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Z Year3 Gastro Conditions > Gastric Cancer > Flashcards

Gastric Cancer Flashcards

1
Q

What classification is used for gastric cancer?

A

Lauren classification-Japanese Endoscopy society classification

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2
Q

Where is gastric cancer very common?

A

West

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3
Q

What are the risk factors for gastric cancer?

A
  1. pernicious anaemia
  2. Helicobacter pylori,
  3. exposure to N-nitroso compounds.
  4. 50-70
  5. Male sex
  6. Smoking
  7. FHx
  8. Blood type A
  9. High salt/low vit C
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4
Q

What is epid for gastric cancer?

A

male, 50-70

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5
Q

What are the gastro symptoms of gastric cancer?

A
  1. Abdominal pain: vague, epigastric
  2. Weight loss
  3. Sometimes ascites, jaundice, dyspepsia, anaemia
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6
Q

What are possible differential diagnosis for gastric cancer?

A
  1. Peptic ulcer disease
  2. Benign oesophageal stricture
  3. Achalasia
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7
Q

What is the 1st line investigation for suspected gastric cancer?

A

Upper GI endoscopy with biopsy:

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8
Q

What may you find in upper GI endoscopy with biopsy with gastric cancer?

A
  • ulcer
  • mass
  • mucosal changes
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9
Q

What other investigations would you consider for gastric cancer are why?

A
  1. Endoscopic US: determines clinical tumour (T) and node (N) stage
  2. Ct abdo / pelvis: metastatic lesion
  3. Chest Xray: ml
  4. CT chest: ml
  5. Laparoscopy: ml
  6. PET/CT
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10
Q

What is the 1st line treatment for localised gastric cancer and is a surgical candidate?

A

1st line: surgery

Adjunct: perioperative chemo or post op chemo

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11
Q

What is the 1st line treatment for localised gastric cancer and is a non surgical candidate?

A

chemoradiation

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12
Q

What is the 1st line treatment for gastric cancer that is advanced and metastatic disease?

A

1st line: chemoradiation or chemo and/or immunotherapy

Adjunct: palliative gastrectomy

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13
Q

What is the 2nd line treatment for gastric cancer that is advanced and metastatic disease?

A

2nd line: ramucirumab plus paclitaxel

Adjunct: palliative gastrectomy

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14
Q

What is the 3rd line treatment for gastric cancer that is advanced and metastatic disease?

A

3rd line: pembrolizumab or triflurifinr/tipiracil

Adjunct: palliative gastrectomy

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15
Q

What are the possible complications of gastric cancer?

A
  1. Malnutrition
  2. gastric obstruction
  3. gastrointestinal bleeding
  4. gastric perforation
  5. small bowel obstruction
  6. postoperative gastroparesis
  7. postoperative dumping syndrome
  8. postoperative anastomotic leak
  9. postoperative wound infection
  10. postoperative myocardial infarction
  11. postoperative pneumonia
  12. chemotherapy-related complications
  13. radiation-related complications
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16
Q

What is the 5 year survival rate for gastric cancer?

A

<10% but usually present late

17
Q

What are signs for gastric cancer?

A
  1. Epigastric mass
  2. Hepatomegaly
  3. Jaundice
  4. Ascites
  5. Virchow’s node
18
Q

What is the defintion of gastric cancer?

A

neoplasm originating in any portion of the stomach, most commonly adenocarcinomas

19
Q

What are different gastric cancers?

A
  1. adenocarcinoms
  2. lymphoma
  3. GI stromal tumours
  4. Carcinoid
20
Q

What are the two types of gastric cancers are what are they associated with?

A
  1. . intestinal- H.pylori associated

2. diffuse- e-cadherin mutation associated

21
Q

What is the gold standard investigation for gastric cancer?

A

upper GI endoscopy with Biopsy

22
Q

What is typical presentation for gastric cancer?

A
  1. Vague but usually epigastric abdominal pain
  2. Weight loss common
  3. Lymphadenopathy
23
Q

What are key metastases of gastric cancer?

A

Sister mary joseph nodule (umbilical) and krukenberg tumour (ovary)

24
Q

What surgery is done in gastric cancer?

A
  1. Roux-en Y

2. D2 gastrectomy: gold standard remove all lymph nodes

25
Q

What are post-op symptoms?

A

nausea, vomiting, lack of appetite

26
Q

How can nutrition be affected from gastrectomy?

A
  • Early satiety, frequent small meals
  • Nutrition: feeding jujunostomy (rare), supplements
  • Total (sub-total): B12 injections
27
Q

What are Cx from surgery?

A
  1. Wound staples remove day 10-12
  2. Dumping syndrome (20%) (early and late)
  3. Diarrhoea

Z Year3 Gastro Conditions (48 decks)

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