CT and PET in Stomach Cancer: Preoperative Staging and Monitoring of Response to Therapy

Lim, Joon Seok; Yun, Mi Jin; Kim, Do Young; Hyung, Woo Jin; Park, Mi‐Suk; Choi, Jin Young; Kim, Tae Sung; Lee, Jong Doo; Noh, Sung Hoon; Kim, Ki Whang

doi:10.1148/rg.261055078

Cited by 170 publications

(105 citation statements)

References 42 publications

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“…Positron emission tomography (PET) is also used in staging. Combined modality PET-CT has higher accuracy in preoperative staging (68%) than PET (47%) or CT (53%) alone [Dassen et al 2009;Lim et al 2006].…”

Section: Introductionmentioning

confidence: 99%

Gastric cancer and trastuzumab: first biologic therapy in gastric cancer

et al. 2013

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Gastric cancer remains difficult to cure and has a poor overall prognosis. Chemotherapy and multimodality therapy has shown some benefit in the treatment of gastric cancer. Current therapies for gastric cancer have their limitations; thus, we are in need of newer treatment options including targeted therapies. Here, we review the biologic therapy with trastuzumab in human epidermal growth factor receptor 2 (HER2)+ gastric cancer.

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Section: Introductionmentioning

confidence: 99%

Gastric cancer and trastuzumab: first biologic therapy in gastric cancer

et al. 2013

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“…PET-CT may be useful for gastric cancer patients in whom there is a clinical suspicion of recurrence [5]. However, PET-CT has limitations for the detection of recurrence if the histopathologic types of gastric cancer are mucinous and signet ring cell carcinoma, as well as poorly differentiated adenocarcinoma [6]. Therefore, there are still no sure tools for the detection of recurrence despite the availability of these diagnostic methods.…”

Section: Discussionmentioning

confidence: 99%

Duodenal stump cancer after Billroth-II distal gastrectomy for gastric cancer

Lee

Kim

2009

Gastric Cancer

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EGC have a risk of developing a second primary (metachronous) cancer, such as colorectal, lung, or liver cancer [1][2][3].The duodenal stump after Billroth II (B-II) distal gastrectomy is a rare site for cancer recurrence unless a tumor-free margin has not been achieved. Moreover, to our knowledge, there are no previously published studies regarding the occurrence of recurrent or metachronous cancer at the duodenal stump. Here, we describe duodenal stump cancer that occurred after a B-II distal gastrectomy for advanced gastric cancer (AGC), particularly focusing on the diffi culties associated with distinguishing recurrent gastric cancer from metachronous duodenal cancer. Case reportA 68-year-old man who had undergone distal gastrectomy with B-II type gastrojejunostomy for AGC in June 2005, presented with abrupt onset of dizziness and tarry stool in June 2008. The previously removed tumor was 8.5 × 7.5 cm in size, and located in the posterior wall of the mid-body portion of the stomach, and there was no duodenal lesion on the gastrofi berscopic (GFS) examination that had been performed before the gastrectomy. Pathologic examination revealed that the gastric lesion was a poorly differentiated adenocarcinoma infi ltrating the subserosa, accompanied by multiple lymph node metastases (48 of 77 retrieved nodes were metastatic); the duodenum was resected, using a linear stapler, about 2 cm below the pyloric ring. The proximal and distal resected margins were 1.5 cm and 8.0 cm, respectively. Subsequently, six cycles of adjuvant chemotherapy, including 5-fl uorouracil (FU), epirubicin, and cisplatinum, were performed without any problems. The patient was followed up every 6 months by tumor marker analysis, ultrasonography, and computed tomography (CT) and his last checkup had been in January 2008. During Abstract Duodenal cancer is an uncommon neoplasm and it mostly arises from the periampullary area. However, metachronous or even recurrent cancer at the duodenal stump following Billroth II type distal gastrec tomy for gastric cancer is extremely rare and, to our knowledge, has not yet been reported. A 68-year-old man underwent Billroth II distal gastrectomy with D2 lymph node dissection for an advanced gastric cancer. At that time the tumor stage was T2bN3M0, with 44 of 78 retrieved lymph nodes showing metastasis. He was well without recurrence for 3 years; however, he visited our hospital because of the abrupt onset of dizziness and tarry stool. A polypoid tumor that bled easily when touched was found at the end of the afferent loop of the duodenal stump by gastrofi berscopic examination, and it was proven to be an adenocarcinoma by endoscopic biopsy. Fortunately, additional studies, including abdominal computed tomography and positron emission tomography-computed tomography, showed no other sites of recurrence. The patient underwent pancreaticoduodenectomy for local control of the recurrent tumor at the duodenal stump, and the pathologic fi ndings, based on immunohistochemical staining, strongly suggested that the du...

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“…Patient's history and gastroscopic examination is the diagnostic method [59].Upper GI series (barium roentgenogram),and computed tomography or CT scanning of the abdomen may revel gastric cancer [65].In 2013,Chinese and Israeli scientists reported a successful pilot study of a breathalyzer-style breath test indented to diagnose stomach cancer by analyzing exhaled chemicals without the need for an intrusive endoscopy [66].A biopsy with subsequent histological analysis, is the only sure way to confirm the presence of cancer cells [59].Other gastroscopic modalities such as optical coherence tomography are being tested investigationally for similar applications [67].A number of cutaneous conditions are associated with gastric cancer include tripe palms, a darkening hyperplasia of the skin of palms [68].Blood tests for tumor markers, such as CEA(carcinoembryonic antigen) and CA( carbohydrate antigen) may be ordered, as their levels correlate to extent of metastasis especially the liver, and the cure rate [69]. Gastric cancer staging: The clinical staging of gastric cancer includes: [70,71].…”

Section: Diagnosismentioning

confidence: 99%