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Gastric Cancer(GC) Xu  da-zhi   Department of gastro-pancreas, Cancer Center E-mail:xudzh@sysucc.org.cn Mobile:13660677656
What is gastric cancer?
GC is not far from us…… Napoleon‘s   gastric cancer : tumor found on the lesser curvature of the stomach:  What cause? How to treat? Ambition is never content ,  even on the summit of greatness . He conquered the larger part of Europe, but he could not conquer gastric cancer
How to diagnose What is epidemiology and etilogy   What is the pathology How to treat Content
How to diagnose What is epidemiology and etilogy   What is the pathology How to treat Content
GC Worldwide incidence In terms of geographic distribution, high rates apply to Japan, China and Eastern Europe and low rates to North America.  Almost 40% of cases occur in China  . Pazdur R et al. Cancer management: A multidisciplinary approach. edition,2002  Male 16.4 Female 8.2 Male 36.3 Female 16.9 Male 77.9 Female 33.3 Male 10.8 Female 4.9 Male 43.6 Female 19.0 Male 5.9 Female 2.6 Male 11.5 Female   4.3 Male 18.6 Female 13.3 Male 8.4 Female 4.0 Eastern  Europe Japan Australia/ New Zealand China Northern  Africa Southern  Africa Central  America Western Europe  North America
Distribution of mortality in China In China, there is an obvious clustering of geographic distribution of GC, high mortality located in rural areas.
Etiological Factors of G C Gastric  Cancer   H. pylori Precancerous changes Genetic factors Diet
Helicobacter ,[object Object],[object Object]
Diet ,[object Object],[object Object],[object Object]
Genetic factors ,[object Object],[object Object]
Precancerous changes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why Napoleon died of GC “ The new study suggest he was chronically infected with the bacteria Helicobacter pylori.” “ full of salt-preserved foods but sparse in fruits and vegetables--common fare for long military” H. pylori Genetic factors “ his father had also died of stomach cancer which led to the theory that he had inherited the disease.” Diet Precancerous changes chronic atrophic gastritis?
How to diagnose What is epidemiology and etilogy   What is the pathology How to treat Content
Early gastric cancer ,[object Object]
Advanced gastric cancer ,[object Object]
Bormann classifications ,[object Object],[object Object],[object Object],[object Object],[object Object]
Histology classification   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Lauren classification   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TNM classification ——T ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
T:Primary tumor  ,[object Object],[object Object]
TNM classification ——N ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
N: Regional Lymph Nodes ,[object Object],[object Object]
TNM classification ——M ,[object Object],[object Object],[object Object],[object Object]
Spread Patterns ,[object Object],[object Object],[object Object],[object Object]
Special term ,[object Object],[object Object],[object Object],[object Object]
TNM classification (UICC) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is the classification for Napoleon ,  GC ,[object Object]
Have a rest
How to diagnose What is epidemiology and etilogy   What is the pathology How to treat Content
Clinical manifestation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical manifestation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Special  signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sister Mary Joseph’s node
Laboratory tests ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Imaging Studies ,[object Object],Distal GC Proximal  GC Linitis plastica
Imaging Studies ,[object Object],[object Object],[object Object],[object Object]
Preoperative staging: C TNM ,[object Object],[object Object],[object Object]
Preoperative staging: C TNM ,[object Object],[object Object],[object Object],[object Object]
How to diagnose   Napoleon ,  GC Endoscopic diagnosis? Endoscopic Ultrasonography? CT scan? Preoperative staging ...... Why?
How to diagnose What is epidemiology and etilogy  What is the pathology How to treat Content
Treatment Surgical resection EMR/ESD Adjuvant therapy Palliative therapy
Surgical treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Radical resection  ,[object Object],[object Object],[object Object]
Radical resection ,[object Object],[object Object],[object Object]
Adjuvant Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Palliative operations
How to treat   Napoleon ,  GC Surgical resection? EMR? ESD? Adjuvant therapy? Palliative therapy? ...... Why?
Prognosis ,[object Object],[object Object],[object Object],[object Object]
Recommend reading article ,[object Object]
Thank you!

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Gastric cancer

  • 1. Gastric Cancer(GC) Xu da-zhi Department of gastro-pancreas, Cancer Center E-mail:xudzh@sysucc.org.cn Mobile:13660677656
  • 2. What is gastric cancer?
  • 3. GC is not far from us…… Napoleon‘s gastric cancer : tumor found on the lesser curvature of the stomach: What cause? How to treat? Ambition is never content , even on the summit of greatness . He conquered the larger part of Europe, but he could not conquer gastric cancer
  • 4. How to diagnose What is epidemiology and etilogy What is the pathology How to treat Content
  • 5. How to diagnose What is epidemiology and etilogy What is the pathology How to treat Content
  • 6. GC Worldwide incidence In terms of geographic distribution, high rates apply to Japan, China and Eastern Europe and low rates to North America. Almost 40% of cases occur in China . Pazdur R et al. Cancer management: A multidisciplinary approach. edition,2002 Male 16.4 Female 8.2 Male 36.3 Female 16.9 Male 77.9 Female 33.3 Male 10.8 Female 4.9 Male 43.6 Female 19.0 Male 5.9 Female 2.6 Male 11.5 Female 4.3 Male 18.6 Female 13.3 Male 8.4 Female 4.0 Eastern Europe Japan Australia/ New Zealand China Northern Africa Southern Africa Central America Western Europe North America
  • 7. Distribution of mortality in China In China, there is an obvious clustering of geographic distribution of GC, high mortality located in rural areas.
  • 8. Etiological Factors of G C Gastric Cancer H. pylori Precancerous changes Genetic factors Diet
  • 9.
  • 10.
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  • 13. Why Napoleon died of GC “ The new study suggest he was chronically infected with the bacteria Helicobacter pylori.” “ full of salt-preserved foods but sparse in fruits and vegetables--common fare for long military” H. pylori Genetic factors “ his father had also died of stomach cancer which led to the theory that he had inherited the disease.” Diet Precancerous changes chronic atrophic gastritis?
  • 14. How to diagnose What is epidemiology and etilogy What is the pathology How to treat Content
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  • 30. How to diagnose What is epidemiology and etilogy What is the pathology How to treat Content
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  • 38.
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  • 40. How to diagnose Napoleon , GC Endoscopic diagnosis? Endoscopic Ultrasonography? CT scan? Preoperative staging ...... Why?
  • 41. How to diagnose What is epidemiology and etilogy What is the pathology How to treat Content
  • 42. Treatment Surgical resection EMR/ESD Adjuvant therapy Palliative therapy
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48. How to treat Napoleon , GC Surgical resection? EMR? ESD? Adjuvant therapy? Palliative therapy? ...... Why?
  • 49.
  • 50.