Diagnose Of

Stomach
Cancer
Presentation by : Dr. Sameem Munir
Supervised by : Ustad Jawid Hanafi
Date of Presentation :
Jamhuriat Hospital –General Surgery Department
 Outline
Stomach Cancer
Epidemiology of Stomach Cancer
Pathology of Stomach Cancer
Classification of Stomach Cancer
Clinic presentation of Stomach Cancer
Diagnose Of Stomach Cancer
Staging of Stomach Cancer
Prognosis of Stomach Cancer
Summary
Reference
Reference
2
 Stomach cancer is a multifactorial disease.
Although, there is no definite underlying
cause and etiology, several
environmental an have
been implicated

3
”
 Epidemiology of Stomach
4 cancer

▹ Is the second leading cause of cancer death worldwide.

▹ The incidence of GC varies geographically.
▹ It is more common in Japan—70 per 1,00,000 population.
▹ It is more common in males 2:1.
▹ Peaks of GC in seventh decade of life
▹ Histologic pattern is shifting from predominantly intestinal
type (distal) to diffuse type (proximal)
 Pathology of Stomach Cancer
5
▹ Gastric cancer consists of two pathological variants.
• The intestinal-type 54%
• The diffuse-type 32%
 Classification of Stomach Cancer
6
 Clinic presentation of Stomach Cancer
7
▹ Persistent stomach pain
▹ Nausea and vomiting and/or bloating after meals
▹ Vomiting blood, or blood in the stool - anemia
▹ Loss of appetite and Unexplained weight loss
▹ Weakness and fatigue
▹ Lesion of proximal - Dysphagia
▹ Diffuse infiltrative lesions produce early satiety
▹ Gastric outlet obstruction
8 Instrumental Examination

▹ Genetic Screening
▹ Transabdominal ultrasonography
▹ Radiological Diagnosis/ Barium meal
▹ Abdominal computed tomography (CT)
▹ Positron emission tomography (PET) or PET-CT
▹ Endoscopic Diagnosis
▹ Endoscopic ultrasound
▹ Laparoscopic Diagnosis
9 Radiological Diagnose/Barium meal
10 Abdominal computed tomography (CT)
11 Positron emission
tomography (PET)
CT scan
12 Endoscopic Diagnosis
13 Endoscopic ultrasound
14
Importance of
Endoscopic
Diagnosis
15 Con..
16 Laparoscopic Diagnosis
17 Differential Diagnose

▹ Gastritis and Atrophic Gastritis

▹ Peptic ulcer disease
▹ Pyloric stenosis with gastric outlet obstruction.
▹ Esophageal Cancer
▹ Pancreatic mass—carcinoma
▹ Transverse colon mass—carcinoma
▹ Advanced fixed stomach mass retroperitoneal or
nodal mass.
 Anatomy of stomach Cancer
18
19 Con…
20
Staging of
Stomach
Cancer
21 Prognosis of Stomach Cancer
▹ Delay diagnosis has poor prognosis (tumors of the cardia)
▹ Age
▹ Sex
▹ Primary tumor site
▹ Lauren Classification
▹ Number of positive and Negative lymph nodes
▹ Depth of Invasion
▹ Five-year survival rate 90% in Japan,  In European countries, 10% to 30%.
▹ But overall 5 years survival is 31%, 68% for localized SC, 40% without
nodal involvement and 5.2% for metastatic disease.
22 Summary
▹ Epidemiological studies further support the link between
H. pylori and cancer of the distal stomach (i.e., antrum).
▹ Endoscopic mucosal resection has good choice for early
gastric cancer
▹ Active screening endoscopy increase the five-year
survival rate.
▹
23 Reference
24 THANK
S!
Any questions?