Expression of MMP-7 and MT1-MMP in peritoneal dissemination of gastric cancer.

Background/aims: In this study, we examined the expression of MMP-2, MMP-7, and MT1-MMP in peritoneal dissemination of gastric cancer, so as to clarify a possible role of these MMPs in developing peritoneal dissemination, using culture cells and an animal model with peritoneal dissemination.

Methodology: Total RNA was extracted from tumor tissues of disseminated foci from 7 patients with gastric cancer and human gastric cancer cell lines of STSA, STKM-1, MKN-28, MKN-45, and KATOIII. Expressions of mRNA for MMP-2, MMP-7, and MT1-MMP were analyzed by reverse transcriptase-polymerase chain reaction.

Brief psychotic disorder mimicking the symptoms of cerebrovascular attack evoked by symptoms that symbolized death in a patient with terminal stage stomach cancer: case report and review of the literature.

Objective: We report here a terminally ill patient with stomach cancer who developed a brief psychotic disorder mimicking cerebrovascular attack after a short episode of nasal bleeding. Close examination of the patient revealed that nasal bleeding was an event that symbolized deterioration of the general condition leading to death for the patient.

Methods: A 77-year-old male, who was diagnosed as having stomach cancer and was receiving palliative care, presented with tremor and insomnia just after a short episode of nasal bleeding and showed reduced response to stimuli mimicking cerebrovascular attack.

Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial.

Background: Because of the inaccessibility of mediastinal nodal metastases, the left thoracoabdominal approach (LTA) has often been used to treat gastric cancer of the cardia or subcardia. In a randomised phase III study, we aimed to compare LTA with the abdominal-transhiatal approach (TH) in the treatment of these tumours.

Methods: Between July, 1995, and December, 2003, 167 patients were enrolled from 27 Japanese hospitals and randomly assigned to TH (n=82) or LTA (n=85).

Protein levels of tissue inhibitor of metalloproteinase-1 in tumor extracts as a marker for prognosis and recurrence in patients with gastric cancer.

Background: Tissue inhibitor of metalloproteinase-1 (TIMP-1) correlates with tumor progression in patients with gastric cancer; however, the clinical significance of TIMP-1 as a marker for prognosis and recurrence has not been fully clarified.

Methods: TIMP-1 protein was measured by an enzyme-linked immunosorbent assay in tumor samples from 86 patients who had undergone surgical resection. An intratumoral TIMP-1 value of 10.

Feasibility study of biweekly CPT-11 plus CDDP for S-1- and paclitaxel-refractory, metastatic gastric cancer.

Background: To confirm the feasibility and efficacy of biweekly irinotecan (CPT-11) plus cisplatin (CDDP) as third-line chemotherapy, the response rate (RR), overall survival and toxicity were evaluated in patients who had been treated with S-1 as a first-line and paclitaxel as a second-line chemotherapy for metastatic gastric cancer.

Patients And Methods: The eligibility criteria of our study were: i) pathologically-confirmed adenocarcinoma of the stomach, ii) primary non-resectable or recurrent tumors, iii) Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2 or less, iv) age less than 75 years, v) adequate hepatic, renal and bone marrow functions and vi) patients had received S-1 as a first-line and paclitaxel as a second-line chemotherapy and both regimens had failed. The treatment consisted of CPT-11 (60 mg/m2) and CDDP (30 mg/m2) on day 1 and day 15, repeated every 4 weeks.

Victims of physical abuse among patients with cancer referred to psychiatric clinic in a cancer center hospital: a pilot study.

Objective: Physical abuse is one of the most important public health problems, but little is known about physical abuse of cancer patients. The objects of this study are (1) to identify whether cancer patients have sustained physical abuse; (2) to explore clinical characteristics of the abused patients.

Methods: We reviewed 584 cancer patients referred to our psychiatry clinic by a cancer center hospital and investigated whether there were victims of physical abuse among these patients.

The efficacy of gastrectomy for large gastric cancer.

Background: Large gastric cancer (LGC) is frequently associated with extended disease, and the role of surgical resection has been debated. We investigated the efficacy of surgical treatment for LGC.

Methods: The size of LGC was defined as 8 cm or greater.

A genetic variant in the gene encoding the stress70 protein chaperone family member STCH is associated with gastric cancer in the Japanese population.

Association analysis, based on linkage disequilibrium between specific alleles in the candidate loci and nearby genetic markers, has been proposed to identify genes conferring susceptibility to multifactorial diseases. Using the affected sib-pair method, we previously mapped four candidate chromosomal regions, 1p32, 2q33-q35, 11p13-p14, and 21q21, for gastric cancer by linkage analysis. To identify genes involved in the disease, we performed a gene-based association analysis of 66 genes, located on 21p11-21q22, using 126 single nucleotide polymorphisms (SNPs) as genetic markers in 373 patients with 250 controls.

Induction of lymphokine-activated cytotoxic T lymphocytes stimulated by dendritic cells and autologous tumor from a patient with gastric cancer and their effects in vitro.

Background/aims: The purpose of the study was to generate lymphokine-activated cytotoxic T lymphocytes stimulated by dendritic cells (DC) and autologous tumor from a patient with gastric cancer and to clarify their cytotoxic effects in vitro.

Methodology: DC was induced by interleukin-4 (IL-4) and granulocyte-macrophage-colony-stimulating factor (GM-CSF) from the peripheral blood mononuclear cells (PBMC). Then, PBMC was incubated with mitomycin C-treated tumor cells and DC, and following that was activated with IL-2 and anti-CD3.

Route from the paraaortic lymphatic system to the tracheobronchial lymph nodes evidenced on lymphangiogram in a patient with gastric cancer.

Lung metastasis from gastric or colonic cancer, without liver metastasis, is seldom seen. However, its metastatic pathway has not been delineated on imaging. We present and discuss such a lymphatic route in a patient with gastric cancer.

Effects of TS-1 on peritoneal dissemination of gastric cancer in nude mice.

Background/aims: We investigated the effects of TS-1 on the survival of nude mice developing peritoneal dissemination of gastric cancer.

Methodology: MKN-45 cells were injected into the peritoneal cavity of nude mice and a model of peritoneal dissemination was developed. TS-1 was administered orally every day from day 1 to day 10 or day 10 to day 19.

Is bursectomy necessary for patients with gastric cancer invading the serosa?

Background/aims: To confirm the impact of bursectomy on survival, we reviewed the clinical records of patients who underwent radical total gastrectomy with bursectomy for gastric cancer invading the serosa, with special reference to the location of tumor invasion.

Methodology: From the records, patients were selected for this retrospective cohort study according to the following criteria: (a) Invasion beyond the serosal surface, (b) No metastases to liver, peritoneum, or distant organs, (c) Negative for peritoneal lavage cytology, and (d) Patients underwent curative D2 total gastrectomy with complete omental bursectomy. A total of 134 patients were eligible.

Feasibility study of adjuvant chemotherapy with S-1 (TS-1; tegafur, gimeracil, oteracil potassium) for gastric cancer.

Background: We conducted a feasibility study using S-1, a novel oral derivative of 5-fluorouracil, as postoperative adjuvant chemotherapy for curatively resected gastric cancer patients.

Methods: Adjuvant chemotherapy consisted of eight courses (4-week administration and 2-week withdrawal) of S-1, at 80-120 mg/body per day. Forty-one patients from 11 institutions were enrolled in this pilot study, from November 1999 to October 2000.

A combination immunochemotherapy of 5-fluorouracil, cisplatin, leucovorin, and OK-432 for advanced and recurrent gastric carcinoma.

Background/aims: Based on theories of biochemical modulation and immunotherapy, a novel regimen consisting of 5-fluorouracil, cisplatin, leucovorin, and OK-432 (FLPO therapy) was devised for the treatment of patients with advanced and recurrent gastric carcinoma.

Methodology: The 14-day combination therapy consisted of continuous infusion of 5-fluorouracil (250 mg/m2/day), a bolus injection of 10 mg cisplatin and 30 mg leucovorin every other day, and a subcutaneous injection or per oral administration of OK-432 (3KE or 5KE) every other day. Thirty patients completed 59 courses of treatment consisting of 2 weeks of therapy followed by at least 2 weeks rest.

Indications of limited surgery for gastric cancer with submucosal invasion--analysis of 715 cases with special reference to site of the tumor and level 2 lymph nodes.

Background/aims: There is controversy as to whether limited or extended lymph node dissection should be performed for gastric cancer with submucosal invasion.

Methodology: To clarify the indications of limited surgery for gastric cancer invading the submucosa, we retrospectively examined the incidence of lymph node metastases with regard to the location of the tumor and distant lymph node station in 715 patients who underwent curative gastrectomy with D2 lymphadenectomy for gastric cancer with submucosal invasion. We classified the level 2 lymph nodes into four groups as follows: group 1 was defined as perigastric lymph nodes far from the primary tumors, group 2 as nodes around the left gastric and the common hepatic arteries, group 3 as nodes around the celiac axis, and group 4 as nodes along the splenic artery.

Should gastric cancer with peritoneal metastasis be treated surgically?

Background/aims: This study was attempted to elucidate the role of surgery in patients with gastric carcinoma and peritoneal dissemination.

Methodology: A database of 128 patients was retrospectively examined with univariate and multivariate analyses after selecting 4 treatment factors, 7 tumor factors evaluated preoperatively, 2 tumor factors evaluated intraoperatively, and 2 patient factors.

Results: The overall median survival time was 188 days.

Peritoneal cytology in patients with gastric cancer exposed to the serosa--a proposed new classification based on the local and distant cytology.

Background/aims: The clinical impact of the cytology of intraperitoneal samples taken from the local and distant sites was examined in patients with gastric carcinoma.

Methodology: Intraoperative peritoneal cytology was evaluated in 149 patients with gastric cancer invading the serosa but no metastasis to the peritoneum (macroscopic P0), the liver (H0), or distant organs (M0). Lavage samples were collected from the Douglas pouch and the left subphrenium (distant sites).

Longterm control of advanced and recurrent gastric cancer (ARGC) by S-1.

Background: An oral tegafur compound, S-1 (TS-1), was developed to potentiate antitumor activity and to reduce gastrointestinal toxicities for patients with gastric cancer. It has achieved a high response rate against advanced and recurrent gastric cancer (ARGC) in Japan; however, the efficacy and adverse reactions of longterm administration of S-1 remain to be elucidated.

Methods: Sixty-nine patients with ARGC treated with S-1 were studied; 58 patients had measurable lesions, while 11 patients did not.

Clinical and pathological study of gastric cancer with ovarian metastasis.

Background: The aim of this study was to determine the treatment strategy for ovarian metastases from gastric cancer, by a retrospective study of the treatment results.

Methods: We reviewed the records of patients with ovarian metastases from primary gastric cancer. Ovarian metastases were found in 24 of 897 female patients with gastric cancer.

[A case of metastatic gastric cancer responding to weekly administration of paclitaxel as a second-line therapy].

We report a 65-year-old man who underwent distal gastrectomy for advanced and metastatic gastric cancer in June 2000. TS-1 was administered for remnant metastatic lesions as first-line chemotherapy, but a recurrence was found in June 2001. Paclitaxel 80 mg/m2 was then administered weekly in a 1-h infusion on day 1, 8, and 15 as one cycle.

[Examination of percutaneous microwave coagulation and radiofrequency ablation therapy for metastatic liver cancer].

Percutaneous microwave coagulation therapy (PMCT) and radio frequency ablation therapy (RFA) as treatments for metastatic liver cancer were examined. PMCT or RFA was administered for 18 metastatic liver cancer lesions (primary lesion: 11 colon rectal cancer, one esophagus cancer, one thyroid cancer, one pancreatic cancer, one pheochromocytoma) in 16 patients from July 1999 to March 2002. RFA was performed 1 time for 12 minutes in principle, using a Cool-tip RF system from Radionics.

[Clinical and diagnostic significance of abdominal CT for peritoneal metastases in patients with primary gastric cancer].

The clinical and diagnostic significance of abdominal computed tomography (CT) was evaluated in 123 patients with primary gastric adenocarcinoma and disseminated peritoneal metastases. The peritoneal metastases were diagnosed by CT findings such as ascites (30.1%), wall thickness of the intestine (1.

[Benefit of screening for gastric cancer--a comparison of symptomatic and screened patients who underwent gastrectomy].

Unlabelled: We compared the clinicopathological factors and treatment results with regard to symptoms and screening in patients who underwent gastrectomy for primary gastric cancer.

Patients: The subjects included 797 patients with asymptomatic gastric cancer (SCG) and 1090 patients with symptomatic cancer (SYG) who had undergone gastrectomy for gastric cancer from 1989 to 2000.

Results: The proportion of early gastric cancer, N0 cases, and curative cases in the SCG and SYG patients were 70% & 33%, 77% & 44%, and 98% & 80%, respectively (p = 0.