• Title/Summary/Keyword: Advanced stomach cancer

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Prognostic Significance of Preoperative Blood Transfusion in Stomach Cancer

  • Kim, Seok-Hwan;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • v.10 no.4
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    • pp.196-205
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    • 2010
  • Purpose: We did a retrospective study to understand the prognostic effects of preoperative blood transfusions in stomach cancer surgery. Materials and Methods: Data for 1,360 patients who underwent gastrectomy for stomach cancer between 2001 and 2009 were retrospectively reviewed. We analyzed factors that affect preoperative transfusion and clinicopathologic features. We also analyzed 5-year and overall survival rates of the transfusion and non transfusion subgroups. Results: Sixty patients (4.4%) required blood transfusion within the preoperative period. The transfused group included patients who took aspirin or clopidogrel (P<0.001), with more advanced T stages (P<0.001), with more advanced nodal metastasis (P=0.00), and with more advanced stages (P=0.00) than the non transfusion group. On multivariate analysis, preoperative transfusion was a statistically significant negative influence on 5-year survival and overall survival rates (58.2% vs 79.9% (P=0.00), 58.2% vs 76.8% (P=0.00)). Applying Cox-regression analyses, blood transfusion did appear to have an effect on prognosis and on 5-year and overall survival rates. Conclusions: We found a direct negative relation between preoperative transfusion and long term prognosis in patients receiving gastric cancer surgery.

A Case Report of Advanced Gastric Cancer Patient Treated with Bojungikgi-tang Gamibang (절제불가능한 위암의 위장관 출혈에 대한 보중익기탕 가미방 투여 1례)

  • Lee, Hyun-Il;Jerng, Ui-Min;Jeong, Jong-Soo;Lee, San-Hun;Choi, Won-Cheol;Yoon, Seong-Woo
    • Journal of Korean Traditional Oncology
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    • v.14 no.1
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    • pp.29-35
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    • 2009
  • Approximately 10 percent of advanced stomach cancer patients have internal bleeding in their stomach. It is crucial to treat internal bleeding since it severely deteriorates patient's condition, and disturbs process of chemotherapy. There are hemostatic agents and dressing, radiotherapy, endoscopic ligation and coagulation, surgical methods to treat bleeding. However, these methods cannot be executed in some cases in which patient is in terminal stage or not in desirable condition to take these treatments. We are going to introduce a case of advanced gastric cancer patient having stomach bleeding who made a choice to take oriental medical treatments. The patient was on third stage of stomach cancer, had 3200cc of blood transfusion for five times. After diagnosed as not being able to have resection, he started to oriental medical treatments to stop bleeding. From March 28, 2009 to April 16, 2009, we administer 120cc Bojungikgi-tang gamibang to the patient in 90minutes after each meal. During 19days of having Bojungikgi-tang gamibang, we observed that the patient needed significantly lower amount blood transfusion, to 640cc. The patient improves in performance, and was able to eat more. Despite of short period of observation, this case indicates that Bojungikgi-tang gamibang treatment to the patient could work as hemostat, further improved quality of patient's life.

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Quality of Life in Patients with Stomach Cancer after Operation (위암 수술 환자에서의 삶의 질)

  • Jeon Yang-Whan;Han Sang-Ick;Jeon Chul-Eun;Kim Jin-Jo;Park Seung-Man
    • Journal of Gastric Cancer
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    • v.4 no.1
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    • pp.27-31
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    • 2004
  • Purpose: This study was designed to explore quality of life (QOL) in patients with stomach cancer by using the World Health Organization Quality of Life (WHOQOL) Instrument- Korean version. Materials and Methods: Thirty-one (31) patients with stomach cancer after curative resection were recruited with informed consent. Age- and gender-matched hospital staff served as controls. The 100-item WHOQOL Instrument, including physical domain, psychological domain, social domain, independence domain, environment domain, and spiritual domain, was employed for the all subjects. Results: In patients with stomach cancer after operation, only two domains, physical and independence, were associated with worse quality of life. In those domains, patients with advanced stage, with total gastrectomy, with adjuvant chemotherapy, and early or late postoperative period ($\leqq$2 years or >5 years after operation), could be perceived of having a worse quality of life. Conclusion: Not only scientific objective success but also individual subjective perception of condition could be important for managing patients with stomach carcinomas after curative resection. In this context, the WHOQOL reflecting multi-dimensional state of well being could be a useful tool across a variety of cultural and value systems in the world.

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Current and New Molecularly Targeted Agents for Metastatic Gastric Cancer

  • Sung Chul Park
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.11-16
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    • 2015
  • The discovery of HER2, a biomarker in advanced gastric cancer, and successful clinical trial using trastuzumab that targets this biomarker signaled a revolutionary turning point in treatment of metastatic gastric cancer. Many studies about targeted agents for gastric cancer have been attempted. Among them, ramicirumab, a monoclonal antibody that targets vascular endothelial growth factor receptor-2 (VEGFR-2), and apatinib, a tyrosine kinase inhibitor (TKI) that targets VEGFR2, have shown to improve the survival rates in advanced gastric cancer patients, for whom previous therapies had failed; hence, they are expected to be accepted as one of the standard therapies for advanced gastric cancer.

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Oncological Treatment of Advanced Gastric Cancer (진행성 위암의 항암 약물 요법에 대하여)

  • Hee Seok Moon;Hyun Yong Jeong
    • Journal of Digestive Cancer Research
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    • v.6 no.1
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    • pp.16-24
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    • 2018
  • Gastric cancer is not a single, uniform disease, but rather heterogeneous in nature. It is generally not possible to cure patients with inoperable advanced or metastatic stomach cancer. In the absence of chemotherapy, the median survival time is 3 to 6 months. Therefore, several studies have confirmed the superiority of chemotherapy to the best supportive treatment, in terms of improving the quality of life and prolonging life. Various chemotherapies have been used in the past to treat advanced gastric cancer. Recently, various target therapies and immunotherapy have been introduced. However, compared to other malignancies, the quality of life and life expectancy remain relatively poor in patients with gastric cancer. We expect to overcome these difficulties in the future, with better elucidation of the molecular biology of gastric cancer.

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Immunohistochemical Analysis of Fas-associated Death Domain Protein Expression in Stomach Cancers (위암의 Fas-associated Death Domain Protein 단백질의 발현)

  • Lee, Sug-Hyung;Lee, Jong-Woo;Park, Won-Sang;Lee, Jung-Young;Yoo, Nam-Jin
    • Journal of Gastric Cancer
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    • v.3 no.2
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    • pp.80-83
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    • 2003
  • Purpose: Evidence exists that dysregulation of apoptosis is involved in the pathogenesis of cancer development. Fasassociated death domain (FADD) protein, an adaptor protein of death receptors, is a critical regulatory component of the extrinsic cell- death pathway that exerts its pro-apoptotic effect upon binding with death receptors. Expression of the FADD protein has not been reported in stomach cancer. The aim of this study was to explore the expression status of the FADD protein in stomach cancers. Materials and Methods: In the current study, we analyzed the expression of the FADD protein in 60 advanced stomach cancer by using immunohistochemistry and a tissue microarray approach. Results: Immunopositivity (defined as $\geq\30\%$) was observed for the FADD protein in 23 ($38\%$) of the 60 cancers. Normal gastric mucosal cells showed expression of the FADD protein. Conclusion: Taken together, these results indicate that decreased expression of the FADD protein is a frequent event in stomach cancers and suggest that to avoid apoptosis, stomach cancer cells in vivo may need loss of FADD expression, which might contribute to tumor development.

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Palliative Treatment with Celestin`s tube in Advanced Esophageal Cancer (진행성 식도암의 Celestin`s tube 를 이용한 고식적 치료)

  • 백광제
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.529-533
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    • 1985
  • Though esophageal cancer was not a common disease, early metastasis and direct extension to adjacent organ were important on the treatment of disease. Therefore, palliative operation was often useful in advanced esophageal cancer. Between June 1985 through July 1985, we treated three cases of inoperable esophageal cancer with Celestin`s endo-esophageal tube by esophageal intubation. Three operations were done under general anesthesia. Celestin`s tube were inserted via oral cavity and additional traction on stomach were applied. After complete insertion of tube was done, the distal end of Celestin`s tube was modified in length. Also stay suture was applied between tube and stomach wall was applied. Postoperative esophagogram revealed good esophageal patency through Celestin`s tube. Clinically, swallowing difficulty was much improved after operation.

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Rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer

  • Kong, Eunjung;Koh, Sung Ae;Kim, Won Jae
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.159-162
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    • 2019
  • The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.

Comparison of Laparoscopic and Open Gastrectomy for Patients With Gastric Cancer Treated With Neoadjuvant Chemotherapy: A Multicenter Retrospective Study Based on the Korean Gastric Cancer Association Nationwide Survey

  • Seul Ki Oh;Chang Seok Ko;Seong-A Jeong;Jeong Hwan Yook;Moon-Won Yoo;Beom Su Kim;In-Seob Lee;Chung Sik Gong;Sa-Hong Min;Na Young Kim;the Information Committee of the Korean Gastric Cancer Association
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.499-508
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    • 2023
  • Purpose: Despite scientific evidence regarding laparoscopic gastrectomy (LG) for advanced gastric cancer treatment, its application in patients receiving neoadjuvant chemotherapy remains uncertain. Materials and Methods: We used the 2019 Korean Gastric Cancer Association nationwide survey database to extract data from 489 patients with primary gastric cancer who received neoadjuvant chemotherapy. After propensity score matching analysis, we compared the surgical outcomes of 97 patients who underwent LG and 97 patients who underwent open gastrectomy (OG). We investigated the risk factors for postoperative complications using multivariate analysis. Results: The operative time was significantly shorter in the OG group. Patients in the LG group had significantly less blood loss than those in the OG group. Hospital stay and overall postoperative complications were similar between the two groups. The incidence of Clavien-Dindo grade ≥3 complications in the LG group was comparable with that in the OG group (1.03% vs. 4.12%, P=0.215). No statistically significant difference was observed in the number of harvested lymph nodes between the two groups (38.60 vs. 35.79, P=0.182). Multivariate analysis identified body mass index (odds ratio [OR], 1.824; 95% confidence interval [CI], 1.029-3.234; P=0.040) and extent of resection (OR, 3.154; 95% CI, 1.084-9.174; P=0.035) as independent risk factors for overall postoperative complications. Conclusions: Using a large nationwide multicenter survey database, we demonstrated that LG and OG had comparable short-term outcomes in patients with gastric cancer who received neoadjuvant chemotherapy.

Immunohistochemical Analysis of BAD Protein Expression in Gastric Carcinomas (위암의 BAD 단백질의 발현)

  • Yoo, Nam-Jin;Lee, Jong-Woo;Park, Won-Sang;Lee, Jung-Young;Lee, Sug-Hyung
    • Journal of Gastric Cancer
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    • v.3 no.2
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    • pp.75-79
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    • 2003
  • Purpose: Evidence exists that dysregulation of apoptosis is involved in the pathogenesis of cancer development. The Bcl-$x_{L}$/Bcl-2-associated death promoter (BAD), a member of the Bcl-2 family, is a critical regulatory component of the intrinsic cell-death pathway that exerts its pro-apoptotic effect upon heterodimerization with anti-apoptotic proteins Bcl-2 and Bcl-$X_{L}$. Expression of the BAD protein has been reported in several cancer types, but not in stomach cancer. The aim of this study was to explore the expression status of the BAD protein in gastric carcinomas. Materials and Methods: In the current study, we analyzed the expression of the BAD protein in 60 advanced gastric adenocarcinomas by using immunohistochemistry and a tissue microarray approach. Results: Immunopositivity (defined as $\geq\30\%$) was observed for the BAD protein in 57 ($95\%$) of the 60 cancers. Normal gastric mucosal cells showed weaker expressions of the BAD protein than gastric carcinomas. Conclusion: Taken together, these results suggest that stomach cancer cells in vivo may need BAD protein expression for apoptosis. Also, the higher expression of the BAD protein in stomach cancer cells than in normal gastric mucosal cells suggests that apoptosis might be easily triggered in susceptible stomach cancer cells, thereby producing selective pressure to make more apoptosis-resistant cells during tumor development.

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