Trajectories of endoscopic Barrett esophagus: Chronological changes in a community-based cohort.

Aim: To elucidate longitudinal changes of an endoscopic Barrett esophagus (BE), especially of short segment endoscopic BE (SSBE).

Methods: This study comprised 779 patients who underwent two or more endoscopies between January 2009 and December 2015. The intervals between the first and the last endoscopy were at least 6 mo.

Unraveling trastuzumab and lapatinib inefficiency in gastric cancer: Future steps (Review).

The newly developed concept of oncogene addiction provides a rationale for the use of targeted therapies. In sharp contrast to the field of breast cancer treatment, attempts to target human epidermal growth factor receptor 2 (HER2) among gastric cancer (GC) patients have been unsatisfactory. The ToGA trial reported only a modest prolongation of progression-free survival (PFS) with trastuzumab and the subsequent TYTAN and LOGiC trials failed to demonstrate any survival advantage with lapatinib.

Diabetes mellitus carries a risk of gastric cancer: a meta-analysis.

Aim: To investigate the association and quantify the relationship between diabetes mellitus (DM) and gastric cancer (GC) by an updated meta-analysis.

Methods: The initial PubMed search identified 1233 publications. Studies not reporting GC or those not reporting actual number of GC were excluded.

[S-1 monotherapy achieved twenty-month survival for peritoneal lavage cytology-positive gastric cancer patient undergoing noncurative resection].

We report a gastric cancer patient with positive peritoneal lavage cytology (CY1) who achieved 20-month progression free survival by S-1 monotherapy. An 82-year-old male patient who underwent distal gastrectomy with residual disease for type 4 scirrhous gastric cancer manifesting pyloric stenosis, direct invasion to the pancreas, and CY1. He received S-1 monotherapy postoperatively.

A substantial incidence of silent short segment endoscopically suspected esophageal metaplasia in an adult Japanese primary care practice.

Aim: To determine the incidence and characteristics of endoscopically suspected esophageal metaplasia (ESEM) in a primary adult care institution.

Methods: Eight hundred and thirty two consecutive individuals (mean age, 67.6 years) undergoing upper gastrointestinal endoscopy between January 2009 and December 2010 were included in this study.

Statins and gastric cancer risk.

Background/aims: Statin is the most promising agent in the improvement of blood lipid profiles, and a substantial risk reduction of subsequent cardiovascular events leads to a rapid increase in current prescription rates. However, statin use or a lower total cholesterol has been associated with an increased cancer risk, although some deny such an association. Whether a positive statin-cancer association exists or not remains a matter of debate because such a causal association, if any, may offset anticipated cardioprotective benefits from statins.

Statins are logical candidates for overcoming limitations of targeting therapies on malignancy: their potential application to gastrointestinal cancers.

Purpose: Molecular targeting approaches have been an intensive focus of treatment strategies against advanced gastric and colorectal cancers. Recent clinical trials have demonstrated promising survival prolongation of targeted human epidermal growth factor receptors; however, patients harboring mutations in the K-Ras gene (human homolog of the Kirsten rat sarcoma-2 virus oncogene) do not derive benefit from the anti-epidermal growth factor receptor antibodies. K-Ras mutations cause a stimuli-independent activation of a large cohort of downstream effectors that permit cells to acquire a sustained growth.

Successful type-oriented endoscopic resection for gastric carcinoid tumors: A case report.

The standard treatment in Japan for gastric carcinoid has been gastrectomy with lymphadenectomy. This report describes the possibility of endoscopic treatment as an appropriate option for gastric carcinoid fulfilling certain conditions. A 46 year old woman underwent endoscopic mucosal resection for two 3 mm gastric carcinoids.

Pharmacogenetics of irinotecan: An ethnicity-based prediction of irinotecan adverse events.

Irinotecan is now regarded as the most active drug for the treatment of colorectal cancer. However, one of the most difficult issues oncologists face is deciding the optimal dose for an individual patient, as each individual shows different outcomes even at the same dose with regard to treatment related adverse events, ranging from no toxicity to a lethal event. Inherited genetic polymorphism of a single gene or multiple genes (haplotype or linkage disequilibrium) involved in SN-38 glucuronidation, a predominant route of irinotecan detoxification, is now recognized as a significant factor that can alter the incidence of side effects.

[Our experiences of best supportive care for gastric cancer patients].

Background: The literature contains only a small number of reports concerning best supportive care(BSC)in gastric cancer. With the progress of social healthcare systems supporting medical care at home, the quality and performance of BSC at present are different from those in the mid-1990s, when the previous reports were published. We evaluated the quality and performance of BSC in gastric cancer patients in collaboration with visiting nurses.

Pharmacogenetics of fluoropyrimidine and cisplatin. A future application to gastric cancer treatment.

Chemotherapy plays an important role in the treatment of gastric cancer both in adjuvant or advanced settings. Recent randomized trials in Japan have proved that S-1, a novel fluoropyrimidine derivative, and cisplatin are the most promising agents. However, both the efficacy and toxicity of a given regimen vary widely among patients due to the inherited variability of genes that involve drug anabolism and catabolism.

A three-year survivor case of gastric cancer with peritoneal dissemination--an outpatient with second-line weekly paclitaxel.

This case report describes a three-year survivor case by weekly paclitaxel, who had peritoneal dissemination of gastric cancer resistant to methotrexate and 5-fluorouracil therapy. A 62-year-old female with massive ascites, abdominal pain, and difficulty in eating received a weekly paclitaxel schedule which consisted of a 1-hour infusion of paclitaxel (70 mg/m(2)) given once a week for three weeks followed by a 1-week rest, repeated every four weeks. Short course premedication was given 30 minutes prior to paclitaxel.

Nutritional comparisons between a pylorus-preserving gastrectomy with and without suprapyloric lymph node clearance: a preliminary report.

Background/aims: A pylorus-preserving gastrectomy (PPG) is a procedure for gastric cancer (GC) patients which attempts to control gastric emptying and to minimize postoperative nutritional disadvantages. The persistence of conflicting stances concerning qualifying candidates for PPG--a narrower or wider segment of patients--is attributable to a lack of decisive evidence concerning the precise nutritional impact of suprapyloric lymph node clearance.

Methodology: Forty-eight patients underwent a PPG with (30 patients; dissection group) or without (18 patients; preservation group) suprapyloric lymph node clearance between 2002 and 2004.

Laparoscopy-assisted pylorus-preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation.

Background: Pylorus-preserving gastrectomy (PPG) with extensive lymph node dissection is useful for treatment of early gastric cancer with preservation of function. This technique could be improved by using laparoscopy-assisted gastrectomy.

Study Design: Between September 2000 and September 2004, 109 patients with T1 gastric cancer underwent surgical treatment; 72 underwent laparoscopy-assisted PPG (LAPPG) and 37 underwent conventional PPG (CPPG).

Safety of a paraaortic node dissection for selected advanced gastric cancer patients.

Background/aims: Comprehensive evaluations of a superextended (D3) dissection concerning its benefits as well as potential disadvantages have been scanty in the English literature.

Methodology: The patient selection criteria for a D3 dissection were pre- and intraoperatively > or = T3 and/or > or = N2 diseases, no paraaortic node involvement, no distant or peritoneal metastases, and a negative peritoneal lavage cytology. A D3 dissection involved a node clearance up to the third tier including the middle paraaortic region.

Efficacy of triple therapy plus cetraxate for the Helicobacter pylori eradication in partial gastrectomy patients.

In the present study, we aimed to establish an additional standardized protocol with a higher H. pylori eradication rate in the remnant stomach. Fifty-five H.

Concepts, rationale, and current outcomes of less invasive surgical strategies for early gastric cancer: data from a quarter-century of experience in a single institution.

Previously proposed criteria of less invasive surgery for early gastric cancer (EGC) were based mainly on the pathological analyses of the resected specimens; however, preoperative and intraoperative information are also obviously essential for decision making on stage-dependent patient management. Furthermore, most indications and treatment options have not been systematically integrated or evaluated by treatment outcomes. We investigate in this report the rationality of less invasive surgery employed for EGC.

Accuracy of linear-array EUS for preoperative staging of gastric cardia cancer.

Background: The feasibility of a less invasive operation for early stage cancer of the gastric cardia with a low frequency of lymph node involvement has been previously demonstrated by us. Precise discrimination among mucosal, submucosal, and advanced cancers, as well as accurate evaluation of the proximal tumor margin are prerequisites for such stage-specific treatment. EUS is considered the most reliable staging modality.

[Successful downstaging by a low-dose, fractional administration of irinotecan hydrochloride (CPT-11) in combination with cisplatin in peritoneal lavage cytology positive, 5-fluorouracil refractory advanced gastric cancer patients].

A 46-year-old Japanese female with advanced gastric cancer with positive peritoneal cytology and who was refractory to methotrexate plus 5-FU sequential chemotherapy received low-dose, fractional irinotecan hydrochloride (CPT-11) in combination with cisplatin. This regimen could be repeated biweekly on an outpatient basis and was well tolerated. After 8 cycles of administration, a negative change in peritoneal cytology subsequently enabled a total gastrectomy, splenectomy, and cholecystectomy with a D3 lymph node dissection.

Gastric cancer with metastasis to the gingiva.

The present case report describes a gastric cancer which showed unusual metastasis in the oral region. A 56-year-old male patient underwent total gastrectomy and splenectomy due to advanced gastric cancer in the upper third of the stomach. Fifteen months later, he presented with anorexia and gingival swelling of durations of approximately 3 and 1 month, respectively.

Utility of [13C] urea breath test for Helicobacter pylori detection in partial gastrectomy patients.

Many reports on the diagnostic efficacy of the [13C] urea breath test ([13C] UBT) for the detection of Helicobacter pylori in the residual stomach have shown negative results. We previously reported on the utility of [13C] UBT and conducted an evaluation to establish a standardized protocol with a shorter sampling time for [13C] UBT in partial gastrectomy patients. Sixty-two patients who had undergone partial gastrectomy were included.

Indications for a pylorus-preserving gastrectomy for gastric cancer with proper muscle invasion.

Hypothesis: Our previous demonstrations of the feasibility of a pylorus-preserving gastrectomy with a wider-scope lymphadenectomy for early gastric cancer (GC) have raised the possibility of applying pylorus-preserving gastrectomy to a broader segment of GC patients, such as those having GC with invasion extending into the proper muscle layer (GCpm).

Design: Case series.

Setting: Tertiary care center.

Angiogenin in sera as an independent prognostic factor in gastric cancer.

Purpose: The purpose of this study is to elucidate an increased expression of angiogenin (ANG) as a prognostic factor of gastric cancer (GC), against the background of our previous observations of the increased expression of ANG in the more progressed GC.

Methods: We investigated serum ANG concentrations in 123 GC patients and 63 healthy volunteers as well as the distributions of ANG gene message in 52 GC tissues by in situ hybridization. The prognostic significance of ANG was investigated by the Cox proportional hazards model including variable selection and by survival analysis.