Clinical Course of Gastric Cancer
Early gastric cancer is usually asymptomatic, advanced carcinomas can be asymptomatic, but often because of abdominal discomfort or weight loss is revealed. Infrequently they are localized in the cardia neoplasms, dysphagia, or obstructive symptoms may lead them as they occur in the pyloric canal. 10% of patients with one or two may show evidence of metastatic disease. The most common signs of distant metastases palpable supraclavicular lymph node (Virchow node), rectal examination revealed a palpable mass (Blumer shelf), ascites, or liver mass. Hematogenous spread most commonly in liver.
Stomach Cancer Diagnosis
Physical examination, cachexia, abdominal distention, hepatomegaly and lymphadenopathy in the sense of liver metastasis. Upper gastrointestinal series, and gastroesophageal junction (GE) GE junction cancer, stricture, filling defects along the gastric wall due to tumor shrinkage may or linitis plastica. diagnosis is essential. Endoscopic ultrasound is helpful to determine the depth of invasion. Identifying metastatic disease, thoracic-abdominal CT is important. CT imaging in determining depth of invasion and nodal involvement, 40-60% correct. Bone scintigraphy is used for patients showing symptoms. PET imaging is very helpful especially in determining occult metastatic disease. Very small, secret sets of peritoneal or hepatic metastases. Tumor markers including CEA and CA 19-9 patients follow-up is beneficial, but often does not rise.
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