EARLY GASTRIC ADENOCARCINOMA

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Wael Rebai
Fadhel Fterich
Amin Makni
Rachid Ksantini
Haykel Bedioui
Amine Daghfous
Faouzi Chebbi
Mohamed Jouini
Adel Ammous
Montasser Kacem
Zoubeir Ben Safta

Abstract

Aim: the purpose of this study was to determine the epidemiological and clinical behaviour of the superficial adenocarcinoma of the stomach, to clarify its pathological characteristics, therapeutic as well as his its prognosis.
Methods: Over a period of 14 years (1990-2004), 16 patients were operated for a superficial gastric adenocarcinoma among 155 gastric cancers treated during the same period in the service of general surgery “A” La Rabta.
Results: The superficial gastric adenocarcinoma represented 10.3 % of our series. The mean age was 59 years. It was about 8 men and 8 women. Two patients was followed for a chronic stomach ulcer, a patient is followed for Biermer anaemia and another one for Menetrier disease. Among these cancers, 12 were intra mucosal and 4 invaded the submucousa . Lymph node involvement was present only in one case. The cancer was located in the antrium in 8 cases and
was multifocal in 3 cases. One patient died in postoperative case because of a medical cause. The 5-year-overall survival was 65,6 %. The recurrence had interested only one patient.
Conclusion: the superficial gastric adenocarcinoma is rare. The follow up of precancerous states allows its diagnosis. The treatment is based on the gastric resection associated to the D1-type lymph node clearance. The multifocal character imposes a surveillance ofthe remaining gastric stump.

Keywords:

Superficial adenocarcinoma;, Stomach, Gastrectomy, Prognosis

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References

  1. Benhamiche .AM, Faivre .J, Tazi .MA, Darsouni .R, Villing .AL, Couillant .C. les cancers superficiels de l'estomac : évolution de leurs caractéristiques sur une période de 20 ans dans une population. Gastroentertérol Clin Biol.1998; 22 :13-18.
  2. Murakamie T. Pathological diagnosis, definition and gross classification of early gastric cancer.Gan Monogor Cancer Res 1971;11:53-66.
  3. Oota K, Sobin LH. Histological typing of gastric and oesophageal tumors. Geneva,WHO,1977.
  4. Eckardt VF,Giesler W, Kanzler G, Remmele W, Bernhard G. Clinical and morphological characteristics of early gastric cancer. Gastroenterology 1990;98:708-14.
  5. Biasco G, Paganelli GM, Azzaroni D, Grigioni WF, Merighi SM, Stoja R et al. Early gastric cancer in Italy. Clinical and pathological observations on 80 cases. Dig Dis Sci 1987; 32 :113-20.
  6. Inoue K, Tobe T, Kan N, Nio Y, Sakai M, Takeuchi E et al. Problems in the definition and treatment of early gastric cancer. Br j Surg 1991; 78 :818-21.
  7. Belkahla N, Bouzid H, Jouini M et al. Cancer superficiel de l'estomac : à propos de 2 cas. Tun Med 2005 ;83 ;11 :705-710.
  8. Farley DR, Donohue JH, Nagorney DM, Carpenter HA, Katzmann JA, Illstrup DM. Early gastric cancer. Br J Surg 1992; 79 :539-42.
  9. F. Borie, N. Plaisant, B. Millat, J.M.Hay, P.L. Fagniez, B. De Saxe. Européan journal of surgical oncologiy. 2003; 29 : 511-514.
  10. Ranaldi R,Santinelli A, Verdoloni R, Rezai B, Mannollo B, Bearzi I. long-term follow-up in early gastric cancer: evaluation of prognostic factors. J Pathol 1995 ; 177 :343-51.
  11. Mestier. P. Muscosectomie endoscopique pour cancer superficiel de l'estomac : est-ce bien raisonnable ? .J chir 2000 ; 137 :75.
  12. Sagawa T, Takayama T, Oku T,Hayashi T, Ota H, Okamoto T et al. Argon plasma coagulation for successful treatment of early gastric cancer with intra mucosal invasion. Gut 2003;52:334-39.
  13. Ono H, Kondo H, Gotoda T, Shirao K, Yamaguchi H, Saito D et al. Endoscopic mucosal resection for treatment of early gastric cancer.Gut 2001;48:225-29.
  14. Guadagni S, Catarci M, Valenti M, Verzaro R, Cardacci G, Gola P et al. Résultats à long terme du traitement chirurgical des cancers précoces de l'estomac. Ann chir 1994 ; 48 :647-53.
  15. Seto.Y, Yamaguchi H, Shimoyama S, Shimizu N, Aoki F, Kaminishi M. Resultats of local resction with regional lymphadenectomy for early gastric cancer. Am J Surg 2001; 182:498-501.
  16. Shimoyama S, Seto Y, Yasuda H, Mafune KI, Kaminishi M. Concept, Rational, and current outcomes of less invasive strategies of early gastric cancer: Data from a Quarter-Century of experience in a single instituation. World J Surg. 2005 ; 29: 58-65.
  17. Folli S, Dente M, Dell Amore D, Gaudio M, Nanni O, Saragoni L et al. Early gastric cancer :prognostic factors in 223 patients . Br J Surg 1995 ;82:952-6.
  18. Furukawa H, Hiratsuka M, Imaoka S, Ishikawa O, Kabuto T, Sasaki Y et al. Phase II study of limited surgery for early gastric cancer: Segmental gastric resection. Ann Surg Oncol 1999;6:166-70.