Surgical resection of brain and adrenal gland metastases from gastric cancer: a case report and literature review.

The prognosis of recurrent gastric cancer is generally poor, and aggressive surgical treatment is rarely performed. Herein, we present the case of a patient who underwent resection of cerebellar and adrenal gland metastases from gastric cancer. The patient was treated for gastric cancer with distal gastrectomy at 23 years and for remnant gastric cancer with completion gastrectomy at 48 years.

Histological transformation to signet-ring cell carcinoma in a patient with clinically aggressive poorly differentiated adenocarcinoma of the ascending colon after response to chemotherapy plus cetuximab: a case report.

Background: Alteration of chemosensitivity or tumor aggressiveness in response to chemotherapy has been reported, and liquid biopsy assessment during chemotherapy for colorectal cancers has confirmed the acquisition of mutations in various oncogenes. However, the occurrence of histological transformation seems to be extremely rare in colorectal cancers, and the few existing case reports of this transformation are from lung cancer and breast cancer. In this report, we describe the histological transformation of clinically aggressive scirrhous-type poorly differentiated adenocarcinoma of the ascending colon to signet-ring cell carcinoma in almost all recurrent tumors that were confirmed by autopsy after response to chemotherapy plus cetuximab.

Grading of Atrophic Gastritis is Useful for Risk Stratification in Endoscopic Screening for Gastric Cancer.

Objectives: In order to screen for gastric cancer effectively, its interval should be set according to the risk. This study aimed to determine whether risk stratification is possible using the data obtained from medical examination or endoscopic findings.

Methods: First, subjects who underwent both cancer screening and medical examination from 2009 to 2015 and underwent cancer screening once more by 2016 were studied.

A randomized controlled trial of postoperative intravenous acetaminophen plus thoracic epidural analgesia vs. thoracic epidural analgesia alone after gastrectomy for gastric cancer.

Background: Acetaminophen is used in multimodal therapy for postoperative pain management. However, the additional effects of acetaminophen in combination with thoracic epidural analgesia (TEA) are not well understood. This prospective, multicenter randomized study was conducted to evaluate the efficacy of routine intravenous (i.

[A rapidly growing, large, mature retroperitoneal teratoma in an adult male patient].

A 40-year-old man complaining of abdominal distention was referred to our hospital. Computed tomography of the abdomen demonstrated a very large abdominal mass with fat and calcification. The size of the mass rapidly increased from 30cm to 40cm over two weeks.

Sigmoid colon diverticula perforation associated with sevelamer hydrochloride administration: A case report.

Introduction: Sevelamer is an anion exchange resin used to treat hyperphosphatemia. A common adverse effect of sevelamer is constipation. According to a review of the available literature, colon perforation associated with this resin agent was less common.

Evaluation of the efficacy of palonosetron for prevention of chemotherapy-induced nausea and vomiting in patients with gastric cancer treated with S-1 plus cisplatin.

Purpose: The purpose of our study was to evaluate the efficacy of a new combination antiemetic therapy consisting of palonosetron, aprepitant, and dexamethasone in gastric cancer patients undergoing chemotherapy with S-1 plus cisplatin.

Methods: This prospective, multi-institutional observational study assessed patient-reported nausea, vomiting, use of rescue therapy, change of dietary intake, and Functional Living Index-Emesis (FLIE) questionnaire results. The percentages of patients showing complete response (CR; no emesis and non-use of any rescue antiemetics) and complete protection (CP; no significant nausea and non-use of any rescue antiemetics), change of dietary intake, and impact of chemotherapy-induced nausea and vomiting on daily life during the overall (0-120 h after cisplatin administration), acute (0-24 h), and delayed (24-120 h) phases were examined.

Exploratory phase II trial in a multicenter setting to evaluate the clinical value of a chemosensitivity test in patients with gastric cancer (JACCRO-GC 04, Kubota memorial trial).

Background: Although postoperative adjuvant chemotherapy with S-1, an oral fluoropyrimidine, has become a standard of care for gastric cancer in Japan, nonresponders may suffer from the cost and adverse reactions without clinical benefit. This multicenter exploratory phase II trial was conducted to see whether a chemosensitivity test, the collagen gel droplet embedded culture drug sensitivity test (CD-DST), can adequately select patients for chemotherapy.

Methods: The CD-DST using four different concentrations of 5-fluorouracil was conducted with resected specimens from preregistered patients who underwent gastrectomy with D2 or more extensive lymphadenectomy.

Randomized Phase II trial of paclitaxel plus valproic acid vs paclitaxel alone as second-line therapy for patients with advanced gastric cancer.

The standard regimen of second-line chemotherapy for patients with unresectable gastric cancer has not been established. However, weekly paclitaxel (wPTX) has become the preferable second-line chemotherapy in Japan. Histone deacetylase (HDAC) inhibitors have been shown to have antiproliferative activity through cell-cycle arrest, differentiation, and apoptosis in gastric cancer cells.

Clinicopathological characteristics and survival difference between gastric stump carcinoma and primary upper third gastric cancer.

Background: The increased incidence of early gastric cancer in several Asian countries has been associated with an increase in gastric stump carcinoma (GSC) following gastric cancer surgery. The clinicopathological characteristics of GSC remain unclear because of the limited number of patients with GSC.

Methods: The clinicopathological characteristics, including the 5-year survival rate of patients with GSC following distal gastrectomy (167 patients), were compared with those of patients with primary upper third gastric cancer (PGC; 755 patients).

Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute.

Background: Gastric endocrine carcinoma (EC) is an uncommon tumor of the stomach and the clinical features are not well known. Additionally, the classification and staging systems of this tumor are not yet unified worldwide. In this study, we reviewed 27 patients with gastric EC to evaluate the clinicopathological characteristics of this tumor.

Incidence and prognostic value of lymph node metastasis on c-Kit-positive gastrointestinal stromal tumors of the stomach.

Background/aims: Surgical R0 resection is a mainstay of treatment for gastrointestinal stromal tumor (GIST) of the stomach. The incidence of lymph node metastasis (LNM) has been reported as extremely low. However, the actual incidence of LNM still remains unclear due to the limited number of patients who underwent systemic lymph node dissection.

Is preservation of the celiac branch of the vagal nerve effective in preventing stasis following pylorus-preserving gastrectomy?

Background/aims: Although pylorus-preserving gastrectomy (PPG) is performed as a function preserving surgery, patients sometimes suffer from postoperative stasis of the gastric contents after the procedure. Preservation of blood flow and both celiac and pyloric branches of the vagal nerve may decrease the incidence of the stasis.

Methodology: Patients who underwent PPG at the Cancer Institute Hospital between April 2005 and December 2007 were included in the study.

Outcome of surgical treatment for patients with locoregional recurrence of gastric cancer.

Purpose: Locoregional recurrent gastric cancer is commonly treated by systemic chemotherapy. The effectiveness of surgical treatment, in terms of complete tumor resection, is unknown.

Methods: We reviewed the case histories of 36 patients with locoregional recurrent gastric cancer, selected for surgical treatment by careful preoperative assessment.

Long-term outcome and survival with laparoscopy-assisted pylorus-preserving gastrectomy for early gastric cancer.

Background: Laparoscopically assisted pylorus-preserving gastrectomy (LAPPG) is introduced as a function-preserving operation with minimal invasion for early gastric cancer (EGC). This study aimed to investigate the long-term outcome and survival with LAPPG.

Methods: From January 2005 to July 2008, 188 patients with EGC underwent LAPPG.

Can superextended lymph node dissection be justified for gastric cancer with pathologically positive para-aortic lymph nodes?

Background: The prognosis of patients with gastric cancer and para-aortic lymph node (PALN) metastasis is poor. Recent Japanese randomized trials concluded that prophylactic PALN dissection is not effective for curable advanced gastric cancer. However, the value of curative resection in patients with pathologically positive PALN is not determined yet.

Laparoscopy-assisted gastrectomy for patients with earlier upper abdominal open surgery.

Background: Laparoscopy-assisted gastrectomy (LAG) is increasingly carried out owing to its many advantages compared with conventional open gastrectomy. However, the question of whether LAG can be carried out safely in patients with earlier upper abdominal open surgery (EUAOS) remains unclear as laparoscopic adhesiotomy is technically difficult and time consuming.

Methods: This study includes 32 consecutive cases with EUAOS who underwent a LAG in the Cancer Institute Hospital, between April 2005 and October 2008.

Simultaneous adenocarcinoma and leiomyoma of the stomach presenting as a collision tumor.

A 68-year old Japanese man was referred to the Cancer Institute Hospital for the treatment of a rectal cancer. Preoperative esophagogastroduodenoscopy revealed a submucosal tumor with ulcer formation near the esophagogastric junction of the stomach. The initial treatment strategy was to perform a proximal gastrectomy with limited lymph node dissection as well as a simultaneous anterior resection.

Survival benefit of pylorus-preserving gastrectomy in early gastric cancer.

Background: Pylorus-preserving gastrectomy (PPG) is performed in some patients for the treatment of early gastric cancer. The aim of this study was to investigate longterm survival for patients having PPG with extensive lymph node dissection, except for the suprapyloric nodes, for early gastric cancer.

Study Design: From January 1995 to December 2006, 305 patients underwent PPG if they met the following criteria: cT1 (mucosa or submucosa), cN0 gastric cancer in the middle body of the stomach.

Better 5-year survival rate following curative gastrectomy in overweight patients.

Background: Westernization of lifestyle and diet has resulted in an increase in overweight patients in Japan. Although the adverse effects of higher body mass index (BMI) on early surgical outcomes are known, the relationship between BMI and long-term outcome is unclear.

Materials And Methods: Clinicopathological characteristics and 5-year survival rate of overweight (BMI >or= 25 kg/m2; H-BMI; n = 1126) and nonoverweight (BMI < 25 kg/m2; N-BMI; n = 6799) patients who underwent gastrectomy with curative intent at the Cancer Institute Hospital between 1970 and 2004 were compared.

Laparoscopic rectal resection for primary rectal cancer combined with open upper major abdominal surgery: initial experience.

Background/aims: Although laparoscopy is accepted for treatment of colon cancer, its use for rectal cancer still has technical limitations. Whether a laparoscopic approach for rectal cancer is safe and beneficial remains unknown when simultaneous open upper major abdominal surgery is planned.

Methodology: Eight patients underwent laparoscopic rectal resection for primary rectal cancer combined with open upper major abdominal surgery.

Left-sided approach for suprapancreatic lymph node dissection in laparoscopy-assisted distal gastrectomy without duodenal transection.

Laparoscopy-assisted distal gastrectomy (LADG) with extended lymph node dissection has not yet been widely adopted for the treatment of gastric cancers because of the perceived complexity of the procedure. Suprapancreatic lymph node dissection is one of the most important and demanding procedures in this approach. The techniques of duodenal transection within the abdominal cavity or taping of the common hepatic or splenic artery had traditionally been adopted for suprapancreatic nodal dissection during open surgery.