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Palliative surgery for gastric cancer

Haruhiko Cho, Takaki Yoshikawa
Different surgical interventions can be applied for the treatment of peritoneal metastasis of gastric cancer according to the extent of metastasis. Gastrectomy is a consensus-based standard treatment for gastric cancer with minimal peritoneal metastasis, although there is a lack of established evidence. Conversely, gastrectomy for an intermediate to high extent of peritoneal metastasis is not considered a suitable treatment based on the results of the JCOG0705 study. Colostomy or bypass surgery is often performed for intestinal stenosis due to peritoneal metastasis to palliate symptoms and allow the introduction of chemotherapy...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yuanqiang Dong, Shulan Ma, Shuo Yang, Fen Luo, Zhiming Wang, Fenghua Guo
The role of non-curative surgery for patients with M1 gastric cancer (GC) is controversial. This study aimed to evaluate the efficacy of non-curative resectional surgery for patients with GC with local peritoneal metastasis.We reviewed the medical records of 47 patients with GC with local peritoneal metastasis, which was found by laparotomy or laparoscopy. The patients were divided into 2 groups: those who underwent gastric resection (n = 29), and a non-resection group who did not (n = 18). The clinical characteristics, postoperative complications, mortality, palliative intervention, and long-term outcomes of the 2 groups were compared...
December 2016: Medicine (Baltimore)
Alessandro Neri, Daniele Marrelli, Costantino Voglino, Giulio Di Mare, Francesco Ferrara, Mario Marini, Franco Roviello
Recurrent esophago-gastric junction adenocarcinoma is not a rare event and its correct management is still debated. Many approaches for the treatment of these patients exist, but only few studies compare the different techniques. Most of the studies are retrospectives series and describe the experiences of single institutions in the treatment of recurrent esophageal and esophago-gastric junction cancers. Nowadays surgery is still the main and only curative treatment. Other alternative palliative therapies could be endoscopic stent placement and balloon dilation, photodynamic therapy, thermal tumor ablation (laser photoablation and Argon plasma coagulation), radiation therapy and brachytherapy, and chemotherapy...
December 2016: Surgical Oncology
Augustin Marian Marincaş, Virgiliu Mihail Prunoiu, Ciprian Cirimbei, Raluca Buzatu, Rodica Corniciuc, Cristian Sersea, Eugen Brătucu
: Introduction: The risk of digestive fistula in patients operated for gastric neoplasm is increased due to biological imbalances generated by the cancer's progression, by diagnosis in advanced stages, and by the scale of intervention. Under these circumstances the use of some technical means to protect digestive sutures in these patients is useful. AIM: To analyse the efficiency of technical means to protect the digestive sutures in patients operated in various stages of development of gastric cancer...
2016: Chirurgia
Dun Pan, Hui Chen, Liang-Qing Li, Zong-Fang Li
BACKGROUND For patients with stage IV gastric cancer, it is unclear whether splenectomy combined with palliative surgery is needed to reduce tumor load and relieve symptoms. The objective of the present study was to investigate the effect of splenectomy combined with palliative resection for stage IV gastric carcinoma on immunological dysfunction and patient prognosis. MATERIAL AND METHODS We retrospectively analyzed medical records of 106 stage IV gastric cancer patients who underwent palliative surgery; of these, 49 patients were treated with palliative resection for gastric carcinoma combined with splenectomy, while the other 57 patients retained their spleens...
November 6, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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...
November 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
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