๐ฎ๐๐๐๐๐๐ ๐ช๐๐๐๐๐ Flashcards
What is the epidemiological ranking of gastric cancer among malignant tumors worldwide?
5th most common malignant tumor in the world
What is the typical age range for gastric cancer occurrence?
Common in 40-70 years and 55-65 years
What percentage of gastric tumors occur in the pyloric antrum?
65% of tumors occur in the pyloric antrum
What are the three main types of gastric cancer macroscopically?
Ulcerative (50%), Polypoid (20%) & Infiltrative (30%)
What is the most common microscopic type of gastric adenocarcinoma?
Intestinal type (85%)
What are the risk factors for gastric cancer?
-Older age
-Male
-H.Pylori
-Overweight & Obesity
-Food contaminated by Fungal toxin esp Aflatoxin
-Stomach Polyp
-Pernicious anaemia reaulting from poor vitamin B12 absorption
-Alcohol Abuse
What pre-malignant condition is associated with gastric cancer?
Chronic atrophic gastritis and adenomatous polyps
What percentage of gastric cancers present with perforation?
4% of cases present with perforation
Why is the prognosis of gastric cancer generally poor?
Early spread of tumor and late appearance of symptoms
What is the main symptom seen in gastric cancer?
Dyspepsia
What is the primary imaging investigation for suspected gastric cancer?
Oesophago-gastro-duodenoscopy
What does T1 stage indicate in gastric cancer?
Invasion of mucosa or submucosa
What does N2 staging indicate in gastric cancer?
Nodes more than 3cm of tumour involved
What does M1 indicate in gastric cancer staging?
Distant metastasis is present
What percentage of gastric cancers involve the body of the stomach?
25% in the body
What is the definition of Tis in gastric cancer staging?
Pre-invasive carcinoma
What are the three main treatment options for gastric cancer?
Chemotherapy (adjuvant/neo-adjuvant)
Surgery (Resection)
Palliative Care
What common type of anemia is associated with gastric cancer?
Pernicious anemia
What is the main surgical treatment for gastric cancer?
Resection
What lifestyle factor is a significant risk for gastric cancer?
Alcohol abuse
What type of food contamination is associated with gastric cancer risk?
Food contaminated by fungal toxins (Aflatoxins)
What is the most common presenting symptom of gastric cancer?
Dyspepsia
What percentage of cases present with acute bleeding?
10% present with acute bleeding
What imaging test is used after initial endoscopy?
Contrast-enhanced CT scan
What investigation are done in gastric cancer?
- Oesophago-gastro-duodenoscopy
- Barium meal
- Endoscopic ultrasonography
- Ultrasound and contrast-enhanced CT scan
- Laparoscopy
- Hemoglobin
What is dumping syndrome in post-gastric cancer patients?
Rapid movement of food from stomach to duodenum
What factors affect the prognosis?
Gastric wall invasion
1. Nodal involvement
2. Distance metastases
3. Duration of symptoms
4. Degree of cellular differentiation
What are the modes of spread pattern in gastric cancer?
Lymphatic, Local, blood, Trans-peritoneal, Extra-abdominal
What are the microscopic/histologic types of Adenocarcinoma?
Diffuse (50%), Intestinal & Mixed type
How does T4 staging differ from T3?
T4 involves invasion of adjacent structures while T3 involves invasion of serosa
What are the symptoms of gastric cancer?
-Dyspepsia
-Weight-loss
-Anemia
-Lump
Complications of gastric cancer
-Gastric Outlet Obstruction
-Perforation
-Bleeding
-Iron deficiency anemia (Breathlessness & Pallor)
TNM staging of gastric cancer
T (Tumor - Depth of Invasion)
TisโPre-invasive Carcinoma
T1โTumor invades lamina propria, muscularis mucosae, or submucosa
T2โTumor invades muscularis propria
T3โTumor invades subserosa
T4โTumor invades serosa (T4a) or adjacent organs (T4b)
N (Lymph Node Involvement)
N0โNo lymph node involvement
N1โNodes within 3cm of tumor involved
N2โNodes more than 3cm of tumour involved
N3โDistant nodal nvolvement
M (Metastasis - Spread to Distant Sites)
M0โNo distant metastasis
M1โDistant metastasis present (e.g., liver, peritoneum, distant lymph nodes)
What is seen on examination of gastric cancer?
Examination of the patient may reveal;
- A palpable mass in the epigastrium (25%)
- Jaundice
- Hepatomegaly (10%)
- Ascites
- Abdominal masses (Sister Mary-Joseph nodule) /enlarged supraclavicular lymph nodes.
- Weight loss is evident.
Examination may, however, be negative.
Aetiology of Gastric cancer
- Genetics
- Pre-malignant conditions like chronic atrophic gastritis & Adenomatous polyp
- Diet
- Nitrosamine
