Gastric Cancer

Question 1

Describe the usual demographic of patients with gastric cancer

Answer 1

50% of patients are > 75 years
male predominance (2:1)

Question 2

Risk factors for gastric cancer

Answer 2

H. pylori
Atrophic gastritis
Diet (high salt)
Nitrates
Smoking
Blood group A

Question 3

Clinical features

Answer 3

abdo pain
weight loss
nausea and vomiting
dysphagia
some UGI bleeding

Question 4

Common named lymph nodes found in Gastric Cancer with lymphatic spread

Answer 4

Left supraclavicular lymph node (Virchow’s node)

Periumbilical nodule (Sister Mary Joseph’s node)

Question 5

What investigations are used to diagnose gastric cancer

Answer 5

• OGD with biopsy
• staging CT

Question 6

Histological appearance of gastric cancer biopsy

Answer 6

• signet ring cells
• contain a large vacuole of mucin which displaces the nucleus to one side

Question 7

Higher numbers of signet ring cells on gastric biopsy are associated with a worse prognosis. TRUE/FALSE?

Answer 7

TRUE

Question 8

Management of gastric cancer

Answer 8

surgical options:
- endoscopic mucosal resection
- partial gastrectomy
- total gastrectomy

chemotherapy

Question 9

What is gastric MALT lymphoma associated with

Answer 9

H. Pylori