Gastric adenocarcinoma is the second most common cancer worldwide. It is usually diagnosed at a late stage and prognosis is poor; even with modern diagnostic and treatment methods the 5-year survival is only 10%. Improvements in overall patient survival can only be achieved by earlier diagnosis and by tailored therapeutic strategies based on tumor type, location and stage at presentation. This volume provides a state-of-the-art, integrated diagnostic and therapeutic approach to patient management. The role of the upper GI series, endoscopy, endoscopic ultrasound, MDCT, MRI, and PET/CT in the diagnosis, staging and follow-up of patients with gastric cancer is emphasized. The relative strengths and limitations of these diagnostic examinations will be presented in context with the most recent epidemiologic, pathologic, and therapeutic concepts regarding this tumor. With expert contributions from members of an international multidisciplinary team, this is an invaluable guide to the diagnosis and management of gastric malignancies.
Author(s): Richard M. Gore
Edition: 1
Year: 2009
Language: English
Pages: 228
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 8
Series Foreword......Page 10
Preface to Gastric Cancer......Page 11
Incidence and mortality......Page 13
Pathogenesis......Page 16
Ethnic and geographic factors......Page 18
Genetics......Page 20
Environmental and behavioral factors......Page 23
Carcinoid......Page 26
REFERENCES......Page 27
Gross and microscopical anatomy......Page 34
Helicobacter pylori, gastritis, and peptic ulcer disease......Page 36
Gastric atrophy, intestinal metaplasia, and carcinogenesis......Page 37
Gastric carcinoma......Page 38
Gastric lymphoma......Page 45
Gastric carcinoid and other neuroendocrine tumors......Page 46
Gastric stromal tumors......Page 48
Other tumors......Page 49
REFERENCES......Page 50
Introduction......Page 54
General principles......Page 55
Instrument specifications and selection of optimal band images......Page 57
FICE images of EGC without magnification......Page 59
FICE images of EGC with magnification......Page 63
Determination of the extent of EGC......Page 64
General principles......Page 66
The range of extended indications currently considered in Japan......Page 67
Endoscopic submucosal dissection......Page 68
Histologic examination......Page 69
Summary......Page 70
REFERENCES......Page 71
Early gastric cancer......Page 74
Radiographic findings......Page 75
Radiographic findings......Page 77
Ulcerated carcinomas......Page 78
Infiltrative carcinomas......Page 83
Scirrhous carcinomas......Page 84
Carcinoma of the cardia......Page 88
REFERENCES......Page 92
Neoadjuvant therapy......Page 95
Extent of resection......Page 97
Laparoscopic approaches......Page 98
Staging laparoscopy......Page 101
Lymphadenectomy......Page 102
Our preferred surgical technique – distal tumors......Page 104
Outcomes......Page 107
REFERENCES......Page 108
Introduction......Page 110
Systemic therapy......Page 111
Systemic chemotherapy......Page 113
Combination chemotherapy......Page 114
Newer generation of combination chemotherapy......Page 115
ECF-based regimens......Page 116
Future prospects......Page 117
Agents targeting the human epidermal growth factor receptor family......Page 118
Agents targeted to vascular endothelial growth factor (VEGF)......Page 119
Role of chemotherapy in localized disease......Page 120
Neoadjuvant chemotherapy......Page 121
Preoperative radiation......Page 122
Postoperative chemotherapy......Page 123
Postoperative combination of radiation and chemotherapy......Page 124
Immunochemotherapy......Page 125
Recommendations......Page 126
REFERENCES......Page 127
Staging classifications......Page 132
Lesser omentum......Page 138
Gastrocolic ligament......Page 139
Gastrosplenic ligament......Page 140
Hematogenous metastases......Page 142
Peritoneal seeding......Page 143
Multidetector computed tomography (MDCT)......Page 146
Water distention......Page 147
T staging......Page 148
Endoscopic ultrasound......Page 154
Instrumentation and techniques......Page 155
Linear echoendoscopes......Page 156
Normal EUS appearance of the stomach......Page 157
T staging......Page 158
N staging......Page 159
M staging......Page 160
Positron emission tomography-computed tomography (PET-CT)......Page 161
T staging......Page 163
N staging......Page 165
M staging......Page 166
Magnetic resonance imaging......Page 168
T staging......Page 170
M staging......Page 171
Recurrent gastric cancer......Page 172
Introduction......Page 174
Patterns of tumor spread......Page 175
Endoscopic ultrasound......Page 177
MALT lymphoma......Page 178
Magnetic resonance imaging......Page 181
Introduction......Page 182
Imaging features......Page 183
Imaging follow-up of GISTs......Page 186
Introduction......Page 190
Imaging features......Page 193
Summary......Page 195
REFERENCES......Page 196
Diet......Page 207
Helicobacter pylori eradication......Page 209
Screening......Page 210
Genetics......Page 212
High-magnification endoscopy......Page 213
Optical coherence tomography......Page 214
Sentinel node navigation surgery......Page 216
Perfusion imaging......Page 217
REFERENCES......Page 221
Index......Page 225
