MANAGEMENT OF GASTRIC CANCER potx

MANAGEMENTOF GASTRICCANCER  EditedbyNabilIsmaili              Management of Gastric Cancer Edited by Nabil Ismaili Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Davor Vidic Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright Sebastian Kaulitzki, 2010. Used under license from Shutterstock.com First published June, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Management of Gastric Cancer, Edited by Nabil Ismaili p. cm. ISBN 978-953-307-344-6 free online editions of InTech Books and Journals can be found at www.intechopen.com   Contents  Preface IX Part 1 Gastric Cancer Staging 1 Chapter 1 The Role of Computed Tomography in the Imaging of Gastric Carcinoma 3 Marco Moschetta, Amato Antonio Stabile Ianora, Federico Cazzato, Arnaldo Scardapane and Giuseppe Angelelli Chapter 2 MR Imaging of Gastric Carcinoma 19 Il Young Kim Chapter 3 PET Imaging in Gastric Carcinoma 37 Kiyohisa Kamimura and Masayuki Nakajo Chapter 4 Novel Biomedical Imaging Approach for Detection of Sentinel Nodes in an Orthotopic Xenograft Rat Model of Human Gastric Carcinoma 55 Akihito Tsubota, Tomoki Koyama, Yoshihisa Namiki, Norio Tada and Hiroshi Takahashi Part 2 Surgery 71 Chapter 5 Laparoscopic Surgery for Gastric Cancer 73 Kyo Young Song and Jung Ho Shim Chapter 6 Lymph Node Dissection 87 Bulent Cavit Yuksel, Okan Murat Akturk and Ilyas Hakan Ozel Part 3 Chemotherapy 117 Chapter 7 Prospective Study of Triple Combination Chemotherapy Consisting of Paclitaxel, S-1, and 24-Hour Infusion of Cisplatin (PSC) for Inoperable Highly Advanced Gastric Cancer 119 Kenji Ina, Ryuichi Furuta, Takae Kataoka, Satoshi Kayukawa and Hiroaki Iwase VI Contents Part 4 A Rare Gastric Carcinoma 127 Chapter 8 A Rare Gastric Carcinoma - Neuroendocrine Tumors 129 Petar Svorcan, Jelena Djordjevic and Branko Maksimovic   Preface  Gastriccanceristhefifthmostcommoncancerandthesecondmostcommoncauseof cancerdeathworldwide.The highest incidencewasseen in Koreaand Japan because ofearlydiagnosisbyscreeningpolicy.EnvironmentalriskfactorsincludeHelicobacter pyloriinfection,highsaltintake,smokingandgeneticfactors. Twomajorclassificationsarecurrentlyus edandtheJapaneseclassificationisthemost commonly used. More than 50% of the patients have advanced disease at diagnosis and in this case the disease has a poor outcome. The diagnosis is confirmed by endoscopyandthehistologicalexaminationofthebiopsyspecimen.Adenocarcinoma is the most common histological type. The staging of gastric cancers is based on endoscopicultrasound,computedtomography,magneticresonanceimaging,positron emissiontomography,inadditiontothelaparoscopicstaging. In localized disease, the surgery remains the mainstay treatment of this malignancy. Many improvements in the surgical techniques have been seen in the las t decade. Laparoscopic surgery is an emerging approach which offers important advantages: less blood loss, reduced postoperative pain, accelerated recovery, early return to  normalbowelfunctionandre ducedhospitalstay.However,laparoscopicsurgeryasa treatment approach to gastric cancer requires further investigations as the extent of lymph node dissection remains controversial. D1 l ymphadenectomy, with a goal of examining 15 or greater lymph nodes is a standard. D2 dissection is considered as a standardinseveralinstitutionsespeciallyineasternAsia.Perioperativechemotherapy is considered as a therapeutic standard for stage 2 disease. Concurrent radiochemotherapyis also recognizedas astandardafter surger yfor patientsathigh riskofrelapse. Palliative chemotherapy is the mainstay treatment of advanced stages of the disease (metastatic and non‐operable tumors). Several randomized studies have the aim to improvethe efficacyandthe safetyofchemotherapy treatments.The bestknowledge in molecular biologyhas led tothe develop ment of new targeted therapies that have improvedtheresultsinefficacyandsafety. Despitethesetreatmentadvances,theprognosisofgastriccancerremainspoorwitha 5‐yearsurvivalrangingfrom10to15%inallstagescombined. X Preface This bookprovides a real insight into thestaging and treatment ofpatients with this illness that is very relevant to clinicians worldwide.In addition, a chapter has been reservedtoararetypeofgastriccarcinoma. NabilIsmaili,MD DepartmentofMedicalOncology RegionalCancerCenter Agadir, Morocco 