Gastric cancer is the second leading cause of cancer death worldwide. Risk factors include H. pylori infection, smoking, and diet low in fruits and vegetables. Genetic factors include certain gene mutations. Symptoms often include abdominal discomfort and weight loss. Diagnosis involves endoscopy with biopsy. Staging uses TNM classification and involves assessing tumor invasion and lymph node metastasis. Treatment depends on stage but commonly includes surgery such as gastrectomy with lymph node dissection, as well as chemotherapy and radiation therapy. Palliative options are used in advanced cases.
This document discusses gastric cancer, including risk factors, symptoms, diagnostic tests, staging classifications, surgical treatments, chemotherapy regimens, and radiation therapy options. It notes that gastric cancer is the second leading cause of cancer death worldwide. Risk factors include H. pylori infection, smoking, and diet low in fruits and vegetables. Symptoms often include abdominal discomfort, weight loss, and loss of appetite. Staging is done using the TNM classification system. Surgical options range from endoscopic resection for early cancers to gastrectomy with lymph node dissection for more advanced cancers. Neoadjuvant and adjuvant chemotherapy can improve outcomes. Radiation is used in certain settings as well.
This document discusses the epidemiology, risk factors, pathological classification, staging, diagnostic workup, prognostic factors, treatment options and patterns of relapse for gastric cancer. Some key points:
- Gastric cancer is the second leading cause of cancer death worldwide, with highest rates in East Asia. Risk factors include H. pylori infection, smoking, low fruit/vegetable diet.
- Pathologically, 90-95% are adenocarcinomas. Staging involves endoscopy, imaging and laparoscopy to determine tumor extent and metastasis.
- Treatment depends on stage but may include surgery (total/subtotal gastrectomy with D1/D2 lymph node dissection), radiation, chemotherapy
This document provides an overview of gastric carcinoma, including:
- Causes of epigastric lumps that may indicate gastric carcinoma
- Risk factors like H. pylori infection, diet, smoking, and genetic factors
- Staging classifications including TNM, Lauren-Jarvi, and Borrmann systems
- Treatment approaches like endoscopic or surgical resection depending on stage, with lymph node dissection and reconstruction techniques described
- Adjuvant therapies including chemotherapy and radiation to improve survival
- 5-year survival rates are improved with neoadjuvant chemotherapy and adjuvant chemoradiation compared to surgery alone.
Gastric cancer is a common cancer worldwide, with high rates in East Asia and Eastern Europe. Napoleon likely died from a stage IIIA gastric cancer based on historical accounts of his symptoms. For diagnosis, endoscopy with biopsy is needed but endoscopic ultrasound and CT scans can help determine tumor depth and metastasis. Treatment depends on stage - early cancers may be treated with endoscopic resection while later stages typically require surgical resection with chemotherapy sometimes used as adjuvant therapy or for palliation. Prognosis correlates with stage, with 5-year survival rates of 90%, 60%, 30%, 8% for stages I-IV respectively.
Gastric cancer is a common cancer worldwide, with high rates in East Asia and Eastern Europe. Napoleon likely died from a stage IIIA gastric cancer based on historical accounts of his symptoms. For diagnosis, endoscopy with biopsy is needed but endoscopic ultrasound and CT scans can help determine tumor depth and metastasis. Treatment depends on stage - early cancers may be treated with endoscopic resection while later stages typically require surgical resection with chemotherapy sometimes used as adjuvant therapy or for palliation. Prognosis correlates with stage, with 5-year survival rates of 90%, 60%, 30%, 8% for stages I to IV respectively.
Colon cancer is the fourth most commonly diagnosed cancer. About 70% of cases are sporadic, while 23% are genetic. It most commonly presents in the descending and sigmoid colon as a change in bowel habits with blood or mucus in the stool. Staging involves clinical exams, imaging like CT scans, and blood tests like CEA. Treatment depends on the stage, with surgery being the main treatment and chemotherapy sometimes used adjuvantly or palliatively. The 5-year survival ranges from 100% for stage 0 to 3-30% for stage 4 disease.
The document discusses the anatomy, histology, physiology, carcinogenesis, clinical presentation, diagnosis, staging, and treatment of gastric cancer. It notes that gastric cancer typically presents with nonspecific symptoms like abdominal pain or weight loss. Diagnosis involves endoscopy with biopsy. Staging involves endoscopic ultrasound or CT scan to evaluate tumor invasion and lymph node involvement. Treatment depends on stage but may include surgery, chemotherapy, and radiation. Screening high-risk individuals can detect early gastric cancer and improve outcomes.
This document discusses gastric cancer, including risk factors, symptoms, diagnostic tests, staging classifications, surgical treatments, chemotherapy regimens, and radiation therapy options. It notes that gastric cancer is the second leading cause of cancer death worldwide. Risk factors include H. pylori infection, smoking, and diet low in fruits and vegetables. Symptoms often include abdominal discomfort, weight loss, and loss of appetite. Staging is done using the TNM classification system. Surgical options range from endoscopic resection for early cancers to gastrectomy with lymph node dissection for more advanced cancers. Neoadjuvant and adjuvant chemotherapy can improve outcomes. Radiation is used in certain settings as well.
This document discusses the epidemiology, risk factors, pathological classification, staging, diagnostic workup, prognostic factors, treatment options and patterns of relapse for gastric cancer. Some key points:
- Gastric cancer is the second leading cause of cancer death worldwide, with highest rates in East Asia. Risk factors include H. pylori infection, smoking, low fruit/vegetable diet.
- Pathologically, 90-95% are adenocarcinomas. Staging involves endoscopy, imaging and laparoscopy to determine tumor extent and metastasis.
- Treatment depends on stage but may include surgery (total/subtotal gastrectomy with D1/D2 lymph node dissection), radiation, chemotherapy
This document provides an overview of gastric carcinoma, including:
- Causes of epigastric lumps that may indicate gastric carcinoma
- Risk factors like H. pylori infection, diet, smoking, and genetic factors
- Staging classifications including TNM, Lauren-Jarvi, and Borrmann systems
- Treatment approaches like endoscopic or surgical resection depending on stage, with lymph node dissection and reconstruction techniques described
- Adjuvant therapies including chemotherapy and radiation to improve survival
- 5-year survival rates are improved with neoadjuvant chemotherapy and adjuvant chemoradiation compared to surgery alone.
Gastric cancer is a common cancer worldwide, with high rates in East Asia and Eastern Europe. Napoleon likely died from a stage IIIA gastric cancer based on historical accounts of his symptoms. For diagnosis, endoscopy with biopsy is needed but endoscopic ultrasound and CT scans can help determine tumor depth and metastasis. Treatment depends on stage - early cancers may be treated with endoscopic resection while later stages typically require surgical resection with chemotherapy sometimes used as adjuvant therapy or for palliation. Prognosis correlates with stage, with 5-year survival rates of 90%, 60%, 30%, 8% for stages I-IV respectively.
Gastric cancer is a common cancer worldwide, with high rates in East Asia and Eastern Europe. Napoleon likely died from a stage IIIA gastric cancer based on historical accounts of his symptoms. For diagnosis, endoscopy with biopsy is needed but endoscopic ultrasound and CT scans can help determine tumor depth and metastasis. Treatment depends on stage - early cancers may be treated with endoscopic resection while later stages typically require surgical resection with chemotherapy sometimes used as adjuvant therapy or for palliation. Prognosis correlates with stage, with 5-year survival rates of 90%, 60%, 30%, 8% for stages I to IV respectively.
Colon cancer is the fourth most commonly diagnosed cancer. About 70% of cases are sporadic, while 23% are genetic. It most commonly presents in the descending and sigmoid colon as a change in bowel habits with blood or mucus in the stool. Staging involves clinical exams, imaging like CT scans, and blood tests like CEA. Treatment depends on the stage, with surgery being the main treatment and chemotherapy sometimes used adjuvantly or palliatively. The 5-year survival ranges from 100% for stage 0 to 3-30% for stage 4 disease.
The document discusses the anatomy, histology, physiology, carcinogenesis, clinical presentation, diagnosis, staging, and treatment of gastric cancer. It notes that gastric cancer typically presents with nonspecific symptoms like abdominal pain or weight loss. Diagnosis involves endoscopy with biopsy. Staging involves endoscopic ultrasound or CT scan to evaluate tumor invasion and lymph node involvement. Treatment depends on stage but may include surgery, chemotherapy, and radiation. Screening high-risk individuals can detect early gastric cancer and improve outcomes.
This document discusses gastric cancer worldwide. It notes that gastric cancer is the fourth most common cancer globally and has varying incidence rates in different regions. For example, the rate is higher in Japan, Eastern Europe, and lower in the UK and USA. The incidence of cancers in the proximal stomach are increasing while those in the body and antrum are decreasing. Treatment options discussed include surgery, chemotherapy, radiotherapy, and palliative care. Prognosis is better in Japan where more patients undergo curative resection and have higher 5-year survival rates compared to the West.
Gastric cancer seminar presentation covered the following topics in 3 sentences or less:
The presentation discussed the anatomy, blood supply, lymphatic drainage and histology of the stomach. Risk factors, clinical presentation, diagnostic tools and staging of gastric cancer were explained. Surgical treatment options including endoscopic resection, gastrectomy and lymph node dissection were summarized along with reconstruction methods.
colorectal cancer 18 aug 22 final yr.pptxafzal mohd
Colorectal cancer is the third most common cancer worldwide. Risk factors include lifestyle, family history, and certain medical conditions. Screening is recommended starting at age 50. Surgery is the main treatment for localized cancer, with options depending on tumor location. Adjuvant therapies like chemotherapy may be given after surgery. Five-year survival rates range from over 90% for early stage to less than 10% for metastatic disease.
The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum.
Blood supply
The left gastric artery
Right gastric artery
Right gastro-epiploic artery
Left gastro-epiploic artery
Short gastric arteries
Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.
It could be:
malignant or benign
primary or secondary
Gastric carcinoma is the second most common cancer-related death worldwide. It typically spreads through direct extension, lymphatics, or hematogenously to distant sites like the liver. Staging involves endoscopy, imaging, and biopsy to determine the depth of invasion and lymph node involvement. Surgery aims to perform a curative resection with negative margins and lymph node dissection, but outcomes remain poor with high rates of recurrence.
Gastric cancer forms in the inner lining of the stomach and can grow into a tumor. It is usually diagnosed via endoscopy with biopsy. Staging involves endoscopic ultrasound, CT, PET, and endoscopy to determine if the cancer has spread from the stomach lining to deeper layers or lymph nodes. Treatment of early gastric cancer may involve endoscopic resection but later stages typically require surgical resection of part of the stomach along with nearby lymph nodes. The document provides details on the anatomy, symptoms, risk factors, diagnostic tests, classifications, and surgical treatment approaches for gastric cancer.
This document provides information on carcinoma of the stomach, including:
- Risk factors include H. pylori infection, diet, genetics, smoking.
- Types include intestinal and diffuse. Staging uses TNM and other classifications.
- Common symptoms are weight loss, abdominal pain, vomiting. Investigations include endoscopy and biopsy.
- Treatment depends on stage but commonly includes surgery such as gastrectomy along with lymph node dissection. Endoscopic resection may be used for early stages. Adjuvant therapy is sometimes used for later stages.
This document discusses malignant neoplasms of the stomach. Some key points:
- Stomach cancer is the 5th most common cancer globally and the 3rd leading cause of cancer death. Outcomes are generally poor due to late stage at presentation.
- Risk factors include H. pylori infection, smoking, low fruit/vegetable diet, family history, and prior gastric surgery or conditions like pernicious anemia.
- Tumors are classified by location, histology (intestinal vs diffuse), and stage. Diagnosis involves endoscopy, biopsy, and imaging.
- Treatment depends on stage but commonly includes surgical resection with lymph node dissection, with or without adjuvant chemotherapy/radiation
Gastric carcinoma is the fourth most common cancer worldwide and the second leading cause of cancer death globally. It has a poor prognosis except in areas that conduct early screening. Approximately 95% are adenocarcinomas. Risk factors include H. pylori infection, smoking, genetic factors, and precancerous lesions. Staging involves endoscopy, CT, PET, and laparoscopy. Surgery with curative intent plus perioperative chemotherapy may cure early stage tumors. Advanced or metastatic disease is treated with palliative chemotherapy, radiation or surgery.
This document discusses gastric cancer, including:
- Risk factors like H. pylori infection, smoking, diet high in pickled foods, and family history.
- Precursor lesions include atrophic gastritis, intestinal metaplasia, and dysplasia.
- Symptoms are often nonspecific like weight loss, but can include bleeding or obstruction.
- Diagnosis involves endoscopy with biopsy. Staging evaluates depth of invasion and lymph node spread.
- Treatment is surgical resection with chemotherapy or radiation for advanced cases.
- Recurrence after surgery may involve the anastomosis or peritoneal spread.
This document discusses malignant obstructive jaundice and its causes such as gallbladder cancer and bile duct cancer. It provides details on the incidence, risk factors, pathology, staging, clinical presentation, diagnosis, and management of gallbladder cancer. Key points include that gallbladder cancer occurs predominantly in elderly people, has a poor prognosis, and is often diagnosed at late stages. Surgical resection is the main treatment for early stage disease while palliative options are used for advanced or unresectable cases. Prognosis depends on the pathologic stage, with T1a cancers having an excellent prognosis.
The document discusses carcinoma of the colon and its management. It provides details on epidemiology, risk factors, staging, diagnostic workup, surgery, adjuvant therapy including chemotherapy and radiation therapy. Surgery is the primary treatment but adjuvant therapy with chemotherapy improves survival outcomes, especially in stage III disease. Chemotherapy regimens like FOLFOX and 5-FU plus leucovorin are commonly used in the adjuvant and metastatic settings.
1. The document discusses carcinoma of the head of the pancreas, including its epidemiology, risk factors, pathology, clinical features, imaging, staging, and surgical management via the Whipple procedure.
2. It provides details of the Whipple procedure, including exposing and dissecting key structures like the superior mesenteric vein, Kocher maneuver, dividing vessels like the gastroduodenal artery, and transecting the stomach and jejunum.
3. The Whipple procedure involves a pancreaticoduodenectomy to resect the pancreatic head tumors while preserving stomach, duodenum, common bile duct, and pancreas.
Radiotherapy for Seminoma
- Seminoma accounts for over 60% of testicular germ cell tumors with an incidence of 0.95 per 100,000.
- For stage I seminoma, prophylactic radiation to the para-aortic lymph nodes is the standard of care to reduce the risk of recurrence.
- For stage IIA/IIB seminoma, radiotherapy to the para-aortic, iliac, and inguinal lymph nodes is recommended, with 30Gy to the whole field and a 10Gy boost for stage IIA and 36Gy total for stage IIB.
- Intensity modulated radiation therapy (IMRT) allows for improved sparing of
This document provides information on gastric cancer including:
1. Symptoms, signs, diagnosis and staging using endoscopy, CT scans, laparoscopy and more.
2. Treatment options depending on stage including surgery (D1, D2 lymphadenectomy), chemotherapy, and chemoradiation.
3. Adjuvant therapy recommendations after surgery including S-1 chemotherapy or chemoradiation based on clinical trials.
4. Guidelines for radiation therapy planning and target volumes.
5. Systemic therapy options for advanced or metastatic disease including single agent versus multi-agent chemotherapy.
1) The stomach is located in the abdomen between the esophagus and small intestine. It has five regions and receives blood supply from branches of the celiac trunk and superior mesenteric artery.
2) Gastric cancer is usually adenocarcinoma. Risk factors include H. pylori infection, smoking, and family history. Symptoms include dyspepsia, weight loss, and vomiting.
3) Diagnosis involves endoscopy with biopsy. Treatment depends on stage but may include endoscopic resection for early cancer, surgery such as total gastrectomy with lymph node dissection, or chemotherapy and radiation.
1. Colorectal cancer is the second most common malignancy in females and third most common in males. It is also the fourth most common cause of cancer death.
2. Risk factors include red meat, obesity, smoking, alcohol, family history, and inflammatory bowel disease. Most cases are sporadic but some are hereditary.
3. Symptoms depend on the location of the cancer in the colon but may include blood in stool, changes in bowel habits, abdominal pain, weight loss, and anemia.
4. Treatment involves surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy depending on the stage and characteristics of the cancer. The type of surgery performed also depends on the location and
The document summarizes key information about the anatomy, histology, physiology, carcinogenesis, clinical presentation, diagnosis, staging, treatment and screening of gastric cancer. It describes the J-shaped structure of the stomach and its blood supply. Gastric cancer typically presents with nonspecific symptoms like dyspepsia, weight loss or anemia. Diagnosis involves endoscopy with biopsy and staging involves CT, EUS or PET scanning. Treatment depends on stage but commonly includes surgery with lymph node dissection and chemotherapy or radiation. Screening high-risk individuals can detect early gastric cancer and improve survival rates.
This document discusses esophageal cancer. Some key points:
- Squamous cell carcinoma and adenocarcinoma are the most common histologies. Risk factors include smoking, alcohol, obesity, and Barrett's esophagus.
- Staging uses the TNM system. Treatment depends on stage but may include surgery, chemotherapy, radiation therapy, or a combination.
- For locally advanced stages, neoadjuvant chemoradiation can improve resectability and survival compared to surgery alone. The MAGIC trial showed improved survival with perioperative chemotherapy compared to surgery alone.
- Prognosis remains poor with 5-year survival rates of 15-20%, though outcomes have improved with multimod
This document discusses gastric cancer worldwide. It notes that gastric cancer is the fourth most common cancer globally and has varying incidence rates in different regions. For example, the rate is higher in Japan, Eastern Europe, and lower in the UK and USA. The incidence of cancers in the proximal stomach are increasing while those in the body and antrum are decreasing. Treatment options discussed include surgery, chemotherapy, radiotherapy, and palliative care. Prognosis is better in Japan where more patients undergo curative resection and have higher 5-year survival rates compared to the West.
Gastric cancer seminar presentation covered the following topics in 3 sentences or less:
The presentation discussed the anatomy, blood supply, lymphatic drainage and histology of the stomach. Risk factors, clinical presentation, diagnostic tools and staging of gastric cancer were explained. Surgical treatment options including endoscopic resection, gastrectomy and lymph node dissection were summarized along with reconstruction methods.
colorectal cancer 18 aug 22 final yr.pptxafzal mohd
Colorectal cancer is the third most common cancer worldwide. Risk factors include lifestyle, family history, and certain medical conditions. Screening is recommended starting at age 50. Surgery is the main treatment for localized cancer, with options depending on tumor location. Adjuvant therapies like chemotherapy may be given after surgery. Five-year survival rates range from over 90% for early stage to less than 10% for metastatic disease.
The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum.
Blood supply
The left gastric artery
Right gastric artery
Right gastro-epiploic artery
Left gastro-epiploic artery
Short gastric arteries
Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.
It could be:
malignant or benign
primary or secondary
Gastric carcinoma is the second most common cancer-related death worldwide. It typically spreads through direct extension, lymphatics, or hematogenously to distant sites like the liver. Staging involves endoscopy, imaging, and biopsy to determine the depth of invasion and lymph node involvement. Surgery aims to perform a curative resection with negative margins and lymph node dissection, but outcomes remain poor with high rates of recurrence.
Gastric cancer forms in the inner lining of the stomach and can grow into a tumor. It is usually diagnosed via endoscopy with biopsy. Staging involves endoscopic ultrasound, CT, PET, and endoscopy to determine if the cancer has spread from the stomach lining to deeper layers or lymph nodes. Treatment of early gastric cancer may involve endoscopic resection but later stages typically require surgical resection of part of the stomach along with nearby lymph nodes. The document provides details on the anatomy, symptoms, risk factors, diagnostic tests, classifications, and surgical treatment approaches for gastric cancer.
This document provides information on carcinoma of the stomach, including:
- Risk factors include H. pylori infection, diet, genetics, smoking.
- Types include intestinal and diffuse. Staging uses TNM and other classifications.
- Common symptoms are weight loss, abdominal pain, vomiting. Investigations include endoscopy and biopsy.
- Treatment depends on stage but commonly includes surgery such as gastrectomy along with lymph node dissection. Endoscopic resection may be used for early stages. Adjuvant therapy is sometimes used for later stages.
This document discusses malignant neoplasms of the stomach. Some key points:
- Stomach cancer is the 5th most common cancer globally and the 3rd leading cause of cancer death. Outcomes are generally poor due to late stage at presentation.
- Risk factors include H. pylori infection, smoking, low fruit/vegetable diet, family history, and prior gastric surgery or conditions like pernicious anemia.
- Tumors are classified by location, histology (intestinal vs diffuse), and stage. Diagnosis involves endoscopy, biopsy, and imaging.
- Treatment depends on stage but commonly includes surgical resection with lymph node dissection, with or without adjuvant chemotherapy/radiation
Gastric carcinoma is the fourth most common cancer worldwide and the second leading cause of cancer death globally. It has a poor prognosis except in areas that conduct early screening. Approximately 95% are adenocarcinomas. Risk factors include H. pylori infection, smoking, genetic factors, and precancerous lesions. Staging involves endoscopy, CT, PET, and laparoscopy. Surgery with curative intent plus perioperative chemotherapy may cure early stage tumors. Advanced or metastatic disease is treated with palliative chemotherapy, radiation or surgery.
This document discusses gastric cancer, including:
- Risk factors like H. pylori infection, smoking, diet high in pickled foods, and family history.
- Precursor lesions include atrophic gastritis, intestinal metaplasia, and dysplasia.
- Symptoms are often nonspecific like weight loss, but can include bleeding or obstruction.
- Diagnosis involves endoscopy with biopsy. Staging evaluates depth of invasion and lymph node spread.
- Treatment is surgical resection with chemotherapy or radiation for advanced cases.
- Recurrence after surgery may involve the anastomosis or peritoneal spread.
This document discusses malignant obstructive jaundice and its causes such as gallbladder cancer and bile duct cancer. It provides details on the incidence, risk factors, pathology, staging, clinical presentation, diagnosis, and management of gallbladder cancer. Key points include that gallbladder cancer occurs predominantly in elderly people, has a poor prognosis, and is often diagnosed at late stages. Surgical resection is the main treatment for early stage disease while palliative options are used for advanced or unresectable cases. Prognosis depends on the pathologic stage, with T1a cancers having an excellent prognosis.
The document discusses carcinoma of the colon and its management. It provides details on epidemiology, risk factors, staging, diagnostic workup, surgery, adjuvant therapy including chemotherapy and radiation therapy. Surgery is the primary treatment but adjuvant therapy with chemotherapy improves survival outcomes, especially in stage III disease. Chemotherapy regimens like FOLFOX and 5-FU plus leucovorin are commonly used in the adjuvant and metastatic settings.
1. The document discusses carcinoma of the head of the pancreas, including its epidemiology, risk factors, pathology, clinical features, imaging, staging, and surgical management via the Whipple procedure.
2. It provides details of the Whipple procedure, including exposing and dissecting key structures like the superior mesenteric vein, Kocher maneuver, dividing vessels like the gastroduodenal artery, and transecting the stomach and jejunum.
3. The Whipple procedure involves a pancreaticoduodenectomy to resect the pancreatic head tumors while preserving stomach, duodenum, common bile duct, and pancreas.
Radiotherapy for Seminoma
- Seminoma accounts for over 60% of testicular germ cell tumors with an incidence of 0.95 per 100,000.
- For stage I seminoma, prophylactic radiation to the para-aortic lymph nodes is the standard of care to reduce the risk of recurrence.
- For stage IIA/IIB seminoma, radiotherapy to the para-aortic, iliac, and inguinal lymph nodes is recommended, with 30Gy to the whole field and a 10Gy boost for stage IIA and 36Gy total for stage IIB.
- Intensity modulated radiation therapy (IMRT) allows for improved sparing of
This document provides information on gastric cancer including:
1. Symptoms, signs, diagnosis and staging using endoscopy, CT scans, laparoscopy and more.
2. Treatment options depending on stage including surgery (D1, D2 lymphadenectomy), chemotherapy, and chemoradiation.
3. Adjuvant therapy recommendations after surgery including S-1 chemotherapy or chemoradiation based on clinical trials.
4. Guidelines for radiation therapy planning and target volumes.
5. Systemic therapy options for advanced or metastatic disease including single agent versus multi-agent chemotherapy.
1) The stomach is located in the abdomen between the esophagus and small intestine. It has five regions and receives blood supply from branches of the celiac trunk and superior mesenteric artery.
2) Gastric cancer is usually adenocarcinoma. Risk factors include H. pylori infection, smoking, and family history. Symptoms include dyspepsia, weight loss, and vomiting.
3) Diagnosis involves endoscopy with biopsy. Treatment depends on stage but may include endoscopic resection for early cancer, surgery such as total gastrectomy with lymph node dissection, or chemotherapy and radiation.
1. Colorectal cancer is the second most common malignancy in females and third most common in males. It is also the fourth most common cause of cancer death.
2. Risk factors include red meat, obesity, smoking, alcohol, family history, and inflammatory bowel disease. Most cases are sporadic but some are hereditary.
3. Symptoms depend on the location of the cancer in the colon but may include blood in stool, changes in bowel habits, abdominal pain, weight loss, and anemia.
4. Treatment involves surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy depending on the stage and characteristics of the cancer. The type of surgery performed also depends on the location and
The document summarizes key information about the anatomy, histology, physiology, carcinogenesis, clinical presentation, diagnosis, staging, treatment and screening of gastric cancer. It describes the J-shaped structure of the stomach and its blood supply. Gastric cancer typically presents with nonspecific symptoms like dyspepsia, weight loss or anemia. Diagnosis involves endoscopy with biopsy and staging involves CT, EUS or PET scanning. Treatment depends on stage but commonly includes surgery with lymph node dissection and chemotherapy or radiation. Screening high-risk individuals can detect early gastric cancer and improve survival rates.
This document discusses esophageal cancer. Some key points:
- Squamous cell carcinoma and adenocarcinoma are the most common histologies. Risk factors include smoking, alcohol, obesity, and Barrett's esophagus.
- Staging uses the TNM system. Treatment depends on stage but may include surgery, chemotherapy, radiation therapy, or a combination.
- For locally advanced stages, neoadjuvant chemoradiation can improve resectability and survival compared to surgery alone. The MAGIC trial showed improved survival with perioperative chemotherapy compared to surgery alone.
- Prognosis remains poor with 5-year survival rates of 15-20%, though outcomes have improved with multimod
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How to Make a Field Mandatory in Odoo 17Celine George
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Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
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6. 2nd leading cause of cancer related death after lung cancer.
The highest incidences are found in East Asia (Japan and China)>
South America > Eastern Europe
RISK FACTORS
ACQUIRED FACTORS
H. Pylori infection ( 3-6 times)- distal gastric cancer and
intestinal type
High intake of smoked and salted foods
Nitrates
Diet low in fruits and vegetables
Smoking
Obesity proximal gastric lesions
Barrett esophagus/GERD
Prior subtotal gastrectomy (25%)
RT exposure
7. GENETIC FACTORS
E- cadherin (CDH-1 gene)
Type A blood group
Pernicious anemia (5-10%)
HNPCC
Li-Fraumeni syndrome
10. Type I, nodular polypoid tumor without
ulceration and usually with a broad
base;
Type II- fungating, exophytic,
circumscribed tumor with defined
sharp margins, devoid of ulceration
except at its dome
Type III- ulcerating tumor +
penetrating, infiltrating ulcer base;
Type IV - diffuse thickening of the
gastric wall with no discretely
marginated mass or ulceration,leather
bottle,linitis plastica
Type v - unabler to classify
11. 4 groups
Well differentiated (1) to anaplastic (4)
12. Intestinal Diffuse
Environmental
Gastric atrophy and
intestinal metaplasia
M>F
Increase incidence with
age
Gland formation
Haematogenous spread
Epidemic
Distal part of stopmach
Familial
Blood group A
F>M
Younger age
Poorly differentiated
signet ring cells
Transmural/lymphatic
Endemic
Proximal part of stomach
13. Abdominal discomfort
weight loss
Loss of appetite
Early satiety
Nausea and vomiting
Black Tarry stool
Duration of symptom is <3 months in almost 40% of patients
and > 1 year in 20%.
PHYSICAL EXAMINATION
Can reveal advanced disease
- Abdominal mass
-Epigastric or liver mass, periumbilical node (Sister Mary
Joseph node)
- Palpable left supraclavicular node (Virchow’s node)
- Rectal shelf (Blumer’s shelf)
- Left axilla lymphnode (Irish nodes)
14. TEST
ENDOSCOP
Y
Direct visualization /cytology. Biopsy usual in 90% cases
But linitis plastica & small<3 cm & cardia lesion is difficult to diagnose
DOUBLE
CONTRAST
STUDY
: small lesion limited to inner layer of stomach wall.
CECT SCAN: For both extent of spread & radiation portal (abdomen)
Mediastinal LN ( in case of distal esophageal junction and thoracic
mets.)
HELICAL
CT:
More useful In detection of smaller LN
LAPAROSC
OPIC
STUDY:
Helps in detection in metastatic disease in case of operable lesion in
preoperative imaging. Peritoneal fluid should be sampled in case of
+ve is considered as M1 disease.
• T staging is accurate enough in 86 % case by EUS. Whereas 43% by CT.
• EUS is 1st line imaging modality in T category
• Diffuse /mucinous tumors – pet has lower detection rate. As FDG accumulation is
lower in this cases
15. AJCC – TNM staging
Japanese gastric cancer staging
Staging for E G junction cancer
17. Regional Lymph Nodes (N)*
N1 Metastasis in 1-2 regional lymph nodes
N2 Metastasis in 3-6 regional lymph nodes
N3 Metastasis in 7 or more regional lymph nodes
N3a Metastasis in 7-15 regional lymph nodes
N3b Metastasis in 16 or more regional lymph nodes
Distant Metastasis (M)
M0 No distant metastasis
M1 Distant metastasis
18.
19.
20.
21. Correction of anemia
Correction of nutritional status
Fluid and electrolytes
Cardiac, respiratory and renal status
Adequate blood
Pre operative stomach wash
Prophylactic antibiotics
23. Early gastric cancer
Tumor less than 2cm
Elevated well differentiated tumors
Without nodal involvement
Tumour less than 1cm in diffuse
lesion
28. SURGERY
Primary treatment of gastric cancer
OPTIONS-
Radical Total Gastrectomy –
Diffuse involvement
Proximal involvement.
Radical Subtotal Gastrectomy –
Distal cancers,
Equivalent survival
Lesser complications
In proximal cancer, total
gastrectomy is not necessary when
subtotal gastrectomy will provide a
5 cm clearance of the gross tumour.
29. • Ligation of left and
right gastric and
gastro epiploic arteries
• En bloc removal of
75% of stomach
• Pylorus
• 2cm of duodenum
• Greater and lesser
omentum
• All associated
lymphatic tissue
35. • Adherent to pancreas or colon or mesocolon
• Ascites
• Para-aortic lymph nodes
• Secondaries in liver
• Palpable mass is incurable but can be resectable
surgically
• Blumer shelf
• Left supraclavicular nodes
• Sister Mary Joseph nodule
• Irish node (Left axillary lymph node secon daries)
36. Lymphadenectomy:
1. Adequate staging
2.Adequate therapy
At least 15 LN need to be retrieved.
Total gastrectomy
D0: Lymphadenectomy less than
D1
D1: Nos. 1–7
D1+:D1, Nos. 8a, 9, 11p
D2: D1+Nos. 8a, 9, 10, 11p, 11d,
12a.
Distal gastrectomy
D0: Lymphadenectomy less than
D1
D1: Nos. 1, 3, 4sb, 4d, 5, 6, 7
D1+:D1,Nos. 8a, 9
D2: D1+Nos. 8a, 9, 11p, 12a.
Japanese gastric cancer treatment guidelines 2010
37. Pylorus-preserving gastrectomy
D0: Lymphadenectomy less than
D1
D1: Nos. 1, 3, 4sb, 4d, 6, 7
D1+:D1,Nos. 8a, 9.
Proximal gastrectomy
D0: Lymphadenectomy less than D1
D1: Nos. 1, 2, 3a, 4sa, 4sb, 7
D1+:D1,Nos. 8a, 9, 11p
Japanese gastric cancer treatment guidelines 2010
38. Type Descriptions
D1 lymphadenectomy T1a tumors that do not meet the criteria for
EMR
cT1bN0 tumors that are differentiated type
and <1.5 cm
D1+lymphadenectomy cT1N0 tumors other than the above
D2 lymphadenectomy potentially curable T2-T4 tumors, &
cT1N+tumors.
complete clearance of No. 10 nodes by
splenectomy should be considered for
potentially curable T2-T4 tumors invading the
greater curvature of the upper stomach.
D2+lymphadenectomy Non standard
prophylactic para-aortic lymphadenectomy
Denied by jcog 9501
prognosis of this population is poor.
Japanese gastric cancer treatment guidelines 2010
A recent meta-analysisof 12 randomised, controlled trials (RCTs) confirmed
no overall
survival (OS) benefit for D2 lymphadenectomy, although a benefit was seen
among patients who had resection without a splenectomy and/or
pancreatectomy
39. Gastric cancer responds well to
combination cytotoxic
chemotherapy
Neo adjuvant therapy improves
outcome
First line treatment in inoperable
disease
Palliative in advanced disease
Trantuzumab – in HER2 positive
gastric cancer
40. Down staging of disease --- increase
resectability
Determine sensitivity to chemotherapy
Decreases micro-metastatic burden
Epirubicin + cis-platinum+ infusional
5-FU/ capecitabine
41. Post op XRT
Pre op XRT
Intraoperative RT
Palliative RT
Indications-
T3-4 resectable disease
Margins positive
Residual disease
LN +ve disease
Inoperable
42. Idealized portals from patterns of failure data need
modification individually for patient's initial extent of disease.
Gastric/tumor bed, anastomosis and gastric remnant, and
regional lymphatics should be included in most patients.
Major nodal chains at risk include
lesser and greater curvature;
celiac axis;
pancreaticoduodenal,
splenic,
suprapancreatic,
porta hepatis groups;
para-aortics to the level of L3.
Any tumor originating in the stomach has a high propensity of spread to
nodes along the greater and lesser curvature, although they are most
likely to spread to those sites in close anatomic proximity to the primary
tumor mass.