scholarly journals Double PTEG (percutaneous trans-esophageal gastro-tubing) was useful in nutrition and decompression for a gastric cancer patient with pyloric stenosis: a case report

2021 ◽  
pp. 217
Author(s):  
Keyword(s):  
Gastric Cancer ◽  
Preoperative Chemotherapy ◽  
Pyloric Stenosis ◽  
Nasogastric Tube ◽  
Regional Lymph Node ◽  
Gastric Distension ◽  
Central Venous ◽  
Curative Surgery ◽  
Gastric Distention ◽  
Nutrition Management

Background For gastric cancer patients with strong pyloric stenosis, decompression by nasogastric tube insertion for gastric distension and central venous nutrition management have been performed. However long-term indwelling of the nasogastric tube is accompanied by pain, and Central venous catheter placement is inferior to enteral nutrition from infection risk and nutritional viewpoint. Furthermore, these generally require management in hospitalization. Case presentation An 81-year-old male was referred to our hospital for gastric cancer accompanied by pyloric stenosis. Blood test resulted in low nutrition and anemia. CT showed thickening of the wall from the anterior gastric part to the pylorus and enlargement of 50mm in the regional lymph node, and gastric distention. We planned resection after preoperative chemotherapy. We performed double PTEG (Percutaneous Tran Esophageal Gastro-tubing) from cervical co-wound for decompression and nutrition management of the stomach. Total laparoscopic gastrectomy was performed on day 114 after insertion of the double PTEG. During which time he had been good nutrition and no gastric distention with stayed at home for 42 days. On the 10th postoperative day, he was clinically released from hospital without any complications. Conclusions We conducted a new management to reduce and nourish patients with gastric cancer who had a pyloric stenosis by double PTEG (percutaneous trans-esophageal gastro-tubing), and can perform curative surgery after preoperative chemotherapy including home management period.

The effect of preoperative chemotherapy on lymph node yield in gastric cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 80-80
Author(s):  
J. L. Dikken ◽  
P. Krijnen ◽  
C. J. Van De Velde ◽  
M. Verheij ◽  
M. Gonen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Preoperative Chemotherapy ◽  
Distal Gastrectomy ◽  
High Volume ◽  
Curative Surgery ◽  
Lymph Node Yield ◽  
Younger Age ◽  
Node Yield ◽  
The U.S

80 Background: While a minimum of 15 lymphnodes (LNs) should be evaluated for accurate staging of gastric cancer, LN yield in western countries is generally low. With the increasing use of preoperative chemotherapy, it is unknown what the effect of this treatment is on lymph node yield. The aim of the study is therefore to determine whether preoperative chemotherapy influences the number of LNs that can be obtained from specimens of patients who underwent curative surgery for gastric adenocarcinoma. Methods: In1,205 patients from a high-volume U.S. center and 1,220 patients from the Netherlands Cancer Registry (NCR) who underwent a total or distal gastrectomy with curative intent for gastric adenocarcinoma, the LN yield was compared between patients who received preoperative chemotherapy and patients who received no neoadjuvant therapy. Multivariate Poisson regression was used to identify significant predictors of LN retrieval. Results: Of the 2,425 patients who underwent a gastrectomy, 340 patients (14%) received preoperative chemotherapy. Median LN yields were 23 in the U.S. institution and 10 in the NCR. Separate multivariate analyses of the U.S. institution data and the NCR population showed in both groups that preoperative chemotherapy was not associated with a significant difference in LN yield (Table). Factors that were associated with higher LN yield were the same in both groups: female sex, younger age (6% more nodes with every 10 years decrease in age), total gastrectomy (vs. distal gastrectomy) and increasing tumor (T) stage. Conclusions: In both a high-volume cancer center, and a population-based cancer registry, female sex, younger age, total gastrectomy and advanced tumor stage were associated with an increase in lymph node retrieval in surgical specimens. Preoperative chemotherapy did not influence lymph node yield after a resection for gastric cancer. The threshold for what should constitute an adequate assessment of regional lymph nodes after curative surgery for gastric cancer should not be changed after administration of preoperative chemotherapy. [Table: see text] No significant financial relationships to disclose.

Evaluation of hybrid PET/CT gastrography in gastric cancer

2013 ◽  
Vol 04 (06) ◽  
pp. 253-259
Author(s):  
J. Jeong ◽  
E. Kong ◽  
K. Chun ◽  
B. Jang ◽  
T. Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Regional Lymph Node ◽  
Preoperative Evaluation ◽  
Cancer Staging ◽  
Diagnostic Value ◽  
Endoscopic Biopsy ◽  
Depth Of Invasion ◽  
Contrast Enhanced Ct ◽  
Pet Ct ◽  
Ct Gastrography

Summary Aim: With the recent advances in multidetector-row CT, a fusion of functional PET with three dimensional (3D) CT gastrography may provide enhanced diagnostic capability and help surgeons during preoperative planning. The diagnostic value of hybrid PET/CT gastrography was compared with that of conventional PET/CT alone in gastric cancer staging. Patients, methods: Patients with gastric cancer (n = 101) confirmed by endoscopic biopsy specimens underwent conventional PET/CT and regional PET with contrast enhanced CT, followed by gastrectomy with lymphadenectomy at our institution from November 2007 to November 2008. These images were fused into a hybrid PET/CT gastrography using the cardiac IQ fusion software. Conventional PET/CT and hybrid PET/ CT gastrography were evaluated for staging of gastric cancer. After gastrectomy, these were compared with pathologic reports respectively. Results: Gastric cancer was diagnosed as 50 early gastric cancer (EGC) and 51 advanced gastric cancer (AGC) on pathologic examination. In EGC, hybrid PET/CT gastrography and PET/CT identified 36 (72%) and 7 (14%) tumours, respectively. Hybrid PET/CT gastrography correctly delineated the subtype of 25 EGC. In AGC, all 51 (100%) tumours were identified on the hybrid PET/CT gastrography compared to 39 (76.5%) tumours on PET/CT. Hybrid PET/CT gastrography correctly classified the morphology of 42 AGC using the Bormann classification. Additionally, depth of invasion was correctly presented in 38 of 51 AGC. Hybrid PET/CT gastrography for regional lymph node (LN) metastasis in the EGC and AGC showed the sensitivity of 75% and 83.9%, and specificity 90.5% and 55%, respectively. Conclusion: Hybrid PET/CT gastrography is the more intuitive and comprehensive method for the preoperative evaluation of gastric cancer than conventional PET/CT.

scholarly journals A case of gastric and duodenal mucosa-associated lymphoid tissue lymphoma with multiple gastric cancers: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takashi Yokoyama ◽  
Tetsuya Tanaka ◽  
Suzuka Harada ◽  
Takeshi Ueda ◽  
Goki Ejiri ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Regional Lymph Node ◽  
Duodenal Bulb ◽  
Duodenal Mucosa ◽  
Upper Endoscopy ◽  
Gastric Cancers ◽  
Regional Lymph Node Dissection ◽  
H Pylori

Abstract Background Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is often caused by Helicobacter pylori and has a good prognosis. Rarely, patients with MALT lymphoma may have gastric cancer and have a poor prognosis. Case presentation We herein report a case in which surgical treatment was achieved for a 72-year-old male patient with gastric and duodenal MALT lymphoma coexisting multiple gastric cancers. He underwent upper endoscopy for epigastric discomfort, which revealed mucosal erosion on the posterior wall of the middle body of the stomach, an elevated lesion on the duodenal bulb, and a raised tumor on the antrum of the stomach. He was diagnosed with gastric and duodenal MALT lymphoma with early gastric cancer. One month after H. pylori eradication, a second upper endoscopy revealed no improvement in the gastric or duodenal mucosa, and areas of strong redness with a shallow recess just below the cardia of the stomach. As a result, a diagnosis of gastric and duodenal MALT lymphoma with two gastric cancers was made. Total gastrectomy with proximal duodenum resection using intraoperative upper endoscopy and regional lymph node dissection was performed. Pathologically, gastric and duodenal MALT lymphoma and three gastric cancers were detected. Since one of them was an advanced cancer, he started taking S-1 after his general condition improved. Conclusion For early detection of gastric and duodenal MALT lymphoma or gastric cancer, appropriate upper endoscopy and a biopsy are important. It is necessary to select a suitable treatment, such as H. pylori eradication, endoscopic treatment, surgery, chemotherapy, and irradiation, according to the disease state.

What is the most useful body composition parameter for predicting toxicities of preoperative chemotherapy for gastric cancer?

Surgery Today ◽  
2019 ◽  
Vol 50 (5) ◽  
pp. 509-515 ◽  
Author(s):  
Tadayoshi Hashimoto ◽  
Yukinori Kurokawa ◽  
Tsuyoshi Takahashi ◽  
Takuro Saito ◽  
Kotaro Yamashita ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Body Composition ◽  
Preoperative Chemotherapy ◽  
Composition Parameter ◽  
Body Composition Parameter

Perioperative nutrition management for gastric cancer

Nutrition ◽  
2022 ◽  
Vol 93 ◽  
pp. 111492
Author(s):  
Rui Xu ◽  
Xiao-Dong Chen ◽  
Zhi Ding
Keyword(s):  
Gastric Cancer ◽  
Nutrition Management ◽  
Perioperative Nutrition

scholarly journals HER-2 Expression in Immunohistochemistry Has No Prognostic Significance in Gastric Cancer Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Agnieszka Halon ◽  
Piotr Donizy ◽  
Przemyslaw Biecek ◽  
Julia Rudno-Rudzinska ◽  
Wojciech Kielan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Test Score ◽  
Prognostic Significance ◽  
Clinicopathological Parameters ◽  
Prognostic Impact ◽  
Curative Surgery ◽  
Regional Lymph Nodes ◽  
Poorly Differentiated ◽  
Her 2 ◽  
Gastric Cancer Patients

The role of HER-2 expression as a prognostic factor in gastric cancer (GC) is still controversial. The aim of the study was to asses HER-2 status, its correlations with clinicopathological parameters, and prognostic impact in GC patients. Tumor samples were collected from 78 patients who had undergone curative surgery. In order to evaluate the intensity of immunohistochemical (IHC) reactions two scales were applied: the immunoreactive score according to Remmele modified by the authors and standardised Hercep test score modified for GC by Hofmann et al. The HER-2 overexpression was detected by IHC in 23 (29.5%) tumors in Hercep test (score 2+/3+) and in 24 (30.7%) in IRS scale (IRS 4–12). The overexpression of HER-2 was associated with poorly differentiated tumors, but this correlation was not significant (P=0.064). No relationship was found between HER-2 expression and primary tumor size and degree of spread to regional lymph nodes. Both univariate and multivariate analyses revealed that TNM stage and patient’s age were the crucial negative prognostic factors. No correlation was observed between patient survival and expression of HER-2 estimated using both scales. This research did not confirm HER-2 expression (evaluated with immunohistochemistry) value as a prognostic tool in GC.

scholarly journals Neoadjuvant Chemotherapy Compared With Surgery Alone for Locally Advanced Cancer of the Stomach and Cardia: European Organisation for Research and Treatment of Cancer Randomized Trial 40954

2010 ◽  
Vol 28 (35) ◽  
pp. 5210-5218 ◽  
Author(s):  
Christoph Schuhmacher ◽  
Stephan Gretschel ◽  
Florian Lordick ◽  
Peter Reichardt ◽  
Werner Hohenberger ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Preoperative Chemotherapy ◽  
Survival Benefit ◽  
Locally Advanced ◽  
Postoperative Chemotherapy ◽  
Phase Iii ◽  
R0 Resection ◽  
Resection Rate

PurposePatients with locally advanced gastric cancer benefit from combined pre- and postoperative chemotherapy, although fewer than 50% could receive postoperative chemotherapy. We examined the value of purely preoperative chemotherapy in a phase III trial with strict preoperative staging and surgical resection guidelines.Patients and MethodsPatients with locally advanced adenocarcinoma of the stomach or esophagogastric junction (AEG II and III) were randomly assigned to preoperative chemotherapy followed by surgery or to surgery alone. To detect with 80% power an improvement in median survival from 17 months with surgery alone to 24 months with neoadjuvant, 282 events were required.ResultsThis trial was stopped for poor accrual after 144 patients were randomly assigned (72:72); 52.8% patients had tumors located in the proximal third of the stomach, including AEG type II and III. The International Union Against Cancer R0 resection rate was 81.9% after neoadjuvant chemotherapy as compared with 66.7% with surgery alone (P = .036). The surgery-only group had more lymph node metastases than the neoadjuvant group (76.5% v 61.4%; P = .018). Postoperative complications were more frequent in the neoadjuvant arm (27.1% v 16.2%; P = .09). After a median follow-up of 4.4 years and 67 deaths, a survival benefit could not be shown (hazard ratio, 0.84; 95% CI, 0.52 to 1.35; P = .466).ConclusionThis trial showed a significantly increased R0 resection rate but failed to demonstrate a survival benefit. Possible explanations are low statistical power, a high rate of proximal gastric cancer including AEG and/or a better outcome than expected after radical surgery alone due to the high quality of surgery with resections of regional lymph nodes outside the perigastic area (celiac trunc, hepatic ligament, lymph node at a. lienalis; D2).

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