The levels of
gastric mucosal Zn, Cu, cAMP, SOD and 3H-TdR LCT of the treated group
before treatment were all lower than that of the healthy control group,
but they were markedly increased after treatment, while serum LPO,
however, increased before treatment, significant difference existed
between the above groups (P < 0.05, P < 0.01). CONCLUSION: WKF can
reverse IM and ATP of Spleen Deficiency Syndrome through the mechanism
of improving the level of gastric mucosal Zn, Cu, cAMP and SOD,
promoting cytodifferentiation, improving cytoimmunity, reducing
superoxide and LPO.
27
UI - 11783226
AU - Hua B; Wang A
TI -
[Clinical study on treatment of mid-late stage gastric carcinoma by
composite xiansu capsule combined with chemotherapy]
SO - Zhongguo Zhong Xi Yi Jie He Za Zhi 1999 Aug;19(8):470-2
AD - Hou Wei Heilongjiang University of TCM, Harbin (150040).
OBJECTIVE: To assess the effect and mechanism of composite Xiansu
Capsule (CXSC) combined with chemotherapy in treating gastric carcinoma
of mid-late stage. METHODS: The 61 patients of the test group were
treated by CXSC combined with chemotherapy and 30 patients of the
control group treated with chemotherapy alone. The effect of treatment
and cell mediated immunity of patients were observed. RESULTS: The
effective rate of the test group and the control group was 32.8% and
13.3% respectively (P < 0.05), the chemotherapy caused toxic reaction
occurrence was less in the former than that in the latter group (P <
0.01). The CD3 level of patients in the test group was decreased, and
CD4/CD8 level was raised obviously, which suggested that CXSC had
immuno-regulating effect on T-cells. CONCLUSION: CXSC could enhance the
efficacy and reduce the toxic side-effect of chemotherapy. To regulate
the cell mediated immunity of patients is possibly its mechanism.
28
UI - 11857099
AU - Madisch A; Wiedbrauck F; Marquard F; Stolte M; Hotz J
TI -
[5-Fluorouracil-induced colitis--a review based upon consideration of 6
cases]
SO - Z Gastroenterol 2002 Feb;40(2):59-66
AD - Klinik fur Gastroenterologie, Allgemeines Krankenhaus Celle, Germany.
madisch@mk1.med.tu-dresden.de
BACKGROUND: At increasing use of high-dose 5-fluorouracil-based
chemotherapy for metastatic colorectal and gastric cancer complicated
which we looked for involvement of small intestine. We report summing up
on the 6 cases including both endoscopic and histological findings in
both sites of the gut.CASE REPORTS: In 2 men and 4 women (age 49-78
years) with advanced colon (n = 2), gastric (n = 3 ) and gallbladder (n
= 1) cancer a palliative weekly high-dose infusional 5-fluorouracil (2,6
g/m(2)/24 h) and folinic acid (500 mg/m(2)/2 h) chemotherapy was
performed. Few days after 1-5 chemotherapy courses the patients were
admitted to our hospital with abdominal pain and partly severe watery
diarrhea (up to 20 times evacuations/per day). The stool cultures were
negative and there were no proof both of clostridium difficile and his
toxin A and B. In 4 patients colonoscopy showed different grades of
colitis up to diffuse erythema and microlesions, 2 patients had no
visible lesions. In 4 patients endoscopy of the upper GI-tract showed a
severe inflammation (n = 1) and a fibrinopurulent exsudate, severe edema
and isolated ulcerations (n = 3) of jejunum after gastrectomy or
duodenum with intact stomach. In the histological assessment different
grades of 5-FU-induced colitis without (n = 2) or with (n = 4)
involvement of the upper small intestine destruction of the superficial
mucosa and crypts (epitheliumapoptosis) were found. 5 patients were
treated by antibiotics (vancomycin n = 2, metronidazole n = 3),
glucocorticoids (n = 5) and Saccaromyces cerevisiae (n = 3). After 8-10
days the patients were complete free of symptoms. One patient died due
to the enterocolitis.CONCLUSIONS: The present cases demonstrate that
high-dose 5-fluorouracil-based chemotherapy not only induces a colitis
but also may involve the upper small intestine tract. Consequently, it
represents an increasing and serious adverse event of high-dose
chemotherapy. The etiology of the enterocolitis (drug- or
bacterial-induced) needs further investigations in order to find a
causal therapy and/or prophylaxis.
29
UI - 11952248
AU - Liu KJ; Atten MJ; Donahue PE; Attar BM
TI -
Extended lymphadenectomy for gastric cancer: results in a teaching
hospital.
SO - Am Surg 2002 Apr;68(4):365-71; discussion 371-2
AD - Department of Surgery, Cook County Hospital, Chicago, Illinois 60612,
USA.
Lymphadenectomy including second-echelon lymph nodes (D2 resection) for
gastric cancer has not been widely adopted partly as a result of a
reported increase in operative morbidity and mortality. In the present
study we examined the operative risk of D2 resection in a public
teaching hospital. From 1995 to 1998, 57 patients underwent exploratory
laparotomy for gastric neoplasm: nine with curative D2 resection (Group
I), 17 with curative but less than D2 resection (Group II), 16 with
palliative resection (Group III), and 15 with no resection (Group IV).
Among the four groups, patients with curative D2 resection (Group I)
were older and had increased operative time and estimated blood loss,
but their need for blood transfusion, the operative morbidity and
mortality, and the mean hospital stay were not increased. In contrast,
those patients with palliative resection (Group III) had the highest
morbidity among all groups, the only fatality, and prolonged hospital
stay. Therefore, curative D2 resection can be performed safely even with
significant resident involvement. The advanced patient age or the
extensive dissection does not increase its surgical risk. Hence, D2
dissection should be considered whenever curative resection is feasible
because it allows accurate staging with the added benefit of possible
improvement in patient survival.
30
UI - 11468664
AU - Malheiros CA; Rodrigues FC; Rahal F
TI -
[Stomach neoplasm and metastasis. To operate?]
SO - Rev Assoc Med Bras 2001 Apr-Jun;47(2):95-6
31
UI - 11962195
AU - Hehr T; Adamek HE
TI -
[Value of postoperative radiochemotherapy with 5-fluorouracil plus
leucovorin in stage IB-IV M0 stomach carcinoma]
SO - Strahlenther Onkol 2002 Mar;178(3):164-6
32
UI - 11783251
AU - Zhou K; Wang J; Liu B
TI -
[Clinical study on effect of shenqi fuzheng injection combined with
chemotherapy in treating gastric cancer]
SO - Zhongguo Zhong Xi Yi Jie He Za Zhi 1999 Jan;19(1):11-3
AD - Affiliated Dongzhimen Hospital, Beijing University of Traditional
Chinese Medicine, Beijing (100700).
OBJECTIVE: To assess the clinical effect of Shenqi Fuzheng Injection
(SQFZI) combined with chemotherapy in treating gastric cancer. METHODS:
One hundred and twenty patients were randomly divided into 3 groups, the
combined therapy group (Group A), the chemotherapy group (Group B) and
the SQFZI group (Group C) and the effect on remission and stabilization
of patients were observed. RESULTS: The remission rate and stabilizing
rate of Group A were 16.1% and 87.1%, those of Group B were 13.5% and
64.9%, the difference between the two groups was significant, P < 0.05.
The symptom and living quality improving rate of Group A were 75.8% and
43.5% respectively, those of Group C were 61.9% and 57.1% and of Group B
were 35.1% and 29.7% respectively. SQFZI showed good protective effect
on hemopoietic system, 4.8% patients in Group A with WBC count lower
than 4 x 10(9)/L, while the percentage reached 21.6% in Group B, the
difference between the two groups was significant, P < 0.05. Moreover,
SQFZI could raise activity of NK cell, macrophage and T-lymphocyte
subgroups, without any injury on heart, liver and kidney function or
other adverse reaction. CONCLUSION: SQFZI combined with chemotherapy has
certain effect of remission and stabilization on gastric cancer, the
clinical effect is significant to patients with Qi-Deficiency, and is
reliable and safe.
33
UI - 11923778
AU - Miyamoto S; Muto M; Hamamoto Y; Boku N; Ohtsu A; Baba S; Yoshida M;
TI -
Ohkuwa M; Hosokawa K; Tajiri H; Yoshida S
A new technique for endoscopic mucosal resection with an insulated-tip
electrosurgical knife improves the completeness of resection of
intramucosal gastric neoplasms.
SO - Gastrointest Endosc 2002 Apr;55(4):576-81
AD - Division of Digestive Endoscopy and Gastrointestinal Oncology, National
Cancer Center Hospital, East Chiba, Japan.
BACKGROUND: En bloc resection is optimal for the cure of gastric
neoplasms by endoscopic mu
About OncoLink Contact OncoLink Privacy statement Disclaimer Link to OncoLink Home