Management of patients with pregnancy-associated gastric cancer in Japan: a mini-review

  • Kaoru Sakamoto
  • Tatsuo KandaEmail author
  • Manabu Ohashi
  • Takumi Kurabayashi
  • Takehiro Serikawa
  • Masamichi Matsunaga
  • Katsuyoshi Hatakeyama
Review Article


Gastric cancer associated with pregnancy is quite rare, and is most often diagnosed at an advanced stage. Furthermore, physicians are confronted with two conflicting issues in this condition: the need for early treatment of the maternal gastric cancer and the continuation of the pregnancy. To clarify the characteristics of pregnancy-associated gastric cancer and to obtain useful information that would help us choose the best treatment strategy for pregnancy-associated gastric cancer, we reviewed the existing literature, using the key words “pregnancy” and “gastric cancer”. We were able to accumulate 136 cases, including 100 cases reported previously in Japan, and 1 case that we report here. We analyzed a total of 137 cases in the present study. With respect to the stage of gastric cancer, 92.5% of the patients studied had advanced gastric cancer, and only 45.3% of the patients underwent gastrectomy, including incomplete resection. Accordingly, the prognosis was very poor; the 1- and 2-year survival rates were 18.0% and 15.1%, respectively. However, the number of patients found to have early gastric cancer by endoscopic examination has been increasing recently. An endoscopic examination should be conducted immediately in pregnant patients presenting with persistent gastrointestinal symptoms for the differential diagnosis of hyperemesis gravidarum. When an endoscopic examination reveals that pregnant patients have gastric cancer, a therapeutic plan should be promptly formulated, in accordance with the number of weeks of gestation, by a medical team consisting of specialists in perinatal obstetrics and gastric cancer specialists.

Key words

Gastric cancer Pregnancy Gastrectomy Cesarean section 


  1. 1.
    Yamagata S, Uzuka Y (1970) Malignant tumor during pregnancy — from the standpoint of internal medicine (in Japanese). J Cancer Clinic 16:574–584Google Scholar
  2. 2.
    Ueo H, Okudaira Y, Hirabayashi M (1989) Gastric cancer associated with pregnancy. A case report of early gastric cancer and review of 100 cases in Japan (in Japanese). J Jpn Soc Clin Surg 50:312–318Google Scholar
  3. 3.
    Silverberg E, Lubera J (1989) Cancer statistics. Cancer 39:3–20Google Scholar
  4. 4.
    Kodama I, Takeda J, Koufuji K, et al. (1997) Gastric cancer during pregnancy. Kurume Med J 44:179–183PubMedGoogle Scholar
  5. 5.
    Jaspers VK, Gillessen A, Quakernack K (1999) Gastric cancer in pregnancy: do pregnancy, age or female sex alter the prognosis? Case reports and review. Eur J Obstet Gynecol Reprod Biol 87:13–22CrossRefPubMedGoogle Scholar
  6. 6.
    Miura T, Takashima A, Uchiyama T, et al. (1978) Study of gastric cancer with pregnancy (in Japanese). Surgical Therapy 38:1–9Google Scholar
  7. 7.
    Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma: 2nd English edition. Gastric Cancer 1:10–24CrossRefPubMedGoogle Scholar
  8. 8.
    Fill S, Taran A, Schulz HU (2008) Sister Mary Joseph’s nodule as the first sign of pregnancy-associated gastric cancer: a case report. World J Gastroenterol 14:951–953CrossRefPubMedGoogle Scholar
  9. 9.
    Kurt M, Aksoy S, Cizginer S (2007) Gastric cancer and the coincidental finding of herpetic esophagitis immediately after pregnancy: a case report. J Reprod Med 52:425–427PubMedGoogle Scholar
  10. 10.
    Unek IT, Celtık A, Alacacioğlu A (2007) Gastric carcinoma during pregnancy: report of a case. Turk J Gastroenterol 18:41–43PubMedGoogle Scholar
  11. 11.
    Glisić A, Atanacković J (2006) Krukenberg tumor in pregnancy. The lethal outcome. Pathol Oncol Res 12:108–110CrossRefPubMedGoogle Scholar
  12. 12.
    Gojnic M, Dugalic V, Vidaković S (2005) Hyperemesis or stomach carcinoma in pregnancy — a true diagnosis with two lives saved: a case report. Clin Exp Obstet Gynecol 32:201–202CrossRefPubMedGoogle Scholar
  13. 13.
    Yücesoy G, Büyükgebiz O, Yildiz K, et al. (2006) Gastric carcinoma diagnosed at the third trimester: a case report. Arch Gynecol Obstet 274:47–49CrossRefPubMedGoogle Scholar
  14. 14.
    Chong VH, Lim CC (2003) Advanced disseminated gastric carcinoma in pregnancy. Singapore Med J 44:471–472PubMedGoogle Scholar
  15. 15.
    Jasmi AY, Normala B, al-Amin MD (2000) Perforated malignant gastric ulcer in a pregnant young adult: a case report. Med J Malaysia 55:135–137PubMedGoogle Scholar
  16. 16.
    Ohsawa S, Kondo Y, Shiroto H, et al. (1992) A case of an early gastric cancer associated with a pregnancy (in Japanese). Jpn J Cancer Clin 38:1269–1273Google Scholar
  17. 17.
    Serikawa T, Shichiri K, Sanada H (1996) Two cases of pregnancy associated with gastric cancer (in Japanese). Obstetrical and Gynecological Therapy 73:605–607Google Scholar
  18. 18.
    Shibata D, Kawai M, Niwa Y, et al. (1999) Pregnancy with gastric cancer: a case report (in Japanese). Obstet Gynecol (Tokyo) 66:701–704Google Scholar
  19. 19.
    Sato Y, Yokoyama Y, Narikawa N, et al. (2006) Krukenberg tumor metastasized from stomach cancer incidentally discovered at the caesarean section: a case report (in Japanese). Tokai J Obstetrics and Gynecology 43:123–126Google Scholar
  20. 20.
    Shinagawa T, Abe M, Tadokoro M, et al. (1991) A gastric carcinoma in a young pregnant woman with a bilateral breast metastases autopsied and breast carcinoma case findings (in Japanese). Jpn J Cancer Clinics 37:48–54Google Scholar
  21. 21.
    Kishikawa H, Nishiwaki N, Ito K, et al. (1992) Perforated gastric cancer associated with the delivery which is misdiagnosed as abruption of placenta (in Japanese). J Jpn Soc Clin Surg 53:2986–2989Google Scholar
  22. 22.
    Shomura Y, Murabayashi K, Hayashi M, et al. (1995) A resected case of juvenile gastric cancer causing perforation during the course of the observation of pregnancy and an ovarian tumor (in Japanese). J Jpn Soc Clin Surg 56:741–745Google Scholar
  23. 23.
    Sakou T, Seki Y, Takeuchi Y, et al. (1996) A case of cancer of the stomach in a pregnant woman undergoing cesarean section and gastrectomy at the same time (in Japanese). J Jpn Soc Clin Surg 57:1631–1634Google Scholar
  24. 24.
    Ogawa T, Higashi S, Okada Y, et al. (1997) A resected case of gastric cancer with Krukenberg tumor during pregnancy (in Japanese). Surgery (Geka) 59:1391–1393Google Scholar
  25. 25.
    Igarashi S, Kawaguchi T, Hoshi N (1997) Early gastric carcinoma with widespread metastasis and pulmonary tumor thrombotic microangiopathy (PTTM): report of an autopsy case (in Japanese). Stomach and Intestine 32:861–865Google Scholar
  26. 26.
    Nakagawa K (2000) Four cases of gastric cancer during pregnancy (in Japanese). J Jpn College of Surg 25:892–895Google Scholar
  27. 27.
    Tanaka Y, Komiyama M, Akiba Y, et al. (2001) A case of advanced gastric cancer diagnosed after the delivery (in Japanese). The Kanagawa District J Jpn Obstet and Gynecol Society 37:134–137Google Scholar
  28. 28.
    Shimizu M, Nishida M, Eto M, et al. (2004) Gastric cancer during pregnancy: rapid cervical lymph nodes swelling and pericardial effusion at third trimester, a case report (in Japanese). Obstet Gynecol (Tokyo) 71:381–384Google Scholar
  29. 29.
    Umezawa K, Kigawa N, Sudo Y, et al. (2004) A case of pregnancy with gastric cancer (in Japanese). Tokyo J Obstetrics and Gynecology 53:346–348Google Scholar
  30. 30.
    Kurabayashi T, Isii K, Suzuki M (2004) Advanced gastric cancer and a concomitant pregnancy associated with disseminated intravascular coagulation. Am J Perinatol 21:295–298CrossRefPubMedGoogle Scholar
  31. 31.
    Ozeki T, Soeda S, Watanabe T, et al. (2006) Krukenberg tumor increased rapidly with pregnancy: a case report (in Japanese). J Jpn Society of Gynecologic Oncology 24:424–428Google Scholar
  32. 32.
    Ando H, Maeda S, Kameoka N, et al. (2007) A case of perforated gastric cancer associated with pregnancy that was recognized at caesarean operation (in Japanese). J Abdom Emerg Med 27:777–779Google Scholar
  33. 33.
    Yoshida M, Matsuda H, Furuya K (2007) Successful prognosis of pregnancy with gastric cancer in the second trimester: a case report (in Japanese). J Jpn Society of Perinatal and Neonatal Medicine 43:140–142Google Scholar
  34. 34.
    Maeda S, Takigawa J, Toyoyama H, et al. (2007) Two cases of gastric cancer during pregnancy (in Japanese). Surgery (Geka) 69:1077–1080Google Scholar
  35. 35.
    Shimizu K, Utsunomiya M, Kito K (1979) Four cases of gastric cancer in young adults (in Japanese). Jpn Red Cross Med J 31:51Google Scholar
  36. 36.
    Shinagawa N, Koake N, Murata Y, Jin M (1968) Incidence of complications of gastric cancer in pregnancy (in Japanese). Obstetrical and Gynecological Practice 17:1104–1111Google Scholar

Copyright information

© Japan Society of Clinical Oncology 2009

Authors and Affiliations

  • Kaoru Sakamoto
    • 1
  • Tatsuo Kanda
    • 1
    Email author
  • Manabu Ohashi
    • 1
  • Takumi Kurabayashi
    • 2
  • Takehiro Serikawa
    • 2
  • Masamichi Matsunaga
    • 3
  • Katsuyoshi Hatakeyama
    • 1
  1. 1.Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  2. 2.Division of Obstetrics and GynecologyNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  3. 3.Division of PediatricsNiigata University Graduate School of Medical and Dental SciencesNiigataJapan

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