Upper Gastrointestinal Surgery Unit

CANCER OF THE STOMACH

Most gastric tumors are adenocarcinomas, i. e. cancerous lesions developed from the mucosal glands of the stomach.

The surgical technique that has been reported to achieve the best results in terms of cure is gastrectomy combined with the removal of all the potentially invaded lymph nodes in the upper abdomen as described by Japanese surgical teams out of which the one of K. Maruyama at the National Cancer Center, Tokyo.

This technique we call  Skeletonizing en-bloc Gastrectomy  has been used in our Unit for years.

  

Digestive continuity after total gastrectomy is restored using a 60-cm jejunal segment

The chance at a long-term favorable outcome in those patients in whom this skeletonizing en-bloc gastrectomy is feasible (e.i. no distant metastases detected before or during the operation, no diffuse neoplastic spread detected during the operation) are the followings:

   
  • Normal lymph nodes in the resected specimen:
    75% survival rate 5 years after the operation.
  • Fewer than 5 invaded lymph nodes in the resected specimen:
    62 % survival rate 5 years after the operation.
  • 5 or more than 5 invaded lymph nodes in the resected specimen:
    39 % survival rate 5 years after the operation.

In patients who are not eligible for this procedure, treatment may consist of a more limited resection (surgical or endoscopic), radio-chemotherapy, and/or laparoscopic hyperthermic chemotherapy.

Each clinical case is discussed at a bi-monthlymultidisciplinary meeting gathering surgeons, medical gastro-enterologists, radiotherapists, medical oncologists, radiologists, anaesthesiologists, intensive care physicians and histo-pathologists in order to provide each patient with the most relevant treatment.