胃癌的最新治療.pdf

胃癌標靶治療現況與未來展望.pdf

• 85-90% are adenocarcinoma
• Incidence particularly high in Japan, Chile, Scotland, Finland; lower in U.S., U.K., Canada, Greece; more common in blacks
• Overall incidence in U.S. has been steadily dropping over past several years, but the incidence of carcinoma in the cardia is increasing; currently, 50% of gastric cancers in white men are in the cardia; (Male: female = 8:1)
• Risk factors: dietary/environmental (still unidentified)—salt, low intake of animal fat/protein, complex carbohydrates, nitrates; chronic gastritis and pernicious anemia; gastric adenomatous polyps
• Accompanied by hypochlomydria in 85-90% cases, and chronic atrophic gastritis is usually present
• Lesser curvature involved 3x more frequently than greater
• Often present in advanced stage; may present with metastases; only about 50% resectable at diagnosis; 80-90% have local LN metastases
• Virchow's node: isolated metastasis to left supraclavicular LN (also called Trousseau's sign)
• Overall 5 yr survival still 5-15%