Imaging Diagnosis of Gastric Cancer: CT Scan

2002 ◽  
Vol 46 (6) ◽  
pp. 511 ◽  
Author(s):  
Jae Mun Lee ◽  
Seung Eun Jung
Keyword(s):  
Gastric Cancer ◽  
Ct Scan ◽  
Imaging Diagnosis

scholarly journals Pancreatic enzymatic mediastinitis followed by total gastrectomy with splenectomy: report of two cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yoko Zaitsu ◽  
Takashi Nishizaki ◽  
Takuma Izumi ◽  
Daisuke Taniguchi ◽  
Yuichiro Kajiwara ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Abdominal Surgery ◽  
Ct Scan ◽  
Pancreatic Fistula ◽  
Medical History ◽  
Advanced Gastric Cancer ◽  
Total Gastrectomy ◽  
Upper Body ◽  
History Of ◽  
Acute Mediastinitis

Abstract Background Acute mediastinitis is a rare disease that rapidly progresses with a high mortality rate. Its most common cause is direct injury of the mediastinum, including iatrogenic causes such as cardiac surgery or upper endoscopy. Enzymatic mediastinitis is a rare complication of a pancreatic fistula caused by the inflammatory digestion of the parietal peritoneum spreading to the mediastinum. Here, we present two cases of enzymatic mediastinitis caused by total gastrectomy with splenectomy. One of them was successfully treated and cured after early diagnosis and transabdominal drainage. Case presentation Case 1 was that of a 60-year-old man (body mass index [BMI] 27) with a medical history of diabetes and hypertension who was diagnosed with advanced gastric cancer in the upper body of the stomach. A total gastrectomy with splenectomy was performed. The patient experienced acute respiratory failure 24 h after surgery. Pulmonary embolism was suspected, so a computed tomography (CT) scan was performed; however, no relevant causes were found. Although he was immediately intubated and treated with catecholamine, he died in the intensive care unit (ICU) 40 h after surgery. Post-mortem findings revealed retroperitonitis caused by a pancreatic fistula spreading towards the mediastinum, causing severe mediastinitis; a review of the CT scan revealed pneumomediastinum. We concluded that the cause of death was enzymatic mediastinitis due to post-gastrectomy pancreatic fistula. Case 2 involved a 61-year-old man (BMI 25) with a medical history of appendicitis who was diagnosed with advanced gastric cancer at the gastric angle between the lesser curvature and the pylorus, spreading to the upper body of the stomach. A total gastrectomy with splenectomy was also performed. The patient had a high fever 3 days after the surgery, and a CT scan revealed pneumomediastinum, indicating mediastinitis. As the inflammation was below the bronchial bifurcation, we chose a transabdominal approach for drainage. The patient was successfully treated and discharged. Conclusion Acute mediastinitis caused by gastrectomy is rare. The acknowledgment of abdominal surgery as a cause of mediastinitis is important. In treating mediastinitis caused by abdominal surgery, transabdominal drainage may be a minimally invasive yet effective method if the inflammation is mainly located below the bifurcation of the trachea.

scholarly journals Studies of Preoperative Imaging Diagnosis for the Assessment on the Lymph Node Metastasis of Gastric Cancer.

1992 ◽  
Vol 25 (4) ◽  
pp. 1156-1160 ◽  
Author(s):  
Shinichi Yamada ◽  
Kunio Okajima ◽  
Hiroshi Isozaki ◽  
Eiji Nakata ◽  
Toshikazu Kitade ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Preoperative Imaging ◽  
Imaging Diagnosis ◽  
Node Metastasis

scholarly journals A Case of Advanced Gastric Cancer with Peritoneal Metastasis Treated Successfully with Nivolumab

2019 ◽  
Vol 12 (2) ◽  
pp. 523-528
Author(s):  
Hirofumi Tazawa ◽  
Takahisa Suzuki ◽  
Toshiaki Komo ◽  
Haruna Kubota ◽  
Shunya Tahara ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Ct Scan ◽  
Advanced Gastric Cancer ◽  
Peritoneal Metastasis ◽  
Performance Status ◽  
Tumor Biomarkers ◽  
Ureteral Stenosis ◽  
The Third ◽  
Third Line ◽  
And Performance

Peritoneal metastasis (PM) is detected in 14% of gastric cancers at the time of initial diagnosis, with a median survival time of 4 months. A 66-year-old woman diagnosed with cT4a(SE) N2M1(LYN) cStage IV was treated with three lines of chemotherapy for a year. During the third line of chemotherapy, computed tomography (CT) scan revealed a large amount of ascites, periportal collar sign, and bilateral ureteral stenosis owing to PM. The tumor biomarkers (CEA and CA 19–9) remained elevated similar to the initial levels. The patient was administered 3 mg/kg nivolumab intravenously biweekly as the fourth line of chemotherapy. Three months after the nivolumab treatment, gastroscopy revealed an extreme reduction of the tumor size, while CT scan revealed the absence of ascites and a well-controlled tumor. There was no immune-related adverse event with nivolumab during and after the treatment, and performance status improved to 0. The patient has been alive for about 2.5 years since her first visit with her sixth line of chemotherapy (docetaxel). We report a case of advanced gastric cancer with PM that was treated successfully with nivolumab.

A phase II trial of perioperative chemotherapy with folinic acid, 5-fluorouracil, and oxaliplatin in potentially resectable gastric cancer with regional lymph node metastasis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4602-4602 ◽  
Author(s):  
S. Im ◽  
S. Kim ◽  
J. Kim ◽  
H. Lee ◽  
M. Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Ct Scan ◽  
Folinic Acid ◽  
Regional Lymph Node ◽  
Clinical Stage ◽  
Metabolic Responses ◽  
R0 Resection ◽  
Pet Ct ◽  
Modified Folfox6

4602 Background: Peri-operative chemotherapy in operable advanced gastric cancer (AGC) is still in a controversial area. Results from MAGIC trial suggest that a peri-operative regimen of ECF (epirubicin, cisplatin, 5-FU) decreased tumor size and significantly improved PFS and OS in patients with operable AGC (NEJM 355: 11, 2006). The aim of this study was to evaluate the efficacy and toxicity of folinic acid (FA), infusional 5-fluorouracil (5-FU), and oxaliplatin (modified FOLFOX6), administered every 2 wks in potentially operable AGC with regional lymph node (LN) metastasis. Methods: Previously untreated gastric adenocarcinoma patients with measurable LN on CT scan (clinical stage: cT2 or cT3, N+) were eligible. Staging also included a PET-CT and endoscopic ultrasonography (EUS). Patients received 4 cycles of neoadjuvant therapy with FA 100 mg/m2 (2-hr i.v.), 5-FU 2.4 g/m2 (46-hr continuous infusion), and oxaliplatin 100 mg/m2 (2-hr i.v.), followed by curative radical surgery including D2 dissection and 4 cycles of adjuvant modified FOLFOX6. Clinical responses were assessed by RECIST using CT scan before surgery and early metabolic responses were assessed by PET-CT after 2 cycles of chemotherapy. Results: Thirty-one patients were enrolled from Oct. 2004 to Nov. 2006 and currently, 29 of them are evaluable for response. Median age was 56 yrs (range, 35–69). Most patients had EUS T3N1or2 designation. Of 29 evaluable patients, PR were observed in 19 (66%), SD in 9 (31%), and PD in 1 (3%) patient. Early metabolic responses (SUV decrement = 35% by PET-CT) were significantly correlated with conventional radiographic response (p=0.037). The R0 resection rate was 90% and pathologic CR was 7%. Median follow-up duration was 11.8 mo. and median PFS has not been reached yet. Total 219 cycles were administered. G3/4 neutropenia occurred in 6 cycles (3.0%). Nausea G3/4 occurred in 1 cycle (0.5%) and diarrhea in 1 cycle (0.5%). There were no cases of peripheral neuropathy G3/4 or febrile neutropenia G3/4. Conclusions: Peri-operative chemotherapy with modified FOLFOX6 is very effective and feasible in patients with potentially resectable AGC with regional LN metastasis. Early response can be predicted by PET-CT. No significant financial relationships to disclose.

scholarly journals Staging Laparoscopy Is Still a Valuable Tool for Optimal Gastric Cancer Management

2021 ◽  
Author(s):  
Erica Sakamoto ◽  
Marcus Fernando Kodama Pertille Ramos ◽  
Marina Alessandra Pereira ◽  
Andre Roncon Dias ◽  
Ulysses Ribeiro Junior ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Ct Scan ◽  
Imaging Techniques ◽  
Clinicopathological Characteristics ◽  
Staging Laparoscopy ◽  
Preoperative Imaging ◽  
Cancer Center ◽  
Cancer Management ◽  
Stage Ivb ◽  
Sensitivity Specificity

Abstract Purpose: Complete surgical resection is the main determining factor in the survival of advanced gastric cancer (AGC) patients, but resection should be avoided in metastatic disease. Peritoneum is a common site of metastasis and preoperative imaging techniques still fail to detect peritoneal metastasis (PM). Thus, the aim of this study was to evaluate the role of Staging Laparoscopy (SL) in the staging of AGC patients in a Western tertiary cancer center. Methods: We reviewed 130 patients with gastric adenocarcinoma submitted to SL from 2009 to 2020 from a prospective database. Clinicopathological characteristics were analyzed to identify factors associated with the presence of PM. We also evaluated the accuracy and strength of agreement between computed tomography (CT) and SL in detecting PM, and the change in treatment strategy after SL. Results: Among the 130 patients, PM was identified in 66 patients (50.76%) - P1 group. The sensitivity, specificity and accuracy of CT in detecting PM were 51,5%, 87,5% and 69.2%, respectively. According to the Kappa coefficient, concordance between SL and CT was 38.8%. In multivariate analysis, ascites (p=0.001) and suspected PM on CT scan (p=0.007) were statistically correlated with the P1 group. In 40 patients (30.8%), staging and treatment plans changed after SL (32 patients avoided unnecessary laparotomy and 8 patients who were previously considered stage IVb by CT scan were referred for surgical treatment). Conclusions: Even with current advances in imaging techniques, SL demonstrated an important role in the diagnosis of PM and remains valuable for determining the correct therapeutic strategy.

Imaging diagnosis for staging of gastric cancer

1999 ◽  
Vol 17 (2) ◽  
pp. 96-102 ◽  
Author(s):  
Christian Kuntz ◽  
Christian Herfarth
Keyword(s):  
Gastric Cancer ◽  
Imaging Diagnosis ◽  
Staging Of Gastric Cancer

scholarly journals The Role of Hospital Transfer in Reexamination Computed Tomography Scans: A Nationwide Cohort Study of Gastric Cancer Patients Undergoing Surgery

Healthcare ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 2
Author(s):  
Jaeyong Shin ◽  
Yoon Jung Choi ◽  
Young Choi ◽  
Sang Gyu Lee ◽  
Ji Man Kim
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Ct Scan ◽  
Cancer Patients ◽  
Multivariate Logistic Regression Analysis ◽  
High Volume ◽  
Ct Scans ◽  
High Volume Hospital ◽  
Hospital Transfer ◽  
Gastric Cancer Patients

Because the high-cost of medical imaging can cause a tremendous economic burden across the health care system, we investigated factors associated with taking additional computed tomography (CT) scans. Data of gastric cancer patients were eligible for analysis if the patient underwent a gastrectomy during the study period (2002–2013). We defined initial CT scans as those taken within 90 days from the surgery date. If there was an additional CT scan between the date of an initial CT scan and the surgery date, we regarded it as a reexamination. We used multivariate logistic regression analysis for reexamination CT scans. Among 3342 gastrectomy patients, 1165 participants underwent second CT scans. Transfer experience (adjusted odds ratio (OR) = 23.87, 95% confidence interval (CI) = 18.15–31.39) was associated with higher OR for reexamination. Among transferred patients, an increased number per 100 beds at the initial CT hospital was associated with a decreased OR for reexamination (OR = 0.88, 95% CI = 0.83–0.94), but increased beds in surgery hospitals was related to an increased OR for reexamination (OR = 1.29, 95% CI = 1.20–1.36). In our study, transfer experience, initial CT scan in a low-volume hospital, and surgical treatment in a high-volume hospital were associated with reexamination CT scans.

Imaging diagnosis of portal tumor thrombus secondary to gastric cancer

1989 ◽  
Vol 14 (1) ◽  
pp. 161-163 ◽  
Author(s):  
Kenichi Takayasu ◽  
Hisao Tajiri ◽  
Masayuki Noguchi ◽  
Tsutomu Ishikawa ◽  
Keiichi Maruyama
Keyword(s):  
Gastric Cancer ◽  
Tumor Thrombus ◽  
Imaging Diagnosis
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