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Palliative surgery for gastric cancer

Gustavo Dos Santos Fernandes, Luiza D Batista Bugiato Faria, Isadora de Assis Pereira, Natália C Moreira Neves, Yasmine Oliveira Vieira, Alessandro I Cavalcanti Leal
Gastric metastasis is rare but it can be the initial symptom of cancer. The second leading cause of this type of metastasis is breast cancer. A lack of clinical signs and nonspecific side effects of the treatment of primary tumors can lead to the misdiagnosis of metastatic gastric cancer. Upper gastrointestinal endoscopy with biopsy and immunohistochemistry should be used for diagnosis. Treatment is palliative; it includes chemo, endocrine, and radiation therapies. Four patients with breast cancer and gastric metastasis were identified...
September 5, 2016: Rare Tumors
Kostadin Georgiev Angelov, Mariela Borisova Vasileva, Konstantin Savov Grozdev, Svetoslav Yordanov Toshev, Manol Bonev Sokolov, Georgi Todorov Todorov
OBJECTIVE: The aim of this study was to examine the significance of the extent of gastric resection on the postoperative and overall gastric cancer survival. BACKGROUND: Resection with clean margins (4 cm or more) is widely accepted as the standard-ized goal for radical treatment of gastric cancer according to current guidelines, while the type of resection (subtotal or total) is still a matter of debate. PATIENTS AND METHODS: The study included 155 patients diagnosed and treated in the Department of Surgery, Aleksandrovska University Hospital between January 2005 and December 2014...
2016: OncoTargets and Therapy
Yousuke Nakai, Tsuyoshi Hamada, Hiroyuki Isayama, Takao Itoi, Kazuhiko Koike
Patients with periampullary cancer or gastric cancer often develop malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), and combined MBO and GOO is not rare in these patients. Combined MBO and GOO is classified by its location and sequence, and treatment strategy can be affected by this classification. Historically, palliative surgery, hepaticojejunostomy and gastrojejunostomy were carried out, but the current standard treatment is combined transpapillary stent and duodenal stent placement...
August 23, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
D Šmíd, T Skalický, J Fichtl, D Kubačková, J Doležal, P Novák, T Svoboda, D Slouka
BACKGROUND: Gastric cancer is a malignant disease with a poor prognosis. The incidence of gastric cancer in the Czech Republic in 2013 was 14.34 cases per 100,000 citizens. Unfortunately, most patients are dia-gnosed with advanced stage disease and therefore undergo palliative treatment. Some patients undergo surgery and a very small percentage undergo palliative chemotherapy. The five year survival rate for those with advanced gastric cancer ranges from 5-15%. METHODS: This is a prospective study of patients undergoing chemotherapy for advanced gastric cancer...
2016: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Paul R Burton, Geraldine J Ooi, Cheryl Laurie, Kalai Shaw, Paul E O'Brien, Andrew Smith, Peter D Nottle, Wendy A Brown
BACKGROUND: Oesophageal cancer following bariatric surgery adds significant complexity to an already challenging disease. There is limited data on the diagnosis, presentation and management in these complex cases. METHODS: A retrospective cohort study on prospectively collected data over 10 years was conducted. The oesophago-gastric cancer database was searched for patients with prior bariatric surgery. Data were retrieved on bariatric and cancer management. RESULTS: We identified nine patients with oesophageal or gastro-oesophageal junction adenocarcinoma after bariatric surgery...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
A H Hölscher, M Stahl, H Messmann, M Stuschke, H J Meyer, R Porschen
The current German S3 guideline represents the recommendations for the diagnosis and therapy of squamous cell carcinomas and adenocarcinomas of the esophagus based on evidence from the literature and interdisciplinary expert consensus. Esophagogastroscopy with biopsy, endosonography, and spiral CT scan of the neck, thorax, and abdomen are decisive in staging and the choice of therapy. For a curative approach, surgery, especially transthoracic esophagectomy and gastric pull-up, is the most important therapeutic option, except in the case of mucosal carcinomas or cervical squamous cell carcinomas...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Ming Lu, Zuyao Yang, Qi Feng, Mei Yu, Yuelun Zhang, Chen Mao, Lin Shen, Jinling Tang
Although signet ring cell cancer (SRCC) has long been regarded as an adverse prognostic factor of gastric cancer, the findings of existing studies on this issue are inconsistent. We conducted a retrospective cohort study of 2199 consecutive patients with gastric cancer treated in a tertiary cancer hospital in Beijing, China, 1994 to 2013. The characteristics of SRCC and non-SRCC were compared. The prognostic effects of SRCC and other important clinicopathological factors on overall survival were evaluated by both univariate and multivariate Cox regression analyses and expressed as hazard ratio (HR) with 95% confidence interval (CI)...
July 2016: Medicine (Baltimore)
Yen-I Chen, Mouen A Khashab
PURPOSE OF REVIEW: Malignant gastric outlet obstruction (GOO) is a debilitating complication of cancer associated with a poor prognosis. The primary aim in the management of malignant GOO is usually palliation starting with the reinstitution of luminal patency with either surgical bypass or enteral stenting. These traditional modalities, however, have important limitations. Endoscopic bypass is a novel approach to GOO and may be an ideal technique, in which a sustained bypass can be created through a minimally invasive approach...
July 6, 2016: Current Opinion in Gastroenterology
T Boerner, A Graichen, T Jeiter, F Zemann, P Renner, L März, Y Soeder, H J Schlitt, P Piso, M H Dahlke
PURPOSE: Peritoneal carcinomatosis (PC) is a dismal feature of gastric cancer that most often is treated by systemic palliative chemotherapy. In this retrospective matched pairs-analysis, we sought to establish whether specific patient subgroups alternatively should be offered a multimodal therapy concept, including cytoreductive surgery (CRS) and intraoperative hyperthermic chemotherapy (HIPEC). METHODS: Clinical outcomes of 38 consecutive patients treated with gastrectomy, CRS and HIPEC for advanced gastric cancer with PC were compared to patients treated by palliative management (with and without gastrectomy) and to patients with advanced gastric cancer with no evidence of PC...
June 16, 2016: Annals of Surgical Oncology
Megan M Boniface, Sachin B Wani, Tracey E Schefter, Phillip J Koo, Cheryl Meguid, Stephen Leong, Jeffrey B Kaplan, Lisa J Wingrove, Martin D McCarter
The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical), and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making...
2016: Cancer Management and Research
Daguang Wang, Yanpeng Xing, YuChen Guo, Yang Zhang, Yujia Chen, Jian Suo
OBJECTIVE: The aim of this study is to discuss the curative effect of introperitoneal hyperthermic perfusion chemotherapy(IHPC) combined with systemic neoadjuvant chemotherapy on the gastric cancer patients with peritoneal carcinomatosis. METHODS: Sixty-four patients with gastric cancer and peritoneal carcinomatosis who were hospitalized in the Department of Gastrointestinal Surgery of First Hospital of Jilin University from December 2006 to December 2013. After peritoneal carcinomatosis was confirmed during laparoscopic exploration, FOLFOX6 (oxaliplatin and calcium folinate and 5-Fu) was performed for systemic chemotherapy...
May 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Lin Chen, Jianxin Cui
The new cases and mortality of gastric cancer in the population aged over 75 years account for 21% and 30% of the cases in the whole population respectively. These elderly patients with gastric cancer are characteristic of nonspecific clinical manifestations, high proportion of upper gastric carcinoma, larger tumor size, advanced TNM stage, concomitant diseases, poor body function and high risk of complications. Specialists should pay more attention to the diagnosis and treatment of these patients. Comprehensive and systemic assessment should be performed, and concomitant diseases should be treated...
May 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Alexandra W Acher, Malcolm H Squires, Ryan C Fields, George A Poultsides, Carl Schmidt, Konstantinos I Votanopoulos, Timothy M Pawlik, Linda X Jin, Aslam Ejaz, David A Kooby, Mark Bloomston, David Worhunsky, Edward A Levine, Neil Saunders, Emily Winslow, Clifford S Cho, Glen Leverson, Shishir K Maithel, Sharon M Weber
BACKGROUND: This study utilized a multi-institutional database to evaluate risk factors for readmission in patients undergoing curative gastrectomy for gastric adenocarcinoma with the intent of describing both perioperative risk factors and the relationship of readmission to survival. METHODS: Patients who underwent curative resection of gastric adenocarcinoma from 2000 to 2012 from seven academic institutions of the US Gastric Cancer Collaborative were analyzed...
July 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Yan Liu, Ye Feng, Yongjian Gao, Ruizhi Hou
BACKGROUND AND AIM: Advanced gastric cancer accounts for a substantial portion of cancer-related mortality worldwide. Surgical intervention is the curative therapeutic approach, but patients with advanced gastric cancer are not eligible for the radical resection. The present work aimed to investigate the efficacy and safety of palliative surgery combined with S-1, oxaliplatin, and docetaxel chemotherapy in the treatment of patients with advanced gastric cancer. METHOD: A total of 20 patients who underwent palliative resection of gastric cancer in China-Japan Union Hospital of Jilin University from 2010 to 2011 were evaluated...
2016: OncoTargets and Therapy
Kanefumi Yamashita, Shinsuke Takeno, Satoshi Nimura, Yoshikazu Sugiyama, Takayuki Sueta, Kenji Maki, Yoshiyuki Kayashima, Hironari Shiwaku, Daisuke Kato, Tatsuya Hashimoto, Takamitsu Sasaki, Yuichi Yamashita
INTRODUCTION: We present a very rare case of gastric metastasis mimicking primary gastric cancer in a patient who had undergone surgery for salivary duct carcinoma. PRESENTATION OF CASE: A 67-year-old man had been diagnosed as having right parotid cancer and had undergone a right parotidectomy and lymph node dissection. The histological diagnosis was salivary duct carcinoma. One year after the surgery, a positron emission tomography-computed tomography scan using fluorodeoxyglucose (FDG) revealed an abnormal uptake of FDG in the left cervical, mediastinal, paraaortic, and cardiac lymph nodes; stomach; and pancreas...
2016: International Journal of Surgery Case Reports
Paolo Sammartino, Daniele Biacchi, Tommaso Cornali, Maurizio Cardi, Fabio Accarpio, Alessio Impagnatiello, Bianca Maria Sollazzo, Angelo Di Giorgio
An integrated treatment strategy using peritonectomy procedures plus hyperthermic intraperitoneal chemotherapy (HIPEC) is now a clinical standard of care in selected patients with peritoneal metastases and primary peritoneal tumors. This comprehensive approach can offer many patients, who hitherto had no hope of cure, a good quality of life and survival despite limited morbidity. The increasingly successful results and chance of interfering in the natural history of disease has prompted research to develop for some clinical conditions a therapeutic strategy designed to prevent malignant peritoneal dissemination before it becomes clinically evident and treat it microscopically (tertiary prevention)...
June 2016: Indian Journal of Surgical Oncology
Ramakrishnan Ayloor Seshadri, Olivier Glehen
Peritoneal metastasis, either synchronous or metachronous, is commonly seen in gastric cancer. It is associated with a poor prognosis, with a median survival of less than one year. The outcomes are not significantly improved by the use of systemic chemotherapy. We review the relevant literature on the role of HIPEC in gastric cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used in three situations in gastric cancer. Besides its role as a definitive treatment in patients with established peritoneal metastasis (PM), it has been used as a prophylaxis against peritoneal recurrence after curative surgery and also as a palliative treatment in advanced peritoneal metastasis with intractable ascites...
June 2016: Indian Journal of Surgical Oncology
Masahide Ikeguchi, Kozo Miyatani, Seigo Takaya, Tomoyuki Matsunaga, Youji Fukumoto, Tomohiro Osaki, Hiroaki Saito, Toshiro Wakatsuki
Optimal treatment of patients with gastric cancer with synchronous distant metastases is palliative chemotherapy. However, occasionally gastrectomy should be selected due to control bleeding from tumors, perforation, or obstruction. The aim of this study is to evaluate the survival benefits of non-curative gastrectomy for patients with synchronous distant metastasis. Total 78 gastric cancer patients with synchronous distant metastasis treated in our hospital between 2003 and 2012 were enrolled in this study...
March 2016: Indian Journal of Surgical Oncology
Katherine E Poruk, Christopher L Wolfgang
Pancreatic adenocarcinoma is the fourth leading cause of cancer death in the United States. Surgical resection offers the best opportunity for prolonged survival but is limited to patients with locally resectable disease without distant metastases. Regrettably, most patients are diagnosed at a point in which curative surgery is no longer a treatment option. In these patients, management of symptoms becomes paramount to improve quality of life and potentially increase survival. This article reviews the palliative management of unresectable pancreatic cancer, including potential palliative resection, surgical and endoscopic biliary and gastric decompression, and pain control with celiac plexus block...
April 2016: Surgical Oncology Clinics of North America
E A Godzhello, M V Khrustaleva, R D Sharipzhanova, M A Dekhtyar
INTRODUCTION: Gastroduodenal, enteral and colorectal stenting of blastomatous stenosis is a reasonable alternative to operative treatment of unresectable tumors. Moreover in some cases it allows to gain time and to prepare the patient for radical surgery. MATERIAL AND METHODS: For the period from 2007 to 2015 in endoscopic department of acad. B.V. Petrovskiy Russian Research Center for Surgery 76 patients with piloroduodenal, enteral and colic stenoses successfully underwent self-expanding metal stents installation...
2015: Khirurgiia
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