Open Access Medical Books



Edited by Daniela Lazăr .

Open Access .

Although gastric cancer was in the past the second most common cancer in the world, its incidence has dropped to fourth place, after cancers of the lung, breast, and colon and rectum. In most developed countries, rates of stomach cancer have shown a dramatically decline over the past half century. Nevertheless, gastric cancer is still the second most common cause of cancer-related death in the world, causing about 800,000 deaths worldwide per year.
Gastric neoplasm is often either asymptomatic or it may cause only nonspecific symptoms in its early stages; by the time symptoms occur, the tumor has often reached a locally advanced stage or may have also metastasized, which is one of the main reasons for the delayed diagnosis and relatively poor prognosis of this cancer.
Gastric cancer may often be multifactorial, involving both genetic predisposition (e.g hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, hereditary diffuse gastric cancer and Peutz–Jeghers syndrome) and environmental factors, such as Helicobacter pylori infection.
Multidisciplinary treatment approach is compulsory for stomach cancer, including surgeons, gastroenterologists, medical and radiation oncologists, radiologists and pathologists. Surgical resection represents the only modality that is potentially curative. In the last years, in the case of early gastric cancer, endoscopic resection may replace the surgical procedure.
Literature data have shown that the 5-year survival rate for curative surgical resection ranges from 30-50% for patients with stage II disease and from 10-25% for patients with stage III disease. Because these patients have a high likelihood of local and systemic relapse, the treatment is completed by adjuvant chemotherapy.
Many trials have demonstrated a survival benefit for adjuvant chemotherapy or chemoradiotherapy in patients with stage II/III gastric cancer. Patients with inoperable, locally advanced gastric cancer should be treated with palliative chemotherapy; afterwards, they may be reassessed for surgery if a good response is achieved. Patients with metastatic disease should be considered for palliative chemotherapy, which improves survival. Recent data have shown the benefit of adding targeted therapy to the chemotherapy schemes on the survival of selected gastric cancer patients (e.g the addition of trastuzumab to chemotherapy in patients with HER2-positive gastric cancer).
This book contains a comprehensive overview of most recent data concerning a multitude of facets of the gastric cancer. The book highlights various aspects of gastric neoplasm, from the epidemiology, preneoplastic lesions, the complex process of carcinogenesis, the risk and protective factors, morphological and molecular changes, up to the modern diagnostic tools and current management of early and advanced gastric cancer, revealing the valuable contribution of the multidisciplinary treatment approach.
This publication is appropriate for students, clinicians and researchers in the field of gastroenterology, oncology, pathology, immunology, genetics, molecular biology, radiology, and many other specialties. They will find interesting data and hot topics in this book, from fundamental research knowledge to clinical issues that may be helpful in daily practice.
This book, written in an easy-to-read style, makes an insight into the diagnosis and assessment of premalignant gastric lesions and into the current management of gastric cancer in its early stages. The authors focus on novel risk factors in gastric carcinogenesis, such as fetal-type glycogen phosphorylase expression in intestinal metaplasia and also new discovered protective factors such as naringenin that inhibits oxidative stress induced macromolecular damage in a model of gastric carcinogenesis in rats. Also, one of the topics  refers to the importance of the host factors in gastric neoplasm associated with H. pylori infection. Furthermore, this publication is presenting the role of endoscopic and histological assessment in order to obtain a proper diagnostic of the premalignant gastric lesions.
“Gastric cancer-new insights into current management” provides a detailed description of the morphologic classification and of the molecular changes encountered in the case of this tumor. Moreover, it depicts some rare histological types of gastric cancers that may help young scientists recognize them. An important topic refers to the epigenetic gene regulation mechanisms and the biological behavior of the tumors, focusing on DNA methylation aspects in aggressive gastric neoplasm. The identification of the molecular mechanisms of gastric carcinogenesis and its progression using recent advances in genomic science allows finding markers for early detection of stomach cancer, and can provide better information on tumor aggressiveness, prognosis and prediction of response to cancer therapy.
The publication reveals some distinct and particular imaging findings that may accompany different histological types of gastric tumors and also, the most important factors contributing to the prognosis of gastric cancer.
There are no screening tests available for diagnosis of gastric cancer, therefore patients usually presents in late stages. The preoperative evaluation stratifies patients in those with loco-regional, potentially resectable disease, and those with systemic involvement. The book describes the role of different diagnostic tools in the preoperative assessment of patients with gastric carcinoma. Currently, early gastric cancer is treated with endoscopic resection, gastrectomy, antibiotic therapy for H.pylori infection and adjuvant treatment. Surgical resection remains the curative treatment for local and locoregional cancer. The authors highlights the fact that adjuvant chemoradiotherapy is an essential part of the treatment schedule as 80% of the cases develop local recurrence.
“Gastric cancer-new insights into current management” represents an important tool for clinicians in the process of continuing medical education by updating with novel information offered by a valuable team of well-known scientist who belong to different specialties. Moreover, it may open new and interesting gates for further research concerning carcinogenesis, genetic and epigenetic alterations, signaling pathways, H. pylori infection, the discovery of protective factors against gastric cancer and of revolutionary therapies of this tumor.
I wish to express my gratitude to all the scientists-authors and co-authors- who have contributed to the elaboration of this comprehensive book, and also to the publisher with his entire team, especially to Ms. Danijela Duric, for the support.
Finally, I wish to dedicate this book to my beloved parents who are my models in life and profession.

Daniela Lazar

Assistant Professor of Gastroenterology,
Gastroenterology and Hepatology Department
University of Medicine and Pharmacy “Victor Babes”
Timisoara, Romania


Section 1 Preneoplastic Lesions and Early Gastric Cancer .

  1 The Role of Endoscopy and Biopsy in Evaluating Preneoplastic and Particular Gastric Lesions 3 
Daniela Lazăr, Sorina Tăban and Sorin Ursoniu

  2 Management of Early Gastric Cancer 41 
Takehiro Okabayashi and Yasuo Shima

Section 2 Risk and Protective Factors .

  3 Risk Factors in Gastric Cancer 55 
Jolanta Czyzewska

  4 Relevance of Host Factors in Gastric Cancer Associated with Helicobacter Pylori 75 
Elvira Garza-González and Guillermo Ignacio Pérez-Pérez

  5 Fetal-type Glycogen Phosphorylase (FGP)Expression in Intestinal Metaplasia as a High Risk Factor of the Development of Gastric Carcinoma 93 
Masafumi Kuramoto, Shinya Shimada, Satoshi Ikeshima, Kenichiro Yamamoto, Toshiro Masuda, Tatsunori Miyata, Shinichi Yoshimatsu, Masayuki Urata and Hideo Baba

  6 Naringenin Inhibits Oxidative Stress Induced Macromolecular Damage in N-methyl N-nitro N-nitrosoguanidine Induced Gastric Carcinogenesis in Wistar Rats 111 
Ekambaram Ganapathy, Devaraja Rajasekaran, Murugan Sivalingam, Muhammed Farooq Shukkur, Ebrahim Abdul Shukkur and Sakthisekaran Dhanapal

Section 3 Morphological and Molecular Aspects .

  7 Gastric Carcinoma: Morphologic Classifications and Molecular Changes 129 
Sun-Mi Lee, Kyoung-Mee Kim and Jae Y. Ro

  8 Variants of Gastric Carcinoma: Morphologic and Theranostic Importance 177 
Sun-Mi Lee, Kyoung-Mee Kim and Jae Y. Ro

 9 DNA Methylation in Aggressive Gastric Carcinoma 223 
Chung-Man Leung, Kuo-Wang Tsai and Hung-Wei Pan

Section 4 Diagnostic Tools, Prognosis and Management .

  10 Imaging Findings of Gastric Carcinoma 245 
Eriko Maeda, Masaaki Akahane, Kuni Ohtomo, Keisuke Matsuzaka and Masashi Fukayama

  11 Prognosis in the Cancer of the Stomach 259 
Okan Akturk and Cemal Ulusoy

  12 Gastric Carcinoma: A Review on Epidemiology, Current Surgical and Chemotherapeutic Options 271 
Rokkappanavar K. Kumar, Sajjan S. Raj, Esaki M. Shankar, E. Ganapathy, Abdul S. Ebrahim and Shukkur M. Farooq

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Published by: Unknown - Wednesday, January 23, 2013


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