Linitis Plastica of The Stomach: A Review

2020 ◽  
Vol 22 (2) ◽  
pp. 125-138
Author(s):  
Md Mizanur Rahman
Keyword(s):  
Gastric Cancer ◽  
Treatment Outcome ◽  
Surgical Resection ◽  
Linitis Plastica ◽  
Diffuse Gastric Cancer ◽  
Biological Behaviour ◽  
Desmoplastic Reaction ◽  
The Poor ◽  
Diagnostic Approaches ◽  
Poor Outcomes

Linitis plastica (LP) is a particular subtype of diffuse gastric cancer and is thought to have a separate entity in respect with its biological behaviour, pathology, presentation and treatment outcome. The poor prognosis of LP gastric cancer is due primarily to its advanced stage at diagnosis. The characteristic histopathological feature of this entity is cellular spread to the submucosa and stroma with minimal mucosal alterations accompanied by an excessive desmoplastic reaction. Despite recent research on alternative therapies, surgical resection appears the only potentially curative approach. Patient selection and multidisciplinary management are paramount when considering surgical resection in patients with gastric LP. The operative approach in patients with LP has historically been questioned because of the poor outcomes. The aim of this review is to highlight different dimension of linitis plastica stomach in respect to its definition, classification, clinico-pathological characters, diagnostic approaches and treatment outcome. Journal of Surgical Sciences (2018) Vol. 22 (2) : 125-138

scholarly journals Survival following operative management of gastric linitis plastica compared with non-operative management

2017 ◽  
Vol 99 (3) ◽  
pp. 228-232 ◽  
Author(s):  
RJ Thompson ◽  
L Ranaghan ◽  
R Kennedy ◽  
WDB Clements ◽  
PD Carey ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Radical Resection ◽  
Linitis Plastica ◽  
Operative Management ◽  
Mortality Data ◽  
Diffuse Gastric Cancer ◽  
Significant Difference ◽  
Poor Outcomes ◽  
New Diagnosis

INTRODUCTION Linitis plastica (LP) is a particular subtype of diffuse gastric cancer and is thought to have a very poor prognosis. The operative approach in patients with LP has historically been questioned because of the poor outcomes. The aim of this study was to determine the current outcomes in LP patients who undergo radical resection. METHODS Patients with a new diagnosis of diffuse gastric adenocarcinoma between 2006 and 2010 were identified from a regional pathology database. LP was diagnosed based on histological, radiological and endoscopic findings. The patients’ health records were analysed retrospectively and mortality data obtained from a regional cancer registry. The primary outcome assessed was overall survival. RESULTS Overall, 273 patients with diffuse gastric cancer were identified; 54 of these were diagnosed with LP. In the LP cohort, 17 patients underwent resection compared with 95 of the 219 patients in the non-LP group. The median survival following resection in patients with LP was 16.7 months (95% confidence interval [CI]: 8.3–25.1) while in LP patients who did not have surgery it was 3.6 months (95% CI: 2.2–4.9 months) (p<0.001). There was no significant difference in survival following resection between those with LP and those with non-LP diffuse gastric adenocarcinoma (median: 23.9 months, 95% CI: 15.8–32.1 months) (p=0.331). CONCLUSIONS Survival following resection in patients with LP is not significantly different to that in those with non-LP diffuse gastric cancer. A preoperative diagnosis of LP should not be a reason for denying radical treatment and such individuals should be managed in the same way as any other patient with diffuse gastric cancer.

scholarly journals Is Linitis Plastica a Contraindication for Surgical Resection: A Multi-Institution Study of the U.S. Gastric Cancer Collaborative

2015 ◽  
Vol 23 (4) ◽  
pp. 1203-1211 ◽  
Author(s):  
Aaron U. Blackham ◽  
Doug S. Swords ◽  
Edward A. Levine ◽  
Nora F. Fino ◽  
Malcolm H. Squires ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Resection ◽  
Linitis Plastica ◽  
The U.S

scholarly journals A Rare Occurrence of Isolated Brain Metastases from Gastric Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Manish M. Karamchandani ◽  
Tej Ganti ◽  
Sunny Jaiswal ◽  
Julian K. Wu ◽  
Muhammad Wasif Saif
Keyword(s):  
Gastric Cancer ◽  
Brain Metastases ◽  
Surgical Resection ◽  
Locally Advanced ◽  
Distant Metastases ◽  
Brain Lesions ◽  
Review Of The Literature ◽  
Advanced Tumor ◽  
Poor Outcomes ◽  
One Year

Background. Gastric cancer is the fourth most common cancer worldwide and the second most common cause of cancer-related death. The majority of newly diagnosed gastric cancer cases present either as locally advanced tumor growth or with distant metastases.Case Report. Here, we describe a case of isolated brain metastases in a male patient with gastric cancer. Initially, our patient presented with dysphagia and was diagnosed with gastric cancer after a thorough evaluation. One year after chemotherapy and surgical resection of his gastric cancer, he presented with headaches, nausea, dizziness, and photophobia. Further evaluation of these symptoms led to the discovery of three metastatic brain lesions without evidence of extracranial metastases.Conclusions. Our review of the literature has found that such cases are rare. Additionally, our review of the literature demonstrates the poor outcomes associated with metastatic brain lesions from gastric cancer and highlights the importance of surgical resection in increasing overall survival time.

Is linitis plastica a contraindication for surgical resection? A 7-institution study of the U.S. Gastric Cancer Collaborative.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 118-118
Author(s):  
Aaron Udell Blackham ◽  
Doug S. Swords ◽  
Edward Allen Levine ◽  
Nora Fitzgerald ◽  
Malcolm Hart Squires ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Resection ◽  
Gastric Adenocarcinoma ◽  
Poor Prognosis ◽  
Disease Patient ◽  
Linitis Plastica ◽  
Stage Iii ◽  
Disease Stage ◽  
Advanced Stage ◽  
Term Survival

118 Background: Linitis plastica (LP) describes a diffusively infiltrative gastric adenocarcinoma that portends poor prognosis. Current treatment guidelines do not differentiate between LP and non-LP cancers and it is not known if the same staging system should be applied to both situations. Methods: Using the multi-institutional U.S. Gastric Cancer Collaborative database, 869 patients with gastric adenocarcinoma who underwent resection between 2000-2012 were identified. Clinicopathologic, perioperative and survival outcomes of the 58 patients with LP were compared to the 811 patients without LP. Results: Advanced disease (stage III/IV) at presentation was more common in patients with LP compared to non-LP patients (90 vs 44%, p<0.01). Despite the fact that most LP patients underwent total gastrectomy (88% vs 57%, p<0.01), positive margins were more common in LP patients (33 vs 7%, p<0.01). There was no difference in perioperative complications (48 vs 43%, p=0.45) or mortality (7 vs 3%, p=0.12) between LP and non-LP patients. While survival correlated with stage in non-LP patients, there was no difference in median overall survival (OS) of LP patients based on stage (I/II, 17.3 mos; III, 10.6 mos; IV, 12.0 mos; p=0.46). Median OS was significantly worse in patients with LP (11.6 vs 37.8 months, p<0.01) when margin status and extent of lymphadenectomy were not factored in the analysis. However, when analyzing only patients with optimal resections (R0, D2 lymphadenectomy), the median OS for stage III LP (n=22) and non-LP (n=185) patients was nearly identical (26.8 vs 25.3 mos, p=0.69). There were no independent prognostic factors identified to predict survival in LP patients undergoing curative resection. Conclusions: The poor prognosis of LP gastric cancer is due primarily to its advanced stage at diagnosis. However, LP patients who undergo optimal resections can expect similar long term survival compared to optimally resected non-LP patients with advanced stage disease. Patient selection and multidisciplinary management are paramount when considering surgical resection in patients with gastric LP.

Surgery and metastases of stomach cancer in liver

2020 ◽  
pp. 21-24
Author(s):  
F. M. Dzhuraev ◽  
S. L. Gutorov ◽  
E. I. Borisova ◽  
G. G. Khakimova
Keyword(s):  
Gastric Cancer ◽  
Liver Metastases ◽  
Lymphovascular Invasion ◽  
Peritoneal Dissemination ◽  
Surgical Removal ◽  
Relapse Free Survival ◽  
Cancer Markers ◽  
Free Survival ◽  
The Poor ◽  
Isolated Liver

Liver metastases of gastric cancer determine the poor prognosis. Until now The expediency of their surgical removal has been controversial. However, according to a number of studies, the removal of potentially operable isolated liver metastases allows a significant increase of overall and relapse-free survival in some cases. The review is dedicated to the analysis of prognostic factors that allow selecting patients for surgical removal of liver metastases of gastric cancer. The main criteria are: effective perioperative chemotherapy; stage under T4, N0, absence of lymphovascular invasion, absence of peritoneal dissemination, number less than 3, size up to 4 cm, localization of metastases in one lobe, low level of cancer markers CA 19-9 and CEA.

Major Hereditary Gastrointestinal Cancer Syndromes: a Narrative Review

2017 ◽  
Vol 26 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Lakshmi Manogna Chintalacheruvu ◽  
Trudy Shaw ◽  
Avanija Buddam ◽  
Osama Diab ◽  
Thamer Kassim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Genetic Testing ◽  
Gastrointestinal Cancer ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Clinical Manifestations ◽  
Micro Rna ◽  
Diffuse Gastric Cancer ◽  
Adenomatous Polyposis ◽  
Cancer Syndromes

Gastrointestinal cancer is one of the major causes of death worldwide. Hereditary gastrointestinal cancer syndromes constitute about 5-10% of all cancers. About 20-25% of undiagnosed cases have a possible hereditary component, which is not yet established. In the last few decades, the advance in genomics has led to the discovery of multiple cancer predisposition genes in gastrointestinal cancer. Physicians should be aware of these syndromes to identify high-risk patients and offer genetic testing to prevent cancer death. In this review, we describe clinical manifestations, genetic testing and its challenges, diagnosis and management of the major hereditary gastrointestinal cancer syndromes.Key words:  −  −  −  − .Abbreviations: ACG: American College of Gastroenterology; AFAP: attenuated FAP; APC: adenomatous polyposis coli; CDH1: E-cadherin; CHRPE: congenital hypertrophy of the retinal pigment epithelium; CRC: colorectal cancer; FAMMM: Familial atypical multiple mole melanoma; FAP: Familial adenomatous polyposis; GC: gastric cancer; HDGC: Hereditary diffuse gastric cancer; IHC: immunohistochemical; IPAA: ileal pouch–anal anastomosis; IRA: ileorectal anastomosis; MSI: microsatellite instability; MMR: mismatch repair; miRNA: micro RNA.

DETERMINATION OF P53 GENE CODON 72 POLYMORPHISMS IN PATIENTS WITH GASTRIC CANCER

2013 ◽  
pp. 11-17
Author(s):  
Thi Tuy Ha Nguyen ◽  
Thi Minh Thi Ha
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
P53 Gene ◽  
Diffuse Gastric Cancer ◽  
Codon 72 ◽  
Cancer Group ◽  
Pcr Rflp ◽  
Gastric Cancer Patients ◽  
The Relationship

Background: The role of p53 gene in the gastric cancer is still controversial. This study is aimed at determining the rate of the p53 gene codon 72 polymorphisms in gastric cancer patients and evaluating the relationship between these polymorphisms and endoscopic and histopathological features of gastric cancer. Patients and methods: Sixty eight patients with gastric cancer (cases) and one hundred and thirty six patients without gastric cancer (controls) were enrolled. p53 gene codon 72 polymorphisms were determined by PCR-RFLP technique with DNA extracted from samples of gastric tissue. Results: In the group of gastric cancer, Arginine/Argnine, Arginine/Proline and Proline/Proline genotypes were found in 29.4%, 42.7% and 27.9%, respectively. The differences of rates were not statistically significant between cases and controls (p > 0,05). In males, the Proline/Proline genotype was found in 38.1% in patients with gastric cancer and more frequent in patients without gastric cancer (15.7%, p = 0,01). An analysis of ROC curve showed that the cut-off was the age of 52 in the Proline/Proline genotype, but it was 65 years old in the Arginine/Proline genotype. The Proline/Proline genotype was found in 41.9% in Borrmann III/IV gastric cancer, this rate was higher than Borrmann I/II gastric cancer (16.2%, p = 0.037) and also higher than controls (18.4%, p = 0,01). The rate of Proline/Proline genotype was 41.7% in the diffuse gastric cancer, it was higher than in controls (p = 0,023). Conclusion: No significative difference of rate was found in genotypes between gastric cancer group and controls. However, there was the relationship between Proline/Proline genotype and gastric cancer in males, Borrmann types of gastric cancer, the diffuse gastric cancer. Key words: polymorphism, codon 72, p53 gene, PCR - RFLP, gastric cancer.

scholarly journals Clinical spectrum and pleiotropic nature of CDH1 germline mutations

2019 ◽  
Vol 56 (4) ◽  
pp. 199-208 ◽  
Author(s):  
Joana Figueiredo ◽  
Soraia Melo ◽  
Patrícia Carneiro ◽  
Ana Margarida Moreira ◽  
Maria Sofia Fernandes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gastric Cancer ◽  
Genetic Alterations ◽  
Tumour Suppressor Gene ◽  
Diffuse Gastric Cancer ◽  
Loss Of Function ◽  
Lobular Breast Cancer ◽  
Cancer Syndrome ◽  
Risk Of Cancer ◽  
E Cadherin

CDH1 encodes E-cadherin, a key protein in adherens junctions. Given that E-cadherin is involved in major cellular processes such as embryogenesis and maintenance of tissue architecture, it is no surprise that deleterious effects arise from its loss of function. E-cadherin is recognised as a tumour suppressor gene, and it is well established that CDH1 genetic alterations cause diffuse gastric cancer and lobular breast cancer—the foremost manifestations of the hereditary diffuse gastric cancer syndrome. However, in the last decade, evidence has emerged demonstrating that CDH1 mutations can be associated with lobular breast cancer and/or several congenital abnormalities, without any personal or family history of diffuse gastric cancer. To date, no genotype–phenotype correlations have been observed. Remarkably, there are reports of mutations affecting the same nucleotide but inducing distinct clinical outcomes. In this review, we bring together a comprehensive analysis of CDH1-associated disorders and germline alterations found in each trait, providing important insights into the biological mechanisms underlying E-cadherin’s pleiotropic effects. Ultimately, this knowledge will impact genetic counselling and will be relevant to the assessment of risk of cancer development or congenital malformations in CDH1 mutation carriers.

Total Gastrectomy for Hereditary Diffuse Gastric Cancer at a Single Center

2017 ◽  
Vol 266 (6) ◽  
pp. 1006-1012 ◽  
Author(s):  
Vivian E. Strong ◽  
Sepideh Gholami ◽  
Manish A. Shah ◽  
Laura H. Tang ◽  
Yelena Y. Janjigian ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Hereditary Diffuse Gastric Cancer ◽  
Diffuse Gastric Cancer ◽  
Single Center
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