Gastric Cancer Erbolatkyzy Akbota

1. Gastric Cancer Erbolatkyzy Akbota

2. Plan: 1 Gastric Cancer 2 Epidemiology 3Risk Factors 4Treatment

3. Epidemiology

Gastric cancer was the fourth most common cancer in
the world in 2004, and is expected to remain fourth in
2005.
World wide there are 930,000 new cases and 700,000
deaths per year. Sixty percent of new cases occur in
developing countries.
There is tremendous geographic variation, with the
highest death rates in Chile, the former Soviet Union,
China, and Japan.

4.

Risk Factors
Predisposing :
Environmental:
Genetic:
1. Pernicious anemia
& atrophic gastritis
(achlorhydra)
2. Previous gastric
resection
3. Chronic peptic ulcer
(give rise to 1%)
4. Smoking.
5. Alcohol.
1.H.pylori infection
Sero(+)patients
have 6-9 folds risk
2.low
socioeconomic
Status
3. Nationality
(JAPAN)
4. Diet (prevention)
1.Blood group A
2.HNPCC:
Heriditory nonpolyposis colon
cancer.

5. Endoscopy

6. Decreasing Incidence

Improved nutrition and refrigeration of foods
Lower incidences of H. pylori due to increased
antibiotic use and cleaner water/sanitation leading to
decreased transmission of disease
Earlier detection and treatment in certain countries

7.

8. Treatment

Surgical resection remains the mainstay of
treatment and is the only curative option.
More recently pre- and post-chemoradiation
therapy has been scrutinized to see if there is any
benefit to survival.
The issue of extent of resection appears to have
been settled. As long as adequate tumor margins
are achieved, subtotal gastrectomy has the same
survival as total, with decreased morbidity.

9.

THE GOLD STANDARD
It allows taking biopsies
Safe (in experienced hands)

10. Outcomes

Recurrence rates remain high, from 40 to 80%
depending on the series being quoted.
Locoregional failure rate 38 to 45%, with most
recurrence in the gastric remnant at the anastamosis,
gastric bed, and lymph nodes.
Surveillance is important. Patients should be followed
every 4 months for the first year, then 6 months for 2
more years. Yearly endoscopy should be performed for
subtotal gastrectomies.

11. End