Chapter 40: Stomach- Gastric Cancer Flashcards
What are the associated risk factors?
- Diet
- smoked meats
- high nitrates
- low fruits and vegetables
- alcohol
- tobacco
- Environment
- raised in high-risk area
- poor socioeconomic status
- atrophicgastritis
- male gender
- blood type A
- previous partial gastrectomy
- pernicious anemia
- polyps
- Helicobacter pylori
Which blood type is associated with gastric cancer?
Blood type A
What are the symptoms?
The acronym “WEAPON”:
- Weight loss
- Emesis
- Anorexia
- Pain/epigastric discomfort
- Obstruction
- Nausea
What is a Blumer’s shelf?
Solid peritoneal deposit anterior to the rectum, forming a “shelf,” palpated on rectal examination
What is a Virchow’s node?
Metastatic gastric cancer to the nodes in the left supraclavicular fossa
What is a surveillance laboratory finding?
CEA elevated in 30% of cases (if +, useful for postoperative surveillance)
What is the initial workup?
- EGD with biopsy
- endoscopic U/S to evaluate the level of invasion
- CT scan of abdomen/pelvis for metastasis
- CXR
- labs
What is the histology?
Adenoca
What is the differential diagnosis for gastric tumors?
- Adenocarcinoma
- leiomyoma
- leiomyosarcoma
- lymphoma
- carcinoid
- ectopic pancreatic tissue
- gastrinoma
- benign gastric ulcer
- polyp
Which morphologic type is named after a “leather bottle”?
Linitis plastica—the entire stomach is involved and looks thickened (10% ofcancers)
Which patients with gastric cancer are NONoperative?
- Distant metastasis (e.g., liver metastasis)
- Peritoneal implants
What is the role of laparoscopy?
To rule out peritoneal implants and to evaluate for liver metastasis
What is the genetic alteration seen in >50% of patients with gastric cancer?
P53
What is the treatment?
Surgical resection with wide (>5 cm checked by frozen section) margins andlymph node dissection
What operation is performed for tumor in the:
Antrum
Distal subtotal gastrectomy
