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Contemporary Approaches to Gastric Carcinoma

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Surgical Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 90))

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Abstract

Gastric carcinoma represents a fascinating disease in terms of the history, development, philosophy, and future of the field of surgical oncology. Many facets of gastric carcinoma intrigue us: the long-term decline in incidence in the United States and other western countries [1], the rapid improvement in stage that has been seen in Japan as a result of widespread population screening [2], the evolution of sophisticated histologic analysis separating better and poorer prognostic histologic types (Lauren classification) [3], the recent significant proximal shift in the location of gastric cancers [4], the inability to find any effective systemic therapy to improve prognosis [5], and the unsubstantiated enthusiasm for a far more radical surgical approach [6,7] to gastric cancer, including radical lymph node removal, recreating a philosophical trend and surgical strategy of the 1950s long since discredited in all other human cancer surgery. This last feature has led to several randomized trials comparing the extent of regional lymph node and stomach resection in an appropriate attempt to evaluate the revived surgical philosophy and strategy [6,8-10]. The history of gastric cancer surgery and the results of these recent prospective clinical trials reaffirms and supports basic surgical oncology principles.

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References

  1. Parker SL, Tong T, Bolden S, Wingo PA. Cancer Statistics, 1996. CA Cancer J Clin 65: 5–27, 1996.

    Article  Google Scholar 

  2. Hisamichi S. Screening for gastric cancer. World J Surg 13: 31–37, 1989.

    Article  PubMed  CAS  Google Scholar 

  3. Lauren PA, Nevalainen TJ. Epidemiology of intestinal and diffuse types of gastric carcinoma: A time-trend study in Finland with comparison between studies from high-and low-risk areas. Cancer 71: 2926–2933, 1993.

    Article  PubMed  CAS  Google Scholar 

  4. Salvon-Harman JC, Cady B, Nikulasson S, Khettry U, Stone MD, Lavin P. Shifting proportions of gastric adenocarcinomas. Arch Surg 129: 381–389, 1994.

    Article  PubMed  CAS  Google Scholar 

  5. Hermans J, Bonenkamp JJ, Boon MC, Bunt AMG, Ohyama S, Sasako M, van de Velde CJH. Adjuvant therapy after curative resection for gastric cancer: Meta-analysis of randomized trials. J Clin Oncol 11: 1441–1447, 1993.

    PubMed  CAS  Google Scholar 

  6. Bunt AMG, Hermans J, Boon MC, van de Velde CJH, Sasako M, Fleuren GJ, Bruijn JA. Evaluation of the extent of lymphadenectomy in a randomized trial of western-versus Japanses-type surgery in gastric cancer. J Clin Oncol 12: 417–422, 1994.

    PubMed  CAS  Google Scholar 

  7. Sawai K, Takahashi T, Suzuki H. New trends in surgery for gastric cancer in Japan. J Surg Oncol 56: 221–226, 1994.

    Article  PubMed  CAS  Google Scholar 

  8. Dent DM, Madden MV, Price SK. Controlled trials and the R1/R2 controversy in the management of gastric carcinoma. Surg Oncol Clin NA 2: 433–441, 1993.

    Google Scholar 

  9. Robertson CS, Chung SCS, Woods SDS, Griffin SM, Raimes SA, Lau JTF, Soc B, Li AKC. A prospective randomized trial comparing R1 subtotal gastrectomy with R3 total gastrectomy for antral cancer. Ann Surg 222: 176–182, 1994.

    Article  Google Scholar 

  10. Cuschieri A, Fayers P, Fielding J, Craven J, Bancewicz J, Joypaul V, Cook P. Surgical treatment of gastric cancer postoperative morbidity and mortality after D1 and D2 resections for Gastric cancer — Preliminar results of the MRC randomized controlled surgical trial. Lancet 1996, in press.

    Google Scholar 

  11. Correa P. The epidemiology of gastric cancer. World J Surg 15: 228–234, 1991.

    Article  PubMed  CAS  Google Scholar 

  12. Correa P. Clinical implications of recent developments in gastric cancer pathology and epidemiology. Semin Oncol 12: 2–10, 1985.

    PubMed  CAS  Google Scholar 

  13. Ramon JM, Serra L, Cerdo C, Oromi J. Dietary factors and gastric cancer risk: a case-control study in Japan. Cancer 71: 1731–1735, 1993.

    Article  PubMed  CAS  Google Scholar 

  14. Cady B, Stone MD, Wayne J. Continuing trends in the prevalence of right-sided lesions among colorectal carcinomas. Arch Surg 128: 505–509, 1993.

    Article  PubMed  CAS  Google Scholar 

  15. Endo S, Ohkusa T, Saito Y, Fujiki K, Okayasu I, Sato C. Detection of Heliobacter pylori infection in early stage gastric cancer. Cancer 75: 2203–2208, 1995.

    Article  PubMed  CAS  Google Scholar 

  16. Antonioli DA, Cady B. Changing aspects of gastric adenocarcinoma. N Engl J Med 310: 1538, 1984.

    PubMed  CAS  Google Scholar 

  17. Zheng T, Mayne ST, Holford TR, Boyle P, Liu W, Chen Y, Mador M, Flannery J. The time trend and age-period-cohort effects on incidence of adenocarcinoma of the stomach in Connecticut from 1995-1989. Cancer 72: 330–340, 1993.

    Article  PubMed  CAS  Google Scholar 

  18. Blot WJ, Devesa SS, Kneller RW, Fraumeni JF. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 265: 1287–1289, 1991.

    Article  PubMed  CAS  Google Scholar 

  19. Menke-Pluymers MBE, Hop WCJ, Dees J, van Blankenstein M, Tilanus HW. Risk factors for the development of an adenocarcinoma in columnar-lined (Barrett) esophagus. Cancer 72: 1155–1158,1993.

    Article  PubMed  CAS  Google Scholar 

  20. The M, Lee YS. HLA-DR Antigen expression in intestinal-type and diffuse-type gastric carcinoma. Cancer 69: 1104–1107, 1992.

    Google Scholar 

  21. Cady B, Rossi RL, Silverman ML, Piccione W, Heck TA. Gastric adenocarcinoma: A disease in transition. Arch Surg 124: 303–308, 1989.

    Article  PubMed  CAS  Google Scholar 

  22. Kim JP, Hur YS, Yang HK. Lymph node metastasis as a significant prognostic factor in early gastric cancer: Analysis of 1136 early gastric cancers. Ann Surg Oncol 2: 308–313, 1995.

    Article  PubMed  CAS  Google Scholar 

  23. Mok YJ, Koo BW, Whang CW, Kim SM, Maruyama K, Sasako M, Kinoshita T. Cancer of the stomach: A review of two hospitals in Korea and Japan. World J Surg 17: 777–782, 1993.

    Article  PubMed  CAS  Google Scholar 

  24. Ikeda Y, Mori M, Kamakura T, Haraguchi Y, Saku M, Sugimachi K. Increased incidence of undifferentiated type of gastric cancer with tumor progression in 912 patients with early gastric cancer and 1245 with advanced gastric cancer. Cancer 73: 2459–2463, 1994.

    Article  PubMed  CAS  Google Scholar 

  25. Siewert JR, Kottcher K, Stein HJ, Roder JD, Busch R. Problem of proximal third gastric carcinoma. World J Surg 19: 523–531, 1995.

    Article  PubMed  CAS  Google Scholar 

  26. Saario I, Schroder T, Lempinen M, Kivilaakso E, Nordling S. Analysis of 58 patietns surviving more than ten years after operative treatment of gastric cancer. Arch Surg 122: 1052–1054, 1987.

    Article  PubMed  CAS  Google Scholar 

  27. Msika S, Chastang C, Houry S, Lacaine F, Huguier M. Lymph node involvement as the only prognostic factor in curative resected gastric carcinoma: A multivariate analysis. World J Surg 13: 121–123, 1989.

    Article  Google Scholar 

  28. Ichikura T, Tominatsu S, Okusa Y, Uefuji K, Tamakuma S. Comparison of the prognostic significance between the number of mctastatic lymph nodes and nodal stage based on their location in patients with gastric cancer. J Clin Oncol 11: 2194–2900, 1993.

    Google Scholar 

  29. Isozaki H, Okajima K, Kawashima Y, Yamada S, Nakata E, Nishimura J, Ichinona T. Prognostic value of the number of metastatic lymph nodes in gastric cancer with radical surgery. J Surg Oncol 53: 247–251, 1993.

    Article  PubMed  CAS  Google Scholar 

  30. Jakl RJ, Miholic J, Koller R, Markis E, Wolner E. Prognostic factors in adenocarcinoma of the cardia. Am J Surg 169: 316–319, 1995.

    Article  PubMed  CAS  Google Scholar 

  31. Lee WJ, Lee WC, Houng SJ, Shun CT, Houng RL, Lee PH, Chang KJ, Wei TC, Chen KM. Survival after resection of gastric cancer and prognostic relevance of systematic lymph node dissection: Twenty years experience in Taiwan. World J Surg 19: 707–713, 1995.

    Article  PubMed  Google Scholar 

  32. Jatzko GR, Kisborg PH, Denk H, Klimfmger M, Stettner HM. A 10-year experience with Japanese-type radical lymph node dissection for gastric cancer outside of Japan. Cancer 76: 1302–1312, 1995.

    Article  PubMed  CAS  Google Scholar 

  33. Tso PL, Bringaze WL, Dauterive AH, Correa P, Cohn I. Gastric carcinoma in the young. Cancer 59: 1362–1365, 1987.

    Article  PubMed  CAS  Google Scholar 

  34. Maeta M, Yamashiro H, Oka A, Tsujitani S, Ikeguchi M, Kaibara N. Gastric cancer in the young, with special reference to 14 pregnancy-associated cases: Analysis based on 2325 consecutive cases of gastric cancer. J Surg Oncol 58: 191–195, 1995.

    Article  PubMed  CAS  Google Scholar 

  35. Marshall SF, Adamson NE, Jr. Carcinoma of the stomach: Follow-up results in a series of 1708 patients. Surg Clin NA 39: 703, 1959.

    CAS  Google Scholar 

  36. Cady B, Ramsden DA, Stein A, Haggitt RC. Gastric cancer: contemporary aspects. Am J Surg 133: 423–429, 1977.

    Article  PubMed  CAS  Google Scholar 

  37. Appleby LH. The coeliac axis in the expansion of the operation for gastric carcinoma. Cancer 6: 704, 1953.

    Article  PubMed  CAS  Google Scholar 

  38. Hoerr SO. Prognosis for carcinoma of the stomach. Surg Gynecol Obstet 137: 205–209, 1973.

    PubMed  CAS  Google Scholar 

  39. Kockerling F, Reck T, Gall FP. Extended gastrectomy: Who benefits? World J Surg 19: 541–545, 1995.

    Article  PubMed  CAS  Google Scholar 

  40. Sindelar WF, Kinsella TJ, Tepper JE, DeLaney TF, Maher MM, Smith R, Rosenberg SA, Glatstein E. Randomized trial of intraoperative radiotherapy in carcinoma of the stomach. Am J Surg 165: 178–187, 1993.

    Article  PubMed  CAS  Google Scholar 

  41. Cady B. Lymph node metastases indicators, but not governors of survival. Arch Surg 119: 1067–1072, 1984.

    Article  PubMed  CAS  Google Scholar 

  42. Fuchs CS, Mayer RJ. Gastric carcinoma. N Engl J Med 333: 32–41, 1995.

    Article  PubMed  CAS  Google Scholar 

  43. Nio Y, Tsubono M, Kawabata K, Masai Y, Hayashi H, Meyer C, Inoue K, Tobe T. Comparison of survival curves of gastric cancer patients after surgery accoding to the UICC stage classification and the general rules for gastric cancer study by the Japanese Research Society for Gastric Cancer. Ann Surg 221: 47–53, 1993.

    Article  Google Scholar 

  44. Shriver CD, Karpeh M, Brennan MF. Extended lymph node dissection in gastric cancer. Surg Oncol Clin NA 2: 393–411, 1993.

    Google Scholar 

  45. Adachi Y, Oshiro T, Okuyama T, Kamakura T, Mori M, Maehara Y, Sugimachi K. A simple classification of lymph node level in gastric carcinoma. Am J Surg 169: 382–385, 1995.

    Article  PubMed  CAS  Google Scholar 

  46. Douglass HO, Jr. R2 dissection in the treatment of gastric malignancy. Surg Oncol Clin NA 2: 413–458, 1993.

    Google Scholar 

  47. Cady B. Comments on the appropriateness of extended resection in gastric adenocarcinoma. Surg Oncol Clin NA 2: 459–466, 1993.

    Google Scholar 

  48. Bonenkamp JJ, van de Velde CJH, Kampschoer GHM, Hermans J, Hermanek P, Bemelmans M, Gouma DJ, Sasako M, Maruyama K. Comparison of factors influencing the prognosis of Japanese, German, and Dutch gastric cancer patients. World J Surg 17: 410–415, 1993.

    Article  PubMed  CAS  Google Scholar 

  49. Maruyama K, Sasako M, Kinoshita T, Sano T, Katai H, Okajima K. Pancreas-preserving total gastrectomy for proximal gastric cancer. World J Surg 19: 532–536, 1995.

    Article  PubMed  CAS  Google Scholar 

  50. Dent DM, Madden MV, Price SK. Randomized comparison of R1 and R2 gastrectomy for gastric carcinoma. Br J Surg 75: 110–112, 1988.

    Article  PubMed  CAS  Google Scholar 

  51. Bollschweiler E, Boettcher K, Hoelscher AH, Sasako M, Kinoshita T, Maruyama K, Siewert JR. Is the prognosis for Japanese and German patients with gastric cancer really different? Cancer 71: 2921–2924, 1993.

    Article  Google Scholar 

  52. Dupont JB, Jr., Lee JR, Burton GR, Cohn I, Jr. Adenocarcinoma of the stomach: Review of 1497 cases. Cancer 41: 941–947, 1978.

    Article  PubMed  Google Scholar 

  53. Adashek K, Sänger J, Longmire WP, Jr. Cancer of the stomach: Review of consecutive ten year intervals. Ann Surg 219: 6–10, 1979.

    Article  Google Scholar 

  54. Weed TE, Nuessle W, Ochsner A. Carcinoma of the stomach: Why are we failing to improve survival? Ann Surg 193: 407–413, 1981.

    Article  PubMed  CAS  Google Scholar 

  55. Feinstein AR, Sosin DM, Wells CK. The Will Rogers phenomenon: stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer. N Engl J Med 312: 1604–1608, 1985.

    Article  PubMed  CAS  Google Scholar 

  56. Mendes de Almeida JC, Bettencourt A, Santos Costa C, Mendes de Almeida JM. Curative surgery for gastric cancer: Study of 166 consecutive patients. World J Surg 21: 889–895, 1994.

    Article  Google Scholar 

  57. Gouzi JL, Huguier M, Fagniez PL, Launois B, Flamant Y, Lacaine F, Paquet JC, Hay JM. Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum. Ann Surg 209: 162–166, 1989.

    Article  PubMed  CAS  Google Scholar 

  58. Fisher B, Anderson S, Fisher ER, et al. Significance of ipsilateral breast tumor recurrence after lumpectomy. Lancet 338: 327–331, 1991.

    Article  PubMed  CAS  Google Scholar 

  59. Balch CM, Urist MM, Karakousis CP, Smith TJ, Temple WJ, Drzewiecki K, Jewell WR, Bartolucci AA, Mihm MC, Jr., Barnhill R, Wanebo HJ. Efficacy of 2-cm surgical margins for intermediate-thickness melanomas (1 to 4 mm): Results of a multi-institutional randomized surgical trial. Ann Surg 221: 262–269, 1993.

    Article  Google Scholar 

  60. Hundahl SA. Gastric cancer nodal metastases: Biological significance and therapeutic considerations. Surg Oncol Clin NA 5: 1–16, 1996.

    Google Scholar 

  61. Lerner A, Gonin R, Steele GD, Jr., et al. Etoposide, doxorubicin, and cisplatin chemotherapy for advanced gastric adenocarcinoma. J Clin Oncol 10: 536–540, 1992.

    PubMed  CAS  Google Scholar 

  62. Severson RK, Davis S. Increasing incidence of primary gastric lymphoma. Cancer 66: 1283–1287, 1990.

    Article  PubMed  CAS  Google Scholar 

  63. Parsonnet J, Hansen S, Rodriguez L, Gelb AB, Warnke RA, Jellum E, Orentreich N, Vogelmen JH, Friedman GD. Helicobacter pylori infection and gastric lymphoma. N Engl J Med 330: 1267–1270, 1994.

    Article  PubMed  CAS  Google Scholar 

  64. Nakamura S, Akazawa K, Yao T, Tsuneyoshi M. Primary gastric lymphoma: A clinicopathologic study of 233 cases with special reference to evaluation with the MIB-1 index. Cancer 76: 1313–1324, 1995.

    Article  PubMed  CAS  Google Scholar 

  65. Lim FE, Hartman AS, Tan ECG, Cady B, Meissner WA. Factors in the prognosis of gastric lymphoma. Cancer 39: 1715–1720, 1977.

    Article  PubMed  CAS  Google Scholar 

  66. Frazee RC, Robert J. Gastric lymphoma treatment, medical versus surgical. Surg Clin NA 72: 1283–1287, 1992.

    Google Scholar 

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Authors
  1. Blake Cady
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Editors and Affiliations

  1. M.D. Anderson Cancer Center, The University of Texas, Houston, Texas, USA

    Raphael E Pollock M.D., Ph.D.

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© 1997 Springer Science+Business Media New York

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Cady, B. (1997). Contemporary Approaches to Gastric Carcinoma. In: Pollock, R.E. (eds) Surgical Oncology. Cancer Treatment and Research, vol 90. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6165-1_13

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  • DOI: https://doi.org/10.1007/978-1-4615-6165-1_13

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7826-6

  • Online ISBN: 978-1-4615-6165-1

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