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Abramson Cancer CenterNCI CANCERLIT® Search: Therapy of Gastric Cancer - October 2001
National Cancer Institute®
Last Modified: November 21, 2001
Table of Contents
1
UI - 21375554
AU - Dumanskii IuV; Shtutin SA; Zagorodnskii VF; Morgunova IN; Zaika AN;
TI -
Stoliarova OIu
[The complications in surgical treatment of gastric cancer in elderly
and senile patients]
SO - Klin Khir 2001 Mar;(3):50-3
Causes of the perioperative complications occurrence in 736 elderly and
senile patients, operated on for gastric cancer, were studied. It was
established that the complications frequency and mortality were depended
on the concomitant diseases presence, on the main disease complications,
duration and volume of operation as well, but not from their age. The
operation performance method and anesthesiological support perfection
would permit to widen indications for the radical surgical intervention
performance and raise the treatment of patients efficacy.
2
UI - 21375561
AU - Evtushenko OI; Boiko GS; Bobokal VN; Shumilin MV
TI -
[Observation of esophageal mycosis after gastric cancer surgery]
SO - Klin Khir 2001 Mar;(3):63
3
UI - 21338544
AU - Uchida K; Hayashi K; Kuramochi H; Takasaki K
TI -
Changes in intratumoral thymidylate synthase (TS) and dihydropyrimidine
dehydrogenase (DPD) mRNA expression in colorectal and gastric cancer
during continuous tegafur infusion.
SO - Int J Oncol 2001 Aug;19(2):341-6
AD - Department of Surgery, Institute of Gastroenterology, Tokyo Women's
Medical University, 8-1 Kawadachou, Shinjuku-ku, Tokyo 162-8666, Japan.
Thymidylate synthase (TS) is the target enzyme of 5-fluorouracil (5-FU),
and dihydropyrimidine dehydrogenase (DPD) is the key enzyme in the 5-FU
catabolic pathway. We wanted to determine whether the TS and DPD mRNA
expression levels of gastric and colorectal cancer patients would be
affected by tegafur (futrafur:FT)-based chemotherapy and whether changes
in their expression might be responsible for patient outcome.
Thirty-five patients with resectable advanced primary gastric cancer and
36 patients with resectable advanced primary colorectal cancer were the
subjects of this study. They all underwent neoadjuvant chemotherapy with
protracted infusion of FT alone or FT plus low doses of cisplatin. The
TS and DPD mRNA expression levels of endoscopic biopsy specimens before
chemotherapy and surgical specimens after chemotherapy were measured by
TaqMan reverse transcription-PCR assay using glyceraldehyde-3-phosphate
dehydrogenase (GAPDH) as the internal standard. There was a significant
difference in the DPD mRNA levels during chemotherapy in the colorectal
cancers. Although the TS and DPD levels were unrelated to any
conventional histopathological grade factors, colorectal cancer patients
whose surgical specimens contained lower TS and DPD mRNA levels had
longer disease-free intervals. The results of this study suggest that FT
may affect DPD mRNA expression in colorectal cancer patients, that
TS/DPD expression can be regarded as an independent prognostic factor,
and that colorectal cancer patients with low TS and low DPD mRNA are
candidates for FT-based adjuvant chemotherapy. In addition, quantitative
analysis of the change in TS/DPD mRNA in surgical specimens during
FT-based chemotherapy might be a more accurate means of predicting the
post-operative disease-free interval of colorectal cancer patients than
analysis of endoscopic specimens before chemotherapy. There also seems
to be a relation between regulation of TS and DPD during FT
chemotherapy. Elucidation of the mechanisms regulating TS and DPD mRNA
expression might make it possible to predict sensitivity and/or toxicity
to FT.
4
UI - 21340678
AU - Morant R
TI -
Neoadjuvant and adjuvant chemotherapy of locally advanced stomach
cancer.
SO - Onkologie 2001 Apr;24(2):116-21
AD - Zentrum fur Tumordiagnostik und Pravention, St. Gallen.
rmorant@dplanet.ch
Surgical treatment of locally advanced gastric carcinoma still results
in unsatisfactory survival results. The addition of adjuvant
chemotherapy has been shown to be of little value and is not considered
standard practice. Preoperative chemotherapy, however, has a strong
theoretical basis and may achieve significant tumor shrinkage and
downstaging and thus allow complete resection of cancers previously
judged by the responsible surgeon to be inoperable. However, it has not
yet been demonstrated whether preoperative chemotherapy prolongs the
survival of patients with potentially resectable cancers. Based on
theoretical reasons, preoperative chemotherapy may be expected to be
more efficient than postoperative chemotherapy. Various phase II trials
have shown the feasibility of this approach, and encouraging results
were found. Differing diagnostic methods, inclusion criteria, and
chemotherapy regimens hamper direct comparisons between the trials.
Several useful new drugs including taxanes and camptothecins and
promising chemotherapy regimens incorporating continuously infused
5-fluorouracil have been introduced recently. Ongoing large randomized
clinical trials (MAGIC trial, EORTC, SAKK) currently study the efficacy
of preoperative chemotherapy in locally advanced gastric carcinoma.
Copyright 2001 S. Karger GmbH, Freiburg
5
UI - 21367962
AU - Matsuo A; Watanabe A; Takahashi T; Futamura M; Mori S; Sugiyama Y;
TI -
Takahashi Y; Saji S
A simple method for classification of cell death by use of thin layer
collagen gel for the detection of apoptosis and/or necrosis after cancer
chemotherapy.
SO - Jpn J Cancer Res 2001 Jul;92(7):813-9
AD - Second Department of Surgery, Gifu University School of Medicine, Gifu
500-8705, Japan. atsushim@cc.gifu-u.ac.jp
To assess the efficacy of cancer chemotherapy, an important index is
apoptosis of the target cells, which can usually be confirmed by
electron microscopy (EM). We established a new experimental technique,
whereby cancer cells (MKN45) were distributed in thin collagen gel as
one or two cell layers, and cultured with anti-cancer drugs (5-FU and
CDDP). The cells were stained with fluorescent Hoechst 33258 (Ho) and
photographed, then with hematoxylin and eosin (H&E) and again
photographed, and processed for EM. This approach allowed us to
characterize the patterns of death of single cells in detail. There were
six patterns of cell damage: two patterns of apoptosis, early peripheral
condensation of chromatin and late apoptotic bodies, two patterns of
necrosis, cytoplasmic swelling and washed-out images, and two further
patterns, with morphological features of both apoptosis and necrosis,
neither classified into necrosis nor apoptosis. The results show that
cell death patterns can be mostly determined by combining observations
of Ho and H&E-stained cells without the necessity for EM observation.
6
UI - 21262956
AU - Caporale A; Cosenza UM; Vestri AR; Giuliani A; Costi U; Galati G;
TI -
Cannaviello C; Franchi F
Has desmoplastic response extent protective action against tumor
aggressiveness in gastric carcinoma?
SO - J Exp Clin Cancer Res 2001 Mar;20(1):21-4
AD - Dept. of Surgery Pietro Valdoni, Universita di Roma La Sapienza, Rome,
Italy.
A clinical assessment of protective action of desmoplastic response by
limiting tumor aggressiveness has been carried out in 171 patients with
gastric carcinoma, surgically treated at the First Surgical Clinic of
the University of Rome "La Sapienza" between 1988-1999. A univariate
statistical analysis was performed using Kaplan-Meier method for:
desmoplastic reaction, age, sex, histologic type, tumor size, stage,
lymphonodal status and metastases. To determine the influence of these
factors on prognosis, the Cox regression was applied. We found a
significant association between desmoplastic reaction extent and
presence or absence of metastases (p= 0.026), lymphonodal involvement (p
= 0.05), stage (p = 0.036). In the univariate analysis, survival was
significantly related to sex (p = 0.012), tumor size (p = 0.009),
lymphonodal involvement (p = 0.000), metastases (p = 0.000), stage (p =
0.000), desmoplastic reaction extent (p = 0.05); age and histologic type
showed no relationship (p = n.s.). The desmoplastic response extent is
not a protective factor against tumor invasiveness in gastric carcinoma,
on the contrary it may be considered a negative prognostic factor.
7
UI - 21271508
AU - Saito A; Noguchi Y; Yoshikawa T; Doi C; Fukuzawa K; Matsumoto A; Ito T;
TI -
Tsuburaya A; Nagahara N
Gastrectomized patients are in a state of chronic protein malnutrition
analyses of 23 amino acids.
SO - Hepatogastroenterology 2001 Mar-Apr;48(38):585-9
AD - First Department of Surgery, Yokohama City University School of
Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004 Japan.
a-saito@rf6.so-net.ne.jp
BACKGROUND/AIMS: Malnutrition is one of the major postoperative
complications of radical subtotal or total gastrectomy for gastric
cancer. This study was conducted to clarify the nutritional consequences
of radical gastrectomy with respect to protein metabolism. METHODOLOGY:
To evaluate the nutritional status and the abnormalities in protein
metabolism in such cases, serum concentrations of 23 amino acids were
measured by high performance liquid chromatography in 40 patients who
had undergone either subtotal (n = 20) or total (n = 20) gastrectomy
more than 6 months prior to this analysis. RESULTS: Serum concentrations
of total amino acids and nonessential amino acids were the same between
gastrectomized patients and healthy controls (n = 50). However,
concentrations of essential amino acids, essential amino
acid/nonessential amino acid and branched-chain amino acid/total amino
acid ratios were significantly lower in patient groups than in normal
controls. Each essential amino acid was decreased and concentrations of
glutamate and citrulline were increased in both patient groups compared
with controls. The major differences between patients with subtotal and
total gastrectomies included an increased ornithine and a decreased
arginine concentration in patients with subtotal gastrectomy.
CONCLUSIONS: These changes suggest that malabsorption of protein from
the intestinal tract causes persistent proteolysis in the skeletal
muscle for long periods of time after surgery in these patients and that
changes in ornithine and citrulline levels may reflect more severe
alterations in those with total gastrectomy.
8
UI - 21271511
AU - Sakaguchi T; Sawada H; Yamada Y; Fujimoto H; Emoto K; Takayama T; Ueno
TI -
M; Nakajima Y
Indication of splenectomy for gastric carcinoma involving the proximal
part of the stomach.
SO - Hepatogastroenterology 2001 Mar-Apr;48(38):603-5
AD - First Department of Surgery, Nara Medical University, 840 Shijo-cho,
Kashihara City, Nara, 634-8522, Japan.
BACKGROUND/AIMS: The role of splenectomy in the surgical management of
gastric carcinoma is controversial and there is no consensus of opinion
regarding the therapeutic value of splenectomy. The aim of this study
was to search for possible metastasis to lymph nodes in the splenic
hilum or along the splenic artery to avoid unnecessary splenectomy and
to determine its indication. METHODOLOGY: The clinical records of 204
patients who underwent total gastrectomy combined with splenectomy for
gastric carcinomas involving the proximal part of the stomach were
analyzed. RESULTS: The incidence of nodal involvement to the splenic
hilum and/or along the splenic artery was 49 (24.0%) of 204 gastric
carcinomas involving the proximal part of the stomach that underwent
combined gastrectomy and splenectomy. The characteristics of gastric
carcinoma with metastasis to these nodes included a larger tumor, deeper
penetration (T3, 4 tumors), a number of lymph node metastasis, and
infiltrative type. In T2 cases, all the tumors with cancerous
involvement to these nodes showed intraoperative gross serosal change).
When the tumor size was less than 40 mm, nodal metastatic rate to the
splenic hilum and/or along the splenic artery was very low. CONCLUSIONS:
In conclusion, splenectomy should be conducted in T2 cases with gross
serosal change and T3, 4 cases. With regard to tumor size, in the cases
with a tumor whose size was less than 40 mm, it is possible to preserve
the spleen in most cases. In the near future, splenectomy should be
clarified precisely by randomized trials in advanced gastric carcinoma.
9
UI - 21381292
AU - Feldman RA
TI -
Review article: would eradication of Helicobacter pylori infection
reduce the risk of gastric cancer?
SO - Aliment Pharmacol Ther 2001 Jun;15 Suppl 1():2-5
AD - The Royal London Hospital, Whitechapel Road, London E1 1BB, UK.
feldman@qmw.ac.uk
This article reviews the data on the epidemiology of gastric cancer, to
determine if treatment of an asymptomatic individual can be justified.
It reviews retrospective and prospective case-control studies of gastric
cancer in Italy and other countries. Mucosa-associated lymphoid tissue
lymphoma is associated with Helicobacter pylori infection. The risk of
noncardia gastric cancer is higher (4-fold or greater) in those with H.
pylori infection. Although no studies have shown prevention following
treatment, eradication of asymptomatic H. pylori infection in an
individual in the age group 40 or lower may be expected to reduce the
risk of gastric cancer.
10
UI - 21424853
AU - Waller MB
TI -
Evaluation and management of gastric adenocarcinoma.
SO - Nurs Clin North Am 2001 Sep;36(3):543-52, xi
AD - Department of Surgery, The University of Texas MD Anderson Cancer
Center, Houston, Texas 77030, USA. mbrame@mdanderson.org
This article reviews the epidemiology, cause, and current staging of
gastric adenocarcinoma. An in-depth discussion regarding patient
assessment and treatment options is presented. Advanced disease
management and clinical trials are reviewed.
11
UI - 21464091
AU - Arai K; Iwasaki Y; Takahashi T
TI -
[Repeated intraperitoneal chemotherapy for peritoneal dissemination from
gastric carcinoma]
SO - Gan To Kagaku Ryoho 2001 Sep;28(9):1257-61
AD - Dept. of Surgery, Tokyo Metropolitan Komagome Hospital.
Repeated intraperitoneal chemotherapy (RIC) via an i.p. port system was
carried out in 16 patients with peritoneal dissemination (P1) and in 10
with positive washing cytology (P0.CY1) from gastric carcinoma. CDDP
dissolved in 500-1,000 ml of physiological saline solution was
periodically administered via the i.p. port system. The change of
washing cytology (CY), which was obtained from i.p. port, was examined
before each administration as a indicator of the response. The average
number of administrations was 5.7 and the average total dose was 301.7
mg. As a result, a negative change of CY after RIC was found in 74% of
patients, and also more than 80% of the response occurred within three
administrations. The prognosis tended to be better in P0.CY1 patients
than in P1 patients. In particular, the median survival time of the CY
responders markedly improved as compared with non-responders (27.8
months versus 7.1 months). Although diarrhea and anorexia of grade 3
developed once in each patient, serious toxicities were not found. In
conclusion, we consider RIC to be an effective therapy for P0.CY1 among
cases with peritoneal dissemination from gastric carcinoma.
12
UI - 21458879
AU - Boku N; Ohtsu A; Nagashima F; Muto M; Shinkai T; Yoshida S
TI -
Retrospective study of hyponatremia in gastric cancer patients treated
with a combination chemotherapy of 5-fluorouracil and cisplatin: a
possible warning sign of severe hematological toxicities?
SO - Jpn J Clin Oncol 2001 Aug;31(8):382-7
AD - Division of Digestive Endoscopy and Gastrointestinal Oncology, National
Cancer Center Hospital East, Kashiwa, Chiba, Japan. nboku@east.ncc.go.jp
BACKGROUND: Some anti-neoplastic agents induce hyponatremia. The
relationship between hyponatremia and other toxicities in gastric cancer
patients treated with 5-fluorouracil and cisplatin (FP) was investigated
retrospectively to clarify its clinical significance. METHODS: The
subjects were 50 advanced gastric cancer patients treated with FP.
Patients' performance status, oral intake, nausea/vomiting, diarrhea,
fever, urine volume, presence of ascites or pleural effusion, laboratory
data and administration of diuretics, corticosteroid and contents and
volume of hydration before and during the first 5 days after
chemotherapy were reviewed. RESULTS: The serum sodium level decreased
after initiation of chemotherapy in all patients and the lowest level
(nadir) was most frequently observed on day 8 (range, days 2-14), which
preceded hematological toxicities. In 10 patients (20%) the nadir of
serum sodium was lower than 125 mEq/l. We classified these 10 patients
as a low-sodium group and the others into a normal-sodium group. Six
(60%) and seven (70%) of the 10 patients in the low-sodium group had
complications with grade 3 or 4 leukopenia and thrombocytopenia, whereas
only one (3%) and two (5%) were seen in the normal-sodium group (p <
0.0001). Stomatitis and diarrhea were also slightly more severe in the
former than the latter group. With respect to sensitivity and
probability, receiver operating characteristic curves showed the nadir
((> or = ) or <125 mEq/l) of the serum sodium level was the best marker
for both leukopenia and thrombocytopenia. CONCLUSION: Hyponatremia after
initiation of chemotherapy with FP may be a warning sign of subsequent
severe hematological toxicity.
13
UI - 21383842
AU - Zherlov GK; Koshel' AP; Efimov NP; Autlev KM
TI -
[Proximal resection of the cardiac portion of the stomach]
SO - Khirurgiia (Mosk) 2001;(4):17-21
From 1989 to 1999 75 proximal resections of the stomach were performed.
There were two variants of operation. In the first variant, invaginative
valve from submucous-mucous membrane of the esophagus and the stomach
was formed in the zone of gastroesophageal anastomosis. In the second
variant, for prevention of anastomotic sutures eruption late after
surgery and prophylaxis of valve expanding, duplication of muscular
membrane on esophagus was formed. 58 patients were operated by the first
variant, 17--by second variant. Postoperative lethality was 2.7% (1
patient died after operation of the first variant, 1 patient--after the
second variant). In early postoperative period the complications were
revealed in 8 (10.7%) patients. There was no insufficiency of
anastomotic sutures. Mean hospital stay after operation was 14.7 +/- 3.5
bed days. Reflux-esophagitis of severe degree in remote period after
operation was seen in 1 (1.3%) patient, catarral--in 4 (5.3%), all the
patients were operated by the first variant.
14
UI - 21290095
AU - de Manzoni G; Pasini F; Bonfiglio M; Di Leo A; Pedrazzani C; Borzellino
TI -
G; Zerman G; Tasselli S; Castelli A
[Results of the surgical treatment of primary gastric lymphoma]
SO - Chir Ital 2001 Jan-Feb;53(2):175-80
AD - Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Ia Divisione
Clinicizzata di Chirurgia, Universita degli Studi di Verona.
The aim of the study was to verify the long term results obtained in
primary gastric lymphoma with a strategy consisting in surgery as
1999, 44 patients with histologically proven primary gastric lymphoma
underwent surgical treatment in the First Department of General Surgery
of the University of Verona. Tumours were staged according to the Ann
Arbor classification and divided, according to the Kiel classification,
into high- and low-grade lymphoma. Patients received adjuvant
chemotherapy depending on the grade of malignancy and/or completeness of
resection. Of the 44 patients, 40 (90.9%) underwent curative resections,
i.e. with complete macroscopic and microscopic tumour removal (R0),
consisting in total gastrectomy in 34 cases and subtotal gastrectomy in
6. Twenty-five of 40 patients had stage IE and 15 stage IIE tumours.
Adjuvant chemotherapy was given to 33 patients (30 high-grade lymphomas
and 3 low-grade lymphomas with N2 metastases). The overall cumulative
10-year survival rate in patients who underwent R0 resection was 79%
without any significant differences in 10-year survival between patients
with high- and low-grade malignancy (both 79%; P = 0.582) or between
patients with or without lymph node metastases (91% and 70%,
respectively; P = 0.426). In conclusion, the present investigation
suggests that surgery yields prolonged complete remission in a high
percentage of patients affected by gastric lymphoma irrespective of
histopathologic grade of the disease and nodal involvement.
15
UI - 21330632
AU - Miwa K
TI -
[Optimal nodal dissection for early gastric cancer]
SO - Nippon Geka Gakkai Zasshi 2001 Jun;102(6):484-9
AD - Department of Surgery II, School of Medicine Kanazawa University,
Kanazawa, Japan.
Extensive lymphadenectomy (D2) in 295 patients with early gastric cancer
(EGC) resulted in a significantly lower 10-year recurrence rate than
limited lymph node dissection (D1) in 97 patients (2.1% vs. 11.9%, p <
0.005). Among node-positive patients, the recurrence rate following D2
was significantly lower than that after D1 (12.5% vs. 44.4%, p < 0.02).
Among node-negative patients, there was no difference in recurrence rate
between two groups (0.6% vs 3.3%, p < 0.2). These observations suggest
that there are two optimal methods of node dissections in EGC surgery
based on nodal status. The sentinel node concept is important to
understand nodal status. In 1993, we developed intraoperative endoscopic
lymphatic mapping with 2% patent blue to demonstrate the lymphatic
basins in EGC. Frozen sections of the blue nodes in 203 patients had a
high predictive value for nodal metastasis, with a sensitivity of 89%,
specificity of 100%, and accuracy of 98%. Four false-negative cases had
clinical metastasis, which was diagnosed at surgery. In 34 of 35
patients, metastatic nodes were located along the lymphatic basins.
Among them, 15 patients had metastasis only in the sentinel lymph nodes.
Of 5 gastric lymphatic basins, 42% of the patients had involvement of
one, 47% 2, and 12% 3. These results show that each EGC has its own
lymphatic basins in which metastasis can develop. The more numbers of
the sections there are, the higher the likelihood of nodal metastasis.
This means that each frozen section slice carries the risk of being
false negative. Therefore we should always dissect the lymphatic basins
even in cases with no sentinel node metastasis. In addition, patients
with sentinel nodes containing metastasis should be treated with the D2
procedure.
16
UI - 21384118
AU - Jagoditsch M; Pertl A; Jatzko GR; Denk H; Stettner HM
TI -
[Long-term outcome of stomach carcinoma achieved in an Austrian standard
hospital with an oncologic focus]
SO - Chirurg 2001 Jul;72(7):822-31
AD - Chirurgische Abteilung, Krankenhaus der Barmherzigen Bruder St.
Veit/Glan, Lehrkrankenhaus der medizinischen Fakultat, Universitat Wien,
Osterreich.
INTRODUCTION: Although two large prospective and randomized planned
European studies failed to show any benefit of radical D2
lymphadenectomy for gastric cancer, the value of radical lymphadenectomy
is still a matter of controversy. METHODS: A radical surgical approach
principally using D2, D3 lymphadenectomy, as defined by the Japanese
Research Society for Gastric Cancer, has been prospectively performed
surgically treated for potential cure between 1984 and 31 December,
1998. Clinical, histopathological and surgical factors were evaluated
for their influence on long-term survival by means of univariate and
multivariate analysis. RESULTS: Tumor-specific 5- and 10-year survival
rates for all patients were 58.5% and 57.5% for patients who underwent
tumor resection 59% and 58%. For operated patients upon with the aim of
achieving cures, the tumor-specific 5- and 10-year survival rates were
63.3% and 62.2% and the median survival time was more than 144 months.
Postoperative hospital mortality was 7.7%, 4.6% for R0 resected
patients, 8.6% for R1,2 resected patients and 21.3% for those undergoing
palliative procedures. Multivariate analysis using the Cox model
identified an age older than 65, total gastrectomy as well as high pN-
and pT category as detrimental factors with an independent influence on
survival. CONCLUSION: After updating the long-term results of gastric
cancer, as already published earlier, it is impressively obvious that
also in a European setting of gastric cancer patients, with a
presupposed appropriate surgical technique and experience, very constant
cure rates are achievable with comparatively low mortality and
morbidity.
17
UI - 21396285
AU - Tokunaga A; Onda M; Yoshiyuki T; Onodera H; Fujita I; Okuda T; Mizutani
TI -
T; Kiyama T; Kato S; Matsukura N; Takano T; Ogawa R
Biochemical assessment of cardiac function in patients undergoing
surgery for gastric cancer.
SO - J Nippon Med Sch 2001 Aug;68(4):351-2
AD - Department of Surgery (I), Nippon Medical School, 1-1-5 Sendagi,
Bunkyo-ku, Tokyo 113-8602, Japan. tokunaga/surg1@nms.ac.jp
18
UI - 21429009
AU - Ell C; Gossner L; May A
TI -
[Early carcinoma of the oesophagus, stomach and large
intestine--endoscopic therapy instead of surgery]
SO - Dtsch Med Wochenschr 2001 Sep 7;126(36):994-5
19
UI - 21429010
AU - Willis S; Schumpelick V
TI -
[Endoscopic mucosal resection instead of surgical intervention for early
carcinoma of the oesophagus, stomach and small intestine]
SO - Dtsch Med Wochenschr 2001 Sep 7;126(36):996
20
UI - 21438127
AU - Gaspar MJ; Arribas I; Coca MC; Diez-Alonso M
TI -
Prognostic value of carcinoembryonic antigen, CA 19-9 and CA 72-4 in
gastric carcinoma.
SO - Tumour Biol 2001 Sep-Oct;22(5):318-22
AD - Department of Clinical Chemistry, University Hospital Principe de
Asturias, Alcala de Henares, Madrid, Spain. mgaspar@hupa.insalud.es
The prognostic value of preoperative serum levels of carcinoembryonic
antigen (CEA), CA 19-9 and CA 72-4 tumor markers was investigated in
patients with gastric cancer. Eighty-two patients who underwent surgical
resection of gastric cancer were entered in the study. Correlation
analyses showed that CA 72-4 was more frequently positive in patients
with advanced tumors (p = 0.04), lymph node invasion (p = 0.02), liver
metastasis (p = 0.02) and peritoneal involvement (p = 0.03). CA 19-9 was
more frequently positive in patients with advanced tumors (p = 0.01) and
with serosal (p = 0.04), lymph node (p = 0.008) and peritoneal
involvement (p = 0.02). CEA was more frequently positive in patients
with liver metastasis (p = 0.03). Low 3-year cumulative survival was
significantly associated with elevated serum levels of CA 72-4 (p =
0.004), CA 19-9 (p = 0.001) and CEA (p < 0.001). Age, tumor stage and CA
72-4 provided prognostic information in the multivariate analysis.
Patients with elevated serum levels of CA 72-4 showed a 4.2 times higher
risk of death than patients with low levels of the marker. Our results
suggest that CA 72-4 has prognostic value in gastric cancer, and
patients with a high preoperative serum level of CA 72-4 have a greater
risk of death due to gastric cancer. Copyright 2001 S. Karger AG, Basel
21
UI - 21300164
AU - Lee KY; Noh SH; Hyung WJ; Lee JH; Lah KH; Choi SH; Min JS
TI -
Impact of splenectomy for lymph node dissection on long-term surgical
outcome in gastric cancer.
SO - Ann Surg Oncol 2001 Jun;8(5):402-6
AD - Department of Surgery, Yonsei University College of Medicine, Seoul,
Korea.
BACKGROUND: In the treatment of gastric cancer, splenectomy is performed
for effective lymph node dissection around the splenic artery and
splenic hilum. The purpose of this study was to clarify the long-term
outcome of splenectomy in the treatment of gastric cancer. METHODS: The
effect of splenectomy on recurrence and prognosis was examined in a
retrospective analysis of 665 patients who had undergone curative total
gastrectomy for gastric carcinoma from 1987 to 1996. The risk factors
associated with recurrence and prognosis were investigated by univariate
and multivariate analysis. RESULTS: The splenectomy group showed more
advanced lesions and a higher recurrence rate than the spleen-preserved
group. However, after adjusting for the TNM (tumor, node, metastasis)
stage, there was no significant difference in recurrence rate and
pattern between the two groups. Logistic regression analysis revealed
that gross type, serosal invasion, and nodal metastasis were independent
risk factors for recurrence while splenectomy was not. When comparing
patients with the same TNM (tumor, node, metastasis) stages, no
significant difference in the 5-year survival rates was apparent.
Multivariate analysis demonstrated that age, serosal invasion, and nodal
metastasis were independent prognostic factors whereas splenectomy was
not. CONCLUSIONS: These data suggest that splenectomy for lymph node
dissection in gastric cancer is not effective regarding long-term
patient prognosis.
22
UI - 21312263
AU - Watanabe Y; Sato M; Kikkawa H; Yoshida M; Shiozaki T; Kotani T; Nezu K;
TI -
Kawachi K
Intragastric endoscopic mucosal resection through a temporary
gastrostomy for early gastric cancer: usefulness of Buess-type
endoscope.
SO - Eur J Surg 2001 May;167(5):362-5
AD - Department of Surgery II, Ehime University, Shigenobu, Japan.
OBJECTIVE: To assess the feasibility of cure of early gastric cancer by
the endoscopic procedure done through a temporary gastrostomy and to use
it to treat patients with various severe complications. DESIGN:
Prospective study. SETTING: University hospital, Japan. SUBJECTS: Four
patients who required gastric mucosal resection for early gastric
cancer. MAIN OUTCOME MEASURES: Ease of the procedure, cure rate, safety
under epidural anaesthesia, and outcome. RESULTS: All patients had the
procedure under epidural anaesthesia without pain or complaints during
operation. Mean operation time was 120 minutes (60-200). Histological
examination showed that the surgical margin was free of tumour in 3 of
the cases. One patient who had microscopic invasion of lymph nodes
subsequently underwent second-look conventional gastrectomy with
lymphadenectomy. Postoperative recovery was rapid, and all patients were
discharged from the hospital uneventfully. CONCLUSION: This
organ-preserving procedure enables good visualisation of the tumour and
is useful even for high-risk patients.
23
UI - 21371224
AU - Wang Y; Yao Z; Huang X
TI -
[Clinical study on preventing and treating chemotherapy induced nausea
and vomiting using supplemented Inula-Ochrae Decoction]
SO - Zhongguo Zhong Xi Yi Jie He Za Zhi 1998 May;18(5):273-5
AD - Nantong First People's Hospital, Nantong, Jiangsu 226001.
OBJECTIVE: To observe supplemented Inula-Ochrae Decoction (SIOD) in
preventing and treating nausea and vomiting induced by chemotherapy for
patients with malignant tumour. METHODS: Seventy-two patients were
divided into two groups, the patients in test group took SIOD and in
control group using ondensetron, and the efficacy of SIOD in preventing
and treating chemotherapy induced nausea and vomiting were studied
prospectively with self-intersection approach. RESULTS: The effective
rate of treating vomiting due to chemotherapy with DDP and without DDP
in the test group was 92.7% and 93.5% respectively, and was higher than
that in the control group 87.8% and 87.1%, the difference was
insignificant statistically (P > 0.05). CONCLUSIONS: The prescription
SIOD could prevent and treat effectively chemotherapy induced nausea and
vomiting without any toxic and side effects, and is inexpensive with
high efficacy for clinical use.
24
UI - 21430359
AU - Balraj V; Perakath B
TI -
Post-gastric surgery: is a closer follow up required?
SO - Natl Med J India 2001 Jul-Aug;14(4):251-2
25
UI - 21441567
AU - Yoshikane H; Sakakibara A; Hidano H; Niwa Y; Goto H; Yokoi T
TI -
Piecemeal endoscopic aspiration mucosectomy for large superficial
intramucosal tumors of the stomach.
SO - Endoscopy 2001 Sep;33(9):795-9
AD - Dept. of Internal Medicine, Handa City Hospital, Handa, Japan.
winwin@cac-net.ne.jp
BACKGROUND AND STUDY AIMS: As endoscopic techniques continue to develop,
endoscopic mucosal resection is increasingly being used in the treatment
of intramucosal gastric tumors. The aim of this study was to explore the
feasibility of piecemeal endoscopic aspiration mucosectomy for large
superficial intramucosal tumors of the stomach. PATIENTS AND METHODS:
The study group consisted of five consecutive patients with large
superficial intramucosal tumors of the stomach, 4 cm or more in
diameter. Piecemeal endoscopic aspiration mucosectomy using a cap-fitted
panendoscope was carried out. The initial resection was undertaken at
the oral side of the lesion. Subsequent resections were carried out
along the anal margin of the previous resection site, until the marks
around the boundary of the tumor completely disappeared. RESULTS: The
shape of the tumors was slightly elevated in four cases and slightly
depressed in one. The mean diameter of the tumors was 4.8 cm. The
diameters of the resected specimens ranged from approximately 1.0 cm to
2.3 cm. The numbers of piecemeal resection procedures needed per lesion
ranged from five to 18 (mean 11). The visual field was well ensured by
the cap, and the tumors were macroscopically completely resected without
any complications in all patients. The final histological diagnoses in
the specimens were adenoma in one case and mucosal carcinoma in adenoma
in four. One patient had residual or recurrent tumor, and received full
treatment with additional endoscopic procedures. CONCLUSIONS: Piecemeal
endoscopic aspiration mucosectomy is a simple and very useful technique
for treating large superficial intramucosal tumors of the stomach.
26
UI - 21179635
AU - Santangelo M; Vescio G; Sommella L; Battaglia M; Valente A; Sammarco G;
TI -
Bossa F; Triggiani E
[Extended total gastrectomy: indications in the 3rd millennium]
SO - Minerva Chir 2001 Feb;56(1):1-6
AD - Istituto di Chirurgia Generale e dei Trapianti, Facolta di Medicina e
Chirurgia, Universita degli Studi Magna Grecia, Catanzaro, Italy.
michsanta@libero.it
BACKGROUND: Total extended gastrectomy (TEG) is indicated in the
treatment of gastric cancer for necessity or to achieve an oncologic
radicality. By this surgical treatment the stomach and other organs or a
part of them involved by primitive tumor are removed. METHODS: The
authors report a study about 15 patients, out of 116 cases of gastric
cancer, operated by TEG between 1990-1998. The middle-age of this
patients was 63 years (range 45-76) and their general conditions were
good in 9 cases and not-good in 6. The postoperative total parenteral
nutrition (TPN) was carried out in all the patients, while
preoperatively only in the most compromised patients. The surgical
treatments were: 2 TG (total gastrectomy)+splenecomy; 3
TG+splenectomy+pancreatic resection; 4 TG+splenectomy+pancreatic
resection+distal esophageal resection; 1 TG+distal esophageal resection;
2 TG+atypic hepatic resection; 1 TG+ atypic hepatic resection+duodenum
resection; 2 TG+large intestine resection. While 10 patients were
operated on to obtain radicality, 5 patients had a palliative treatment.
RESULTS: There was not perioperative mortality, but we have observed:
one dehiscence of the duodenal stump and one pancreatic fistula treated
with conservative therapy; one left subfrenic abscess treated with
surgical therapy. The survival has been higher in the patients treated
with radicality. On the basis of these cases, the authors consider: 1)
the possibility to obtain radicality by TEG; 2) the gastric
localizations more often associated to extravisceral neoplastic
localization; 3) the role of extensive lymph node resection (III and IV
level) to obtain oncological radicality or neoplastic reduction.
CONCLUSIONS. On the basis of their personal experience and related
literature, the authors conclude that TEG is indicated to: 1) obtain a
better lymphadenectomy; 2) obtain an oncologic radicality; 3) reduce the
neoplastic mass in order to facilitate adjuvant therapy; 4) avoid or
treat neoplastic complications; 5) improve the quality of life.
27
UI - 21325275
AU - You WC; Chang YS; Heinrich J; Ma JL; Liu WD; Zhang L; Brown LM; Yang CS;
TI -
Gail MH; Fraumeni JF Jr; Xu GW
An intervention trial to inhibit the progression of precancerous gastric
lesions: compliance, serum micronutrients and S-allyl cysteine levels,
and toxicity.
SO - Eur J Cancer Prev 2001 Jun;10(3):257-63
AD - National Cancer Institute, Division of Cancer Epidemiology and Genetics,
Bethesda, MD 20892, USA. youw@exchange.nih.gov
Gastric cancer is the second most frequent cause of death from cancer in
the world and the leading cause of death from cancer in China. In
inhibit the progression of precancerous gastric lesions in Linqu County,
Shandong Province, an area of China with one of the world's highest
rates of gastric cancer. Treatment compliance was measured by pill
counts and quarterly serum concentrations of vitamin C, vitamin E and
S-allyl cysteine. In 1999, toxicity information was collected from each
trial participant to evaluate treatment-related side-effects during the
trial. Compliance rates were 93% and 92.9% for 39 months of treatment
with the vitamins/mineral and garlic preparation, respectively. The
means for serum concentrations of vitamins C and E were 7.2 microg/ml
and 1695 microg/dl among subjects in the active treatment groups
compared with 3.1 microg/ml and 752 microg/dl among subjects in the
placebo treatment group, respectively. No significant differences in
side-effects were observed between the placebo treatment group and the
vitamins/mineral and garlic preparation treatment groups during the
39-month trial period.
28
UI - 21538324
AU - Uehara S; Murabayashi K; Kusta T; Takahashi K; Ogawa T; Onishi H;
TI -
Saegusa S; Noda N; Okanami Y; Nakamura I
[Neoadjuvant chemotherapy for advanced gastric cancer with para-aortic
lymph node metastasis]
SO - Gan To Kagaku Ryoho 2001 Oct;28(10):1413-8
AD - Dept. of Surgery, Yamada Red Cross Hospital.
Neoadjuvant chemotherapy was applied to patients with advanced gastric
cancer and confirmed para-aortic lymph node metastasis. Subjects were 7
patients. The response to the neoadjuvant chemotherapy was a PR in 5
cases, MR in 2 cases for the primary lesion and CR in 2 cases PR in 5
cases for the para-aortic lymph node metastasis. The grades of
histological response assessed on the resected specimen were Grade 0 in
three cases, Grade 1a in one, Grade 1b in one and Grade 2 in two. While
there was no significant difference in survival rate between patient
groups with and without neoadjuvant chemotherapy, the 2-year survival
rate in patients with neoadjuvant chemotherapy was a good 42.9%,
compared with 10% in patients groups without neoadjuvant chemotherapy.
It is concluded that a better prognosis can be expected for advanced
gastric cancer patients with neoadjuvant chemotherapy.
29
UI - 21538325
AU - Kamata T; Hayashi Y; Minatoya G; Michiwa Y; Onishi I; Takeda T; Koyasaki
TI -
N; Kanno M
[A pilot study of low-dose TS-1 and cisplatin combination chemotherapy
for advanced gastric cancer]
SO - Gan To Kagaku Ryoho 2001 Oct;28(10):1419-22
AD - Dept. of Surgery and Gastroenterology, Keiju Medical Center.
TS-1, a novel oral formation of 5-fluorouracil, consists of tegafur
(5-FU), CDHP and Oxo. Low-dose cisplatin (CDDP) and TS-1 was evaluated
in 12 patients with advanced or recurrent gastric cancer. CDDP was given
biweekly at a dose of 15 mg/m2 infused for 30 minutes, and 80 mg/body of
TS-1 was orally administered as many times as possible. The response
rate was 41.7%. Median survival time was 13.3 months. In one case, an
adverse reaction of grade 3 leucopenia was observed. Thus, thought it is
necessary to watch for leucopenia, this chemotherapy could well be
effective for patients with advanced or recurrent gastric cancer.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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