Gastric Adenocarcinoma

  • José E. Torres
  • Georgios C. Sotiropoulos
  • Christoph E. Broelsch
  • Carol E. H. Scott-Conner

Gastric cancer is rare in the United States, but still common in other parts of the world. The diagnosis is often not suspected until the disease is fairly advanced. When gastric adenocarcinoma is diagnosed, accurate staging and careful multidisciplinary management improve the chances of success. This chapter addresses issues of preoperative staging and choice of surgical procedure.


Gastric Cancer Gastric Carcinoma Early Gastric Cancer Gastric Adenocarcinoma Laparoscopic Gastrectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Brennan MF. Current status of surgery for gastric cancer: a review. Gastric Cancer 2005;8:64-70.CrossRefPubMedGoogle Scholar
  2. D’Ugo, Coppola R, Persiani R, Ronconi P, Caracciolo F, Picciocchi A. Immediately pre-operative laparoscopic staging for gastric cancer. Surg Endosc 1996;10:996-999.CrossRefPubMedGoogle Scholar
  3. D’Ugo DM, Persiani R, Caracciolo F, Ronconi P, Coco C, Picciocchi A. Selection of locally advanced gastric carcinoma by preoperative staging laparoscopy. Surg Endosc 1997;11:1159-1162.CrossRefPubMedGoogle Scholar
  4. Dulucq JL, Wintringer P, Perissat J, Mahajna A. Completely laparoscopic total and par-tial gastrectomy for benign and malignant disease: a single institution’s prospective analysis. J Am Coll Surg 2005;200:191-197.CrossRefPubMedGoogle Scholar
  5. Hunerbein M, Rau B, Hohenberger P, Schlag PM. The role of staging laparoscopy for multimodal therapy of gastrointestinal cancer. Surg Endosc 1998;12:921-925.CrossRefPubMedGoogle Scholar
  6. Lopez CB, Ruggiero R, Poves I, Betonnica C, Procaccini E. The contribution of laparos-copy to the treatment of gastric cancer. Surg Endosc 2002;16:616-619.CrossRefGoogle Scholar
  7. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncol-ogy. Gastric Cancer, vol. 1, 2007.

Suggested Readings

  1. Ajani JA, Mansfield PF, Ota DM. Potentially respectable gastric carcinoma: current approaches to staging and preoperative therapy. World J Surg 1995;19:216-220.CrossRefPubMedGoogle Scholar
  2. Brennan MF, Karpeh MS. Surgery for gastric cancer: the American view. Semin Oncol 1996;23:352-359.PubMedGoogle Scholar
  3. Conlon KC, Karpeh MS Jr. Laparoscopy and laparoscopic ultrasound in the staging of gastric cancer. Semin Oncol 1996;23:347-351.PubMedGoogle Scholar
  4. Cushieri A. Gastric resections. In: Scott-Conner CEH, ed. The SAGES Manual: Funda-mentals of Laparoscopy, Thoracoscopy, and GI Endoscopy, 2nd ed. New York: Springer Verlag, 2006:267-281.Google Scholar
  5. Etoh T, Shiraishi N, Kitano S. Laparoscopic gastrectomy for cancer. Dig Dis 2005;23: 113-118.CrossRefPubMedGoogle Scholar
  6. Gallardo-Rincon D, Onate-Ocana LF, Calderillo-Ruiz G. Neoadjuvant chemotherapy with P-ELF (cisplatin, etoposide, leucovorin, 5-fluorouracil) followed by radical resection in patients with initially unresectable gastric adenocarcinoma: a phase II study. Ann Surg Oncol 2000;7:45-50.CrossRefPubMedGoogle Scholar
  7. Gouma DJ, de Wit LT, Nieveen van Dijkum E, et al. Laparoscopic ultrasonogra-phy for staging of gastrointestinal malignancy. Scand J Gastroenterol Suppl 1996;218:43-49.CrossRefPubMedGoogle Scholar
  8. Hayashi H, Ochiai T, Shimada H, Gunji Y. Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. Surg Endosc 2005;19:1172-1176.CrossRefPubMedGoogle Scholar
  9. Hayes N, Wayman J, Wadehra V, Scott DJ, Raimes SA, Griffin SM. Peritoneal cytology in the surgical evaluation of gastric carcinoma. Br J Cancer 1999;79:520-524.CrossRefPubMedGoogle Scholar
  10. Hunerbein M, Ulmer C, Handke T, Schlag PM. Endosonography of upper gastrointestinal tract cancer on demand using miniprobes or endoscopic ultrasound. Surg Endosc 2003;17:615-619.CrossRefPubMedGoogle Scholar
  11. Huscher CG, Mingoli A, Sgarzini G, et al. Videolaparoscopic total and subtotal gastrec-tomy with extended lymph node dissection for gastric cancer. Am J Surg 2004;188: 728-735.CrossRefPubMedGoogle Scholar
  12. Huscher CG, Mingoli A, Sgarzini G, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 2005;241:232-237.CrossRefPubMedGoogle Scholar
  13. Lowy AM, Mansfield PF, Leach SD, Ajani J. Laparoscopic staging for gastric cancer. Surgery 1996;119(6):611-614.CrossRefPubMedGoogle Scholar
  14. Otsuka K, Murakami M, Aoki T, Lefor A. Minimally invasive treatment of stomach can-cer. Cancer J 2005;11:18-26.CrossRefPubMedGoogle Scholar
  15. Ozmen MM, Zulfikaroglu B, Ozalp N, Ziraman I, Hengirmen S, Sahin B. Staging laparos-copy for gastric cancer. Surg Laparosc Endosc Percutan Tech 2003;13:241-244.CrossRefPubMedGoogle Scholar
  16. Ribeiro U Jr, Gama-Rodrigues JJ, Bitelman B, et al. Value of peritoneal lavage cytol-ogy during laparoscopic staging of patients with gastric carcinoma. Surg Laparosc Endosc 1998;8:132-135.CrossRefPubMedGoogle Scholar
  17. Sendler A, Dittler HJ, Feussner H. Preoperative staging of gastric cancer as precondition for multimodal treatment. World J Surg 1995;19:501-508.CrossRefPubMedGoogle Scholar
  18. Sotiropoulos GC, Kaiser GM, Lang H, et al. Staging laparoscopy in gastric cancer. Eur J Med Res 2005;10:88-91.PubMedGoogle Scholar
  19. Stell DA, Carter CR, Stewart I, Anderson JR. Prospective comparison of laparoscopy, ultrasonography and computed tomography in the staging of gastric cancer. Br J Surg 1996;83:1260-1262.CrossRefPubMedGoogle Scholar
  20. Suga S, Iwase H, Shimada M, et al. Neoadjuvant chemotherapy in scirrhous cancer of the stomach using uracil and tegafur and cisplatin. Intern Med 1996;35:930-936.CrossRefPubMedGoogle Scholar
  21. Usi S, Yoshida T, Ito K, Hiranumo S, Kudo SE, Iwai T. Laparoscopy-assisted total gastrec-tomy for early gastric cancer: comparison with conventional open total gastrectomy. Surg Laparosc Endosc Percutan Tech 2005;15:309-314.CrossRefGoogle Scholar
  22. van Dijkum EJ, Sturm PD, de Wit LT, Offerhaus J, Obertop H, Gouma DJ. Cytology of peritoneal lavage performed during staging laparoscopy for gastrointestinal malig-nancies: is it useful? Ann Surg 1998;228:728-733.CrossRefGoogle Scholar
  23. Wakelin SJ, Deans C, Crofts TJ, Allan PL, Plevris JN, Paterson-Brown S. A comparison of computerised tomography, laparoscopic ultrasound and endoscopic ultrasound in the preoperative staging of oesophago-gastric carcinoma. Eur J Radiol 2002;41: 161-167.CrossRefPubMedGoogle Scholar
  24. Wanebo HJ, Kennedy BJ, Chmiel J, Steele GJ, Winchester D, Osteen R. Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg 1993;218:583-592.CrossRefPubMedGoogle Scholar
  25. Weber KJ, Leyes CD, Coagner M, Divino CM. Comparison of laparoscopic and open gastrectomy for malignant disease. Surg Endosc 2003:17:968-71.CrossRefPubMedGoogle Scholar
  26. Yano M, Tsujinaka T, Shiozaki H, et al. Appraisal of treatment strategy by staging laparos-copy for locally advanced gastric cancer. World J Surg 2000;24:1130-1136.CrossRefPubMedGoogle Scholar
  27. Yonemura Y, Sawa T, Kinashita K, et al. Neoadjuvant chemotherapy for high-grade advanced gastric cancer. World J Surg 1993;17:256-262.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • José E. Torres
    • 1
  • Georgios C. Sotiropoulos
    • 2
  • Christoph E. Broelsch
    • 3
  • Carol E. H. Scott-Conner
    • 1
  1. 1.Department of SurgeryUniversity of Iowa Hospitals and ClinicsIowa CityUSA
  2. 2.Department of General Surgery and TransplantationUniversity Hospital EssenEssenGermany
  3. 3.University of Chicago Medical CenterChicagoUSA

Personalised recommendations