scholarly journals Overview of Gastric Cancer Treatment and Recent Developments – An Updated Review

2020 ◽  
Vol 11 (1) ◽  
pp. 519-531
Author(s):  
Arun Kumar Vadikari ◽  
Akkihebbal R Akhila ◽  
Vishakante Gowda D ◽  
Mahendran Bhaskaran ◽  
Parthasarathi K Kulkarni ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Recurrent Disease ◽  
Intraperitoneal Administration ◽  
Health Issues ◽  
Curative Intent ◽  
First Choice ◽  
Recent Developments ◽  
Life Threatening ◽  
Treatment Concepts ◽  
Gastric Cancer Treatment

Gastric Cancer (GC) is one among the serious diseases prevailing globally. GC has immense global life-threatening health issues by taking 4th place among all the widespread cancers and 2nd foremost reason for fatality around the globe. Numerous patients have an inoperable disease at diagnosis or have recurrent disease after resection with curative intent. Surgery remains the principle therapy, while perioperative and adjuvant chemotherapy and chemoradiation can improve the outcome of GC therapy. Targeted therapies such as Trastuzumab, an antibody against HER2 and the VEGFR-2 antibody ramucirumab highly preferred in GC. Since the last few years, immunotherapy became a significant approach for the cure of various cancers like GC.  In the present review, we have put forward the various stages of GC and all the possible advanced treatments for GC. Surgery is still the first choice analysed in GC followed by chemotherapy and radiotherapy. New frontiers in treatment suggest the growing consideration for intraperitoneal administration of chemotherapeutics and a combination of traditional drugs with the newer generation. A note is added to relevant studies dealing with neoadjuvant and adjuvant treatment concepts and gives an overview of latest trends and developments in GC treatment

scholarly journals Insights into Gastric Cancer

2020 ◽  
Vol 11 (2) ◽  
pp. 2151-2166
Author(s):  
Arun Kumar Vadikari ◽  
Vishakante Gowda D ◽  
Mahendran Bhaskaran ◽  
Vikas Jain
Keyword(s):  
Gastric Cancer ◽  
Monoclonal Antibodies ◽  
Current Knowledge ◽  
Multidrug Resistant ◽  
Health Issues ◽  
Cellular Mechanisms ◽  
Curative Intent ◽  
Life Threatening ◽  
Metastasis Development ◽  
Treatment Concepts

Gastric Cancer (GC) is one of the serious diseases prevailing globally. GC has immense global life-threatening health issues by taking 4th place among all the widespread cancers and 2nd foremost reason for fatality around the globe. Numerous patients have inoperable disease at diagnosis or have recurrent disease after resection with curative intent. In the present review, we have put forward all the possible advanced treatments for GC, which includes the application of Nanotechnology, Monoclonal antibodies, and Robotic surgery. Nanoparticle offers a potentially improved treatment of multidrug-resistant cancers. GC is uniquely positioned as an area of research for targeted and nanoparticle therapies. This review briefs about design and considerations to develop targeted nanoparticle-based approaches for overcoming physiological hurdles in GC treatment. Based on current knowledge, molecular and cellular mechanisms, a number of novel biologic approaches such as monoclonal antibodies have been recently introduced for cancer treatment that mainly affects the immune system or target signaling pathways playing a role in cancer and metastasis development. Surgical robotic systems have been presented into the area of GC therapy as an enhanced technology that has overwhelmed the technical limits of laparoscopy. A note is added to relevant studies dealing with treatment concepts and gives an overview of the latest trends and developments in the treatment of GC.

Evaluation of the extent of lymphadenectomy in a randomized trial of Western- versus Japanese-type surgery in gastric cancer.

1994 ◽  
Vol 12 (2) ◽  
pp. 417-422 ◽  
Author(s):  
A M Bunt ◽  
J Hermans ◽  
M C Boon ◽  
C J van de Velde ◽  
M Sasako ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Trials ◽  
Lymph Nodes ◽  
Randomized Trial ◽  
Surgical Resection ◽  
Extended Lymphadenectomy ◽  
Important Goal ◽  
Curative Intent ◽  
Therapeutic Advantage ◽  
Gastric Cancer Treatment

PURPOSE In the context of a prospective, randomized trial of gastric cancer treatment, comparing Western surgical resection with limited lymphadenectomy (R1) versus Japanese surgical resection with extended lymphadenectomy (R2), we analyzed adherence to the specified surgical-pathologic guidelines. PATIENTS AND METHODS Following evaluation of 389 patients, we quantified noncompliance (ie, performance of less dissection than specified) and contamination (ie, performance of more extensive dissection than specified). Of 389 patients, pathologic data permitted identification of 237 eligible patients treated with curative intent. RESULTS Noncompliance occurred in 84% of R1 and R2 cases, with magnitude significantly (P < .001) higher in R2 cases versus R1 cases. Contamination occurred in 48% of R1 cases and 52% of R2 cases, with the magnitude of contamination moderate and equally distributed between the two groups. The contamination in R1 resections and the noncompliance in R2 resections lead to a partial homogenization of the groups, undermining the likelihood of detecting any potential therapeutic advantage to R2 dissection. CONCLUSION The observed tendency to perform R1 resections combined with insufficient retrieval of lymph nodes underlines the need for increased surgical-pathologic standardization in this trial. Potential remedies are discussed. Proper conduct of clinical trials requires reliable means of standardizing performance of the surgical-pathologic team, an elusive but important goal.

scholarly journals A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masaru Komatsu ◽  
Motoharu Hirai ◽  
Kazuaki Kobayashi ◽  
Hideki Hashidate ◽  
Junki Fukumoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Effects ◽  
Myasthenia Gravis ◽  
Metastatic Gastric Cancer ◽  
Myocardial Biopsy ◽  
Case Presentation ◽  
Antibody Positivity ◽  
Life Threatening ◽  
Gastric Cancer Treatment ◽  
Anti Acetylcholine

Abstract Background Although rare, several immune-related adverse effects can be life-threatening. Here, we describe a metastatic gastric cancer patient presenting with nivolumab-related myasthenia gravis and myocarditis, a previously unreported adverse effect of gastric cancer treatment. Case presentation A 66-year-old man with metastatic gastric cancer visited the emergency department because of dizziness after the first dose of nivolumab. Diagnoses of nivolumab-related myasthenia gravis and myocarditis were established. Myocardial biopsy results and anti-acetylcholine receptor antibody positivity confirmed the diagnoses. Despite plasma exchange and intravenous methylprednisolone and immunoglobulin administration, the patient’s general condition gradually worsened, and he died. Conclusions Strict monitoring for cardiac and neuromuscular symptoms after nivolumab administration is necessary to rapidly treat these adverse effects.

Recent Developments in Nanomedicines for Management of Various Health Issues Via Metabolism and Physico-Chemical Properties

2015 ◽  
Vol 16 (5) ◽  
pp. 389-396
Author(s):  
Mahmood Rasool ◽  
Muhammad Naseer ◽  
Arif Malik ◽  
Abdul Manan ◽  
Ikram Ullah ◽  
...  
Keyword(s):  
Chemical Properties ◽  
Health Issues ◽  
Physico Chemical ◽  
Recent Developments

Perfil dos Pacientes com Câncer Gástrico Atendidos no Hospital Municipal Dr. José de Carvalho Florence no Período de 2007 a 2012 / Profile of Gastric Cancer Patients Treated in Hospital Municipal Dr. José de Carvalho Florence Between the Period from 2007

1970 ◽  
Vol 6 (1) ◽  
pp. 25-42
Author(s):  
Rogério Mariotto Bitetti da Silva ◽  
Rosyane Rena de Freitas ◽  
Thiago Santos Rocha
Keyword(s):  
Gastric Cancer ◽  
Chi Square ◽  
Curative Intent ◽  
Metastatic Lesions ◽  
Initial Symptoms ◽  
Chi Square Test ◽  
Loss Of Appetite ◽  
Gastric Cancer Patients ◽  
Malignant Neoplasia ◽  
Cáncer Gástrico

RESUMOObjetivo: Avaliar o perfil dos pacientes com neoplasia maligna de estômago, que receberam atendimento e tratamento no Hospital Municipal Dr. Jose de Carvalho Florence (HMJCF). Métodos: Estudo retrospectivo a partir do levantamento de prontuários. Análises foram feitas com uma amostragem e proporções esperadas desiguais e Quadros de contingência. Para se verificar associação entre as variáveis, utilizado o teste Qui–Quadrado de Pearson, considerando-se p ≤ 0,05, em um grau de confiabilidade de 95%. Resultados: O sexo masculino é o com maior número de casos na proporção de 2:1. A idade média ao diagnóstico é 65,16 anos. A queixa mais comum apresentada por estes pacientes foi a epigastralgia seguido pela inapetência. A maioria dos tumores encontrava-se no antro gástrico. Cinquenta e nove destes pacientes foram submetidos a cirurgia sendo 45 com intuito curativo. A sobrevida média foi de 15 meses e a taxa de sobrevida em 5 anos de apenas 6%.  Conclusão: O CG é uma doença muito agressiva e de prognóstico ruim. Suas manifestações iniciais são inespecíficas, o que torna seu diagnóstico em fases iniciais muito difícil.Palavras chave: Câncer Gástrico, Úlcera gástrica, Perfil de SaúdeABSTRACTObjective: Evaluate the profile of patients with malignant neoplasia of stomach, receiving care and treatment in Hospital Municipal Dr. Jose de Carvalho Florence (HMJCF). Methods: Retrospective study based on a survey of medical records. Analysis were made with a sampling and unequal expected ratios and contingency tables. To assess the association between variables, will be used the chi-square test, considering p ≤ 0.05, at a reliability level of 95%. Results: The largest number of cases are male, ratio of 2:1. The average age at diagnosis is 65.16 years. Caucasians followed by mulatto were the most frequent with Gastric Cancer. The most common complaint presented by these patients was abdominal pain followed by loss of appetite. Most tumors found in the gastric antrum. Fifty-nine of these patients underwent surgery with curative intent in 45. Twenty of them had some type of metastasis intraoperatively and 12 outpatients progressed to metastatic lesions. The median survival was 15 months and the survivor rate in 5 years was only 6%. Conclusion: The Gastric Cancer is a very aggressive and poor prognosis disease. Its initial symptoms are nonspecific, making diagnosis difficult in the early stages.Keywords: Gastric Cancer, Gastric Ulcer, Health Profile.

scholarly journals Positive lymph node ratio is an index in predicting prognosis for remnant gastric cancer with insufficient retrieved lymph node in R0 resection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Honghu Wang ◽  
Hao Qi ◽  
Xiaofang Liu ◽  
Ziming Gao ◽  
Iko Hidasa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Prognostic Index ◽  
Staging System ◽  
R0 Resection ◽  
Remnant Gastric Cancer ◽  
Curative Intent ◽  
Node Ratio

AbstractThe staging system of remnant gastric cancer (RGC) has not yet been established, with the current staging being based on the guidelines for primary gastric cancer. Often, surgeries for RGC fail to achieve the > 15 lymph nodes needed for TNM staging. Compared with the pN staging system, lymph node ratio (NR) may be more accurate for RGC staging and prognosis prediction. We retrospectively analyzed the data of 208 patients who underwent R0 gastrectomy with curative intent and who have ≤ 15 retrieved lymph nodes (RLNs) for RGC between 2000 and 2014. The patients were divided into four groups on the basis of the NR cutoffs: rN0: 0; rN1: > 0 and ≤ 1/6; rN2: > 1/6 and ≤ 1/2; and rN3: > 1/2. The 5-year overall survival (OS) rates for rN0, rN1, rN2, and rN3 were 84.3%, 64.7%, 31.5%, and 12.7%, respectively. Multivariable analyses revealed that tumor size (p = 0.005), lymphovascular invasion (p = 0.023), and NR (p < 0.001), but not pN stage (p = 0.682), were independent factors for OS. When the RLN count is ≤ 15, the NR is superior to pN as an important and independent prognostic index of RGC, thus predicting the prognosis of RGC patients more accurately.

scholarly journals Loss of HER2 Positivity after Trastuzumab in HER2-Positive Gastric Cancer: Is Change in HER2 Status Significantly Frequent?

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Yu Ishimine ◽  
Akira Goto ◽  
Yoshito Watanabe ◽  
Hidetaka Yajima ◽  
Suguru Nakagaki ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gastric Cancer ◽  
Residual Tumor ◽  
Her2 Status ◽  
Resected Specimen ◽  
Her2 Positive ◽  
Curative Intent ◽  
Course Of Disease ◽  
Trastuzumab Therapy ◽  
Her2 Positivity

Trastuzumab has recently been introduced as a treatment for HER2-positive metastatic and/or unresectable gastric cancer (MUGC); however, compared with breast cancer, some issues concerning HER2 and trastuzumab therapy for gastric cancer remain unclear. A 74-year-old woman received trastuzumab-containing chemotherapy for HER2-positive MUGC. She had a marked response to 8 months of chemotherapy, and gastrectomy and hepatic metastasectomy with curative intent were performed. The resected specimen showed complete loss of HER2 positivity in the residual tumor. For MUGC, a change in HER2 status during the course of the disease with or without chemotherapy has rarely been reported. However, in breast cancer, a significant frequency of change in HER2 status during the course of disease has been reported, and reevaluation of HER2 positivity in metastatic/recurrent sites is recommended. The choice of trastuzumab for MUGC is currently based on the HER2 status of the primary tumor at the time of initial diagnosis, without reassessment of HER2 status during the course of disease and/or in metastatic/recurrent sites, on the assumption that HER2 status is stable. However, our case casts doubt on the stability of HER2 in gastric cancer.

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