carcinoma stomach

1. Carcinoma Stomach
Dr. Tess Jose
Intern
Oncomedicine

2. ANATOMY
• PARTS OF STOMACH

3. • The stomach, is an intraperitoneal digestive
organ located between the oesophagus and
the duodenum.
• It has a ‘J’ shape, and features a lesser and
greater curvature. The anterior and posterior
surfaces are smoothly rounded with a
peritoneal covering.

5. BLOOD SUPPLY

7. Spectrum of gastric carcinoma

8. RISK FACTORS
• Familial
• HNPCC, Li fraumen syndrome
• Perinicious anemia

9. • INTESTINAL 53 %
H pylori induced ,gland formation and definite cellular
architecture are features
• DIFFUSE 33%
Poorly differentiated /signet type with early gastric wal
penetration and lymphatic spread
• UNCLASSIFIED 14%

10. JAPANESE CLASSIFICATION

11. Advanced gastric cancer
• Polypoid
• Ulcer with clear margin
• Ulcer without clear margin
• Diffuse type

12. WHO CLASSIFICATION
• Adenocarcinoma
• Adenosquamous carcinoma
• Squamous cell carcinoma
• Undifferentiated

13. Common sites
• Prepyloric and pyloric region 65%
• Body25%
• Fundus ,OG junction

14. SPREAD
• DIRECT
Horizontal –via stomach wall
Vertical - pancreas , colon , liver
LYMPHATIC

16. Surgical Management
• Gastrectomy
Billroth I benign condition
Billroth II carcinoma stomach
Lower radical gastrectomy- (ca pylorus)
growth +proximal 5 cm of stomach, omentum,spleen ,
tail of pancreas

17. Bilroth typ