Surgical Resection First for Localized Gastric Adenocarcinoma: Are There Adjuvant Options?

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Elena Elimova, Jaffer A Ajani

Abstract

A 55-year-old male presented with upper abdominal bloating followed by modest hematemesis that led to the diagnosis of an ulcerated poorly differentiated (with signet ring cells) adenocarcinoma in the angularis of the stomach. A contrast-enhanced positron emission tomography (PET) with computed tomography (CT) scan showed higher-than-normal physiologic avidity (standardized uptake value, 4.3) in the proximal stomach but not in the lower stomach, and the CT scan vaguely suggested a polypoid lesion in the distal stomach. Nodes were normal in size, and there were no metastases. He underwent esophagoduodenoscopy with ultrasonography (EUS) that showed a 3- x 2-cm flat nodular mass with an 8-mm ulcer in the angularis. The tumor mass was demarcated well on narrow-band imaging, and with a 20-MHz EUS probe, it was designated eusT1bN0. His case was presented to our weekly Multidisciplinary Gastric Adenocarcinoma Conference, and the consensus was to offer surgery as primary therapy. He underwent a subtotal gastrectomy with Roux-en-Y gastrojejunostomy along with D2 nodal dissection. The surgical pathology showed a poorly differentiated adenocarcinoma with signet ring cells; the primary tumor measured 2.8 x 2.2 cm in diameter with infiltrat...Continue Reading

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Citations

Sep 7, 2016·Mayo Clinic Proceedings·Elena ElimovaJaffer A Ajani
Sep 23, 2016·Expert Opinion on Pharmacotherapy·Dilsa Mizrak KayaJaffer A Ajani
Jan 18, 2017·Expert Review of Clinical Pharmacology·Dilsa Mizrak KayaJaffer A Ajani
Jan 19, 2019·Oncology Letters·Honghu XieZhong Guan
Mar 14, 2019·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Kiichi SugimotoMalcolm V Brock
Jan 5, 2019·Clinical Nuclear Medicine·Shumao ZhangYue Chen

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