Clinicopathological Studies on Carcinoma Invading in Stomach and Duodenum

Uchida, Yuzo; Nogawa, Tatsuhiko; Yamashita, Masaru; Hashimoto, Shigehiro; Fujii, Ryosuke; Azekura, Kaoru; Hashimoto, Yoshinori; Ishikawa, Yoshihisa; Kotake, Yasunori; Ino, Mutsuyuki; Hidaka, Shigeyuki; Kitasato, Seiji; Ooe, Hisakuni; Shibata, Okihiko; Ishii, Toshiyo; Shimoyama, Takatoshi; Miura, Toshio; Shirabe, Joji; Tsuji, Yasukuni; Sekine, Ichiro

doi:10.5833/jjgs.12.891

Cited by 3 publications

(7 citation statements)

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“…The cases of submucosal invasion into the duodenum do not always show the longer invasion into duodenum compared with mucosal invasion cases. This finding indicates that, as in the reported advanced cases with duodenal invasion, the depth of duodenal invasion does not independently affect the length of duodenal invasion [ 14 ]. Therefore, these imply us that, it is difficult to anticipate the extent of duodenal invasion, pre and intra operative close observation for duodenal invasion is indispensable to keep the distal surgical margin negative with sufficient duodenal resection.…”

Section: Discussionsupporting

confidence: 54%

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Multiple early gastric cancer with duodenal invasion

Matsuda

Kato

Furuya³

et al. 2007

World J Surg Onc

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Section: Discussionsupporting

confidence: 54%

“…Uchida et al . [ 14 ] reported that papillary-type gastric cancer cells have a high affinity for the duodenal mucosa and that papillary-type gastric adenocarcinoma occasionally shows transient formation in the duodenal mucosa. These findings may help explain the broad duodenal invasion of over 10 mm in our case.…”

Section: Discussionmentioning

confidence: 99%

Multiple early gastric cancer with duodenal invasion

Matsuda

Kato

Furuya³

et al. 2007

World J Surg Onc

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“…1,3 Thirteen such patients who underwent surgical resection for early gastric cancer confined to the mucosa with duodenal invasion were identified in the available literature using a Medline search and Japan Centra Revuo Medicina from 1975 to 2008. [3][4][5][6][7][8][9][10][11] Table 1 reviews these thirteen cases and the present case. The mean age of patients was 64 years (range, 50-84 years), and there was a slight female predominance, with a male-to-female ratio of 4:6.…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative diagnosis of malignant invasion to the duodenum is generally difficult, because the spread of gastric cancer to the duodenum is often infiltrative and occurs directly via the submucosal or subserosal layer, 12 and most often with advanced cancer. 5 In early gastric cancer, gastroenteroscopy is highly reliable in defining the area of cancer infiltration. However, it is occasionally difficult to accurately specify tumor margins in the vicinity of the pyloric ring.…”

Section: Discussionmentioning

confidence: 99%

“…However, from a clinicopathological point of view regarding gastric cancer with duodenal invasion, it is adequate to define the beginning of Brunner's gland as the start of the duodenum. 1,5 When cancer directly invades the mucosal layer, Brunner's gland remains intact, even when virtually surrounded by cancer cells. 1 It was therefore proposed that Brunner's gland might prevent the cancer directly invading from the gastric mucosa to the duodenal mucosa.…”

Section: Discussionmentioning

confidence: 99%

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Early Gastric Cancer With Widespread Duodenal Invasion Within the Mucosa

Namikawa¹,

Kobayashi

Kitagawa³

et al. 2010

Digestive Endoscopy

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We report a rare case of early gastric cancer confined to the mucosal layer with extensive duodenal invasion, curatively removed with distal gastrectomy. An 84-year-old Japanese woman was referred to our hospital with gastric cancer. A barium meal examination and esophagogastroduodenoscopy revealed an irregular nodulated lesion measuring 6.5x5.5 cm in the gastric antrum and an aggregation of small nodules in the duodenal bulb. A biopsy specimen showed well-differentiated adenocarcinoma. The patient underwent distal gastrectomy with partial resection of the duodenal region containing the tumor and regional lymph node dissection, with no complication. Histological examination of the resected tissue confirmed well-differentiated adenocarcinoma limited to the mucosal layer and without lymph node metastasis. The cancer extended into the duodenum as far as 38 mm distant from the pyloric ring, and the resected margins were free of cancer cells. Gastric cancer located adjacent to the pyloric ring thus has the potential for duodenal invasion, even when tumor invasion is confined to the mucosal layer. In such cases, care should be taken during examinations to detect duodenal invasion, and the distal surgical margin must be negative given sufficient duodenal resection.

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Clinicopathological features of early gastric cancer with duodenal invasion

Namikawa¹,

Hanazaki²

2009

WJG

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The incidence of early gastric cancer (EGC) with duodenal invasion is extremely low, although advanced gastric cancer that arises in the antrum occasionally invades the duodenum. We investigated the clinicopathological features of EGC with duodenal invasion and provided strategies for clinical management. A Medline search was performed using the keyword "early gastric cancer" and "duodenal invasion". Additional articles were obtained from references within the papers identified by the Medline search. We revealed that EGC with duodenal invasion was of the superficial spreading type of tumor. Tumors > 60 mm in size invaded the duodenum more extensively, and the distance of duodenal invasion from the pyloric ring was further in the elevated type than in the depressed type of tumor. There was no significant difference between the length of duodenal invasion and the histological type of the tumor. Gastric cancer located adjacent to the pyloric ring, even if cancer invasion was confined to the mucosa or submucosa, was more likely to invade the duodenum. The present study reveals that the elevated type of EGC is associated with more extensive duodenal invasion when the tumor size is > 60 mm, thus highlighting the importance of identification of duodenal invasion in these cases. We also reveal that sufficient duodenal resection with a cancer-free distal surgical margin should be performed in cases of duodenal invasion.

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Clinicopathological Studies on Carcinoma Invading in Stomach and Duodenum

Cited by 3 publications

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Multiple early gastric cancer with duodenal invasion

Multiple early gastric cancer with duodenal invasion

Early Gastric Cancer With Widespread Duodenal Invasion Within the Mucosa

Clinicopathological features of early gastric cancer with duodenal invasion

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