ABSTRACT
BACKGROUND/AIMS: It remains unclear whether synchronous, multiple, early gastric cancers can be radically resected with endoscopic resection. METHODOLOGY: Patients who underwent gastrectomy for early gastric cancer were included in this study and divided into two groups: a solitary gastric cancer group and a multiple gastric cancer group. The clinicopathological features of patients in each group were compared and the criteria for endoscopic resection were subsequently investigated. RESULTS: A total of 244 patients were included in the present study. The solitary and multiple gastric cancer groups included 228 patients (93.4%) and 16 patients (6.6%), respectively. The multiple gastric cancer group included 35 lesions, including a greater number of larger tumors and protruded- type tumors, as well as increased incidence of submucosal and lymphatic invasion. Only 2 of 16 cases (12.5%) in the multiple gastric cancer group met the criteria for endoscopic resection. Eleven cases were excluded due to submucosal invasion and three cases were excluded due to undifferentiated histopathological type tumors. CONCLUSIONS: To be suitable for radical endoscopic resection, prompt detection of early gastric cancer is essential, before they become multiple gastric cancers and invade the submucosa.
Subject(s)
Endoscopy, Gastrointestinal , Gastrectomy , Neoplasms, Multiple Primary/surgery , Stomach Neoplasms/surgery , Aged , Cell Differentiation , Early Detection of Cancer , Female , Gastric Mucosa/pathology , Gastric Mucosa/surgery , Humans , Lymph Node Excision , Male , Middle Aged , Neoplasm Invasiveness , Neoplasms, Multiple Primary/pathology , Patient Selection , Predictive Value of Tests , Stomach Neoplasms/pathology , Treatment OutcomeABSTRACT
On routine endoscopy a Type 2 tumor was found in the esophagogastric junction of a 74-year-old man. A histological diagnosis of squamous cell carcinoma was made based on a biopsy specimen, and lower esophagectomy and proximal gastrectomy were performed. The pathological diagnosis was pT3, N2, M0, pStage III. A low-dose FP treatment as adjuvant chemotherapy was given for only three weeks due to severe anorexia. A liver metastases measuring 22×24 mm in diameter at the s6 lesion was found with a CT examination a year and a half after the operation. A dose of 70 mg/m2 of docetaxel was given by intervenous infusion, and repeated every four weeks. Toxicities, grade 4 neutropenia and mild pneumonia associated with this chemotherapy regimen, were observed after five cycles. Therefore this treatment was discontinued. CT performed at that time showed a complete response (CR) and no more recurrences for six months. Docetaxel treatment is considered to be safe for outpatients and is one of the cures for metastatic esophageal cancer.
Subject(s)
Carcinoma, Squamous Cell/drug therapy , Esophageal Neoplasms/drug therapy , Liver Neoplasms/drug therapy , Taxoids/therapeutic use , Aged , Carcinoma, Squamous Cell/pathology , Docetaxel , Esophageal Neoplasms/pathology , Humans , Liver Neoplasms/secondary , Male , Tomography, X-Ray ComputedABSTRACT
Recently, although chemotherapy for advanced gastric cancer has been proving more highly effective, no standard chemotherapy for gastric cancer has been established. We administered S-1 combined with cisplatin (div) to a patient with advanced gastric cancer who underwent a jejunostomy because of swallowing difficulties (PS 4) due to cerebral infarction. The overall response of this chemotherapy was a partial response (PR) for 14 months. We concluded that the administration of S-1 combined with cisplatin (div) through a jejunostomy can improve the nutrition management and the quality of life (QOL) of a patient with advanced gastric cancer who is incapable of oral intake.