Gastric cancer

Abstract

Gastric cancer is one of the most common cancers and one of the most frequent causes of cancer-related deaths. The incidence, diagnostic studies, and therapeutic options have undergone important changes in the last decades, but the prognosis for gastric cancer patients remains poor, especially in more advanced stages. Surgery is the mainstay of treatment of this disease, even if it is associated with a high rate of locoregional and distant recurrence. There is ongoing debate regarding the role of adjuvant treatment In advanced disease, palliation of symptoms, rather than cure, is the primary goal of patient management. Several combination therapies have been developed and have been examined in phase III trials; however, in most cases, they have failed to demonstrate a survival advantage over the reference arm. This review summarizes the most important recommendations for the management of patients with gastric cancer.

Prognostic Role of C-reactive Protein in Gastric Cancer: A Meta-analysis

“…However, we have to mention that the statistical results on heterogeneity cannot fully reflect the clinical heterogeneity. In our study, we have to consider "TNM stage" as one of the possible source of heterogeneity as the patients in stage IV differ greatly from those in earlier stage: (1) Unlike the patients in earlier stage, gastric cancer patients in stage IV with distant metastasis have lost the opportunity for operation and mostly have to receive palliative therapies (Catalano et al, 2009) and the difference in treatment contributes greatly to the different outcomes; (2) The patients in stage IV are usually in poor physical condition, suffering weight loss, vomiting, poor oral intake caused by gastrointestinal (GI) obstruction, and the eventually cachexia, while patients in earlier stage usually experience less complications and have better nutritional status (Gencer et al, 2009); (3) Tumors with distant metastasis have already undergone a series of changes in a molecular biological level, triggered a sequence of discrete steps such as so-called invasion-metastasis cascade (Talmadge et al, 2010), showing more malignant biological behavior, which results in the clinical heterogeneity between patients in stage IV and earlier stage. Besides the "TNM stage", "max follow-up period" is also considered another potential source of heterogeneity.…”

Phase II study of sequential cisplatin plus 5-fluorouracil/leucovorin (5-FU/LV) followed by irinotecan plus 5-FU/LV followed by docetaxel plus 5-FU/LV in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma

“…[7]. According to a meta-analysis, irinotecan regimens show a non-statistically significant benefit in survival of about 1 month and a lower rate of treatment-related deaths over the reference regimen [3]. Taken together, all these data suggest that irinotecan is efficacious almost as cisplatin, but has a different safety profile.…”

“…Cure for patients with gastric cancer is only available for those in whom a complete surgical resection can be performed. Advanced disease is incurable, and treatment is based on palliative chemotherapy [3].…”

Mide Kanserli Olgularin Geriye Donuk Incelenmesi

“…Tüm mideyi tutan diffüz tip gastrik kanserlerde de total gastrektomi yapılmalıdır. Her ne kadar 1/3 distal yerleşimli tümörlere de total gastrektomi yapılmasını önerenler olsada bu lokalizasyonlar için total gastrektominin sağkalım avantajı gösterilememiştir (2). Yapılan prospektif randomize çalışmalar bu konuda yeterli kanıt sağlamaktadırlar (11)(12)(13).…”

“…Erkeklerde akciğer, prostat, kolorektal ve mesane kanserinden sonra, kadınlarda ise meme, kolorektal, akciğer ve endometrium kanserlerinden sonra gelmektedir. Kadın erkek oranı ise 1,6:1 olarak belirlenmiştir (2). Mide kanseri, kansere bağlı ölümlerde ülkemizde erkeklerde ikinci, kadınlarda ise üçüncü sırada yer almaktadır (3).…”