Gastric Carcinoma Flashcards
What is it?
Cancer of the stomach
What type of cancer usually causes it?
It is usually caused by Adenocarcinoma
What classification does it use?
Borrman Classification
What are the classes of gastric carcinoma?
Polypoid, excavating, ulcerating/raised, diffusely infiltrating
Where is early cancer confined to?
The mucosa and submucosa
Is it common?
23 per 100,000 people
Who does it affect?
It is particularly common in Japan, eastern europe, china and south america, more common in males 2:1
Risk factors (11)
Pernicious anaemia, H.pylori, adenomatous polyps, smoking, blood group A, atrophic gastritis, lower social class, nitrosamine exposure, diet high in nitrates and salt, pickling, low vitamin C
Symptoms (5)
Often non specific, dyspepsia, weight loss, vomiting, dysphagia
Signs (7)
Epigastric mass, jaundice, virchow’s node, anaemia, hepatomegaly, ascites, acanthosis nigricans
Investigations (6)
Urgent 2 week wait gastroscopy and biopsy, Stool sample, h.pylori tests, CT, MRI, cytology of peritoneal washing to check for metastases
Differentials (4)
Dyspepsia, Peptic ulcer, gastritis, gastroenteritis
Treatment
Partial/full gastrectomy, pre and post op chemotherapy, stenting to prevent obstruction, targeted therapies such as Trastuzumab for HER-2 receptor positive tumours
Is there a good prognosis?
It is a cancer known for its gloomy outcome, 5 year survival is <10%, prognosis is much better if detected early
