Gastric Cancer
Gastrolearning 26/5/2014
F.Farinati
S.Lonardi
A.Marchet
Padova
Gastric Cancer
F.Farinati
Epidemiology, precancerous changes, Early Gastric
Cancer
Gastric
cancer
mortality
Gastric cancer: epidemiology
Almost one million new cases of stomach cancer estimated to have
occurred in 2012 (952,000 ca...
Third leading cause of cancer death in both sexes worldwide (723,000 deaths,
9% of the total). Highest estimated mortality...
Hereditary diffuse gastric cancer (HDGC).
Vogelaar et al. Hereditary Cancer in Clinical Practice 2012, 10:18
The role of diet in gastric cancer: still an
open question.
Berretta M et al. Front Biosci
(Landmark Ed). 2012 Jan 1;17:16...
Natural history of H. pylori infection
Gastritis
Atrophy
Days
Weeks
Sipponen et al.1993
Duodenal
ulcer
Gastric
ulcer
Years...
H. pylori and Cancer Collaborative Group, 2001
Association between Helicobacter pylori infection and
non-cardia gastric ca...
The Correa’ s Cascade
Inoue, Cancer. Lett. 2000, RR 2.2 at
5 years in moderate atrophy
You, Int J Cancer 1999 RR = 1
Chronic atrophic gastriti...
Gastric atrophy: OLGA staging
M.Rugge et al
Dysplasia (Intra Epithelial neoplasia – IEN
Non Invasive Neoplasia - NIN)
Cancers detected during the follow-up
Early GC
22 = 88%
Advanced
GC
3 = 12%
Pathological Stage (pTNM) assessed in 25
patie...
Follow-up :
mandatory !!!!
Gastric epithelial dysplasia (NIN-IEN)
CAG
DYSPL
Cancer
EGC
Chemotherapy
Palliative surgery
Radiation
Progress in the treatment of AGC:
median overall survival
BSC1
5FU monotherapy1
Docetaxel-Cisplatin-5FU 2
Capecitabine-Cis...
Gastric Cancer
Early Gastric Cancer
Strip biopsy EMR
Endoscopic Submucosal Dissection ESD
La terapia del cancro dello stomaco - Gastrolearning®
La terapia del cancro dello stomaco - Gastrolearning®
La terapia del cancro dello stomaco - Gastrolearning®
La terapia del cancro dello stomaco - Gastrolearning®
La terapia del cancro dello stomaco - Gastrolearning®
La terapia del cancro dello stomaco - Gastrolearning®
Upcoming SlideShare
Loading in …5
×

La terapia del cancro dello stomaco - Gastrolearning®

1,140 views

Published on

Gastrolearning II modulo/10a lezione
La terapia del cancro dello stomaco
Prof. Fabio Farinati- Università di Padova

Published in: Education, Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,140
On SlideShare
0
From Embeds
0
Number of Embeds
94
Actions
Shares
0
Downloads
21
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

La terapia del cancro dello stomaco - Gastrolearning®

  1. 1. Gastric Cancer Gastrolearning 26/5/2014 F.Farinati S.Lonardi A.Marchet Padova
  2. 2. Gastric Cancer F.Farinati Epidemiology, precancerous changes, Early Gastric Cancer
  3. 3. Gastric cancer mortality
  4. 4. Gastric cancer: epidemiology Almost one million new cases of stomach cancer estimated to have occurred in 2012 (952,000 cases, 7% of the total), the fifth most common malignancy in the world, after the lung, breast, colorectum and prostate. Globocan IARC 2012
  5. 5. Third leading cause of cancer death in both sexes worldwide (723,000 deaths, 9% of the total). Highest estimated mortality rates in Eastern Asia (24 per 100,000 in men, 9.8 per 100,000 in women), lowest in Northern America (2.8 and 1.5, respectively). High mortality rates are also present in Central and Eastern Europe, and in Central and South America.
  6. 6. Hereditary diffuse gastric cancer (HDGC). Vogelaar et al. Hereditary Cancer in Clinical Practice 2012, 10:18
  7. 7. The role of diet in gastric cancer: still an open question. Berretta M et al. Front Biosci (Landmark Ed). 2012 Jan 1;17:1640-7. • Fruit and vegetables • Salt and salted food • Vitamins and mineral • Alcohol • Nitrate, nitrite and nitrosamines High dietary salt intake exacerbates Helicobacter pylori- induced gastric carcinogenesis. Gaddy JA et al 2013 Infect Immun.
  8. 8. Natural history of H. pylori infection Gastritis Atrophy Days Weeks Sipponen et al.1993 Duodenal ulcer Gastric ulcer Years Months Risk 15% 1%Neoplasia Decades
  9. 9. H. pylori and Cancer Collaborative Group, 2001 Association between Helicobacter pylori infection and non-cardia gastric cancer
  10. 10. The Correa’ s Cascade
  11. 11. Inoue, Cancer. Lett. 2000, RR 2.2 at 5 years in moderate atrophy You, Int J Cancer 1999 RR = 1 Chronic atrophic gastritis: Cancer risk Low risk
  12. 12. Gastric atrophy: OLGA staging M.Rugge et al
  13. 13. Dysplasia (Intra Epithelial neoplasia – IEN Non Invasive Neoplasia - NIN)
  14. 14. Cancers detected during the follow-up Early GC 22 = 88% Advanced GC 3 = 12% Pathological Stage (pTNM) assessed in 25 patients 30 Gastric Cancers detected among 129 patients Follow-up > 12 months Follow-up < 12 months 19 11
  15. 15. Follow-up : mandatory !!!! Gastric epithelial dysplasia (NIN-IEN)
  16. 16. CAG DYSPL Cancer EGC Chemotherapy Palliative surgery Radiation
  17. 17. Progress in the treatment of AGC: median overall survival BSC1 5FU monotherapy1 Docetaxel-Cisplatin-5FU 2 Capecitabine-Cisplatin (XP)3 5FU-LV-Oxaliplatin (FLO)4 EOX5 Trastuzumab-CT6 4 months 7 months 9.2 months 10.5 months 10.7 months 11.2 months 13.8 months 1.Wagner JCO 03; 2 Van Cutsem ASCO 09; 3. Kang Ann Oncol 09; 4. Al Batran JCO 09; 5. Cunningham NEJM 07; 6. Van Cutsem ASCO 09. Adapted from Cervantes Gastrointestinal Cancer Symposium Barcellona 2009 O.S.
  18. 18. Gastric Cancer Early Gastric Cancer
  19. 19. Strip biopsy EMR
  20. 20. Endoscopic Submucosal Dissection ESD

×