𝑮𝒂𝒔𝒕𝒓𝒊𝒄 𝑪𝒂𝒏𝒄𝒆𝒓

Question 1

What is the epidemiological ranking of gastric cancer among malignant tumors worldwide?

Answer 1

5th most common malignant tumor in the world

Question 2

What is the typical age range for gastric cancer occurrence?

Answer 2

Common in 40-70 years and 55-65 years

Question 3

What percentage of gastric tumors occur in the pyloric antrum?

Answer 3

65% of tumors occur in the pyloric antrum

Question 4

What are the three main types of gastric cancer macroscopically?

Answer 4

Ulcerative (50%), Polypoid (20%) & Infiltrative (30%)

Question 5

What is the most common microscopic type of gastric adenocarcinoma?

Answer 5

Intestinal type (85%)

Question 6

What are the risk factors for gastric cancer?

Answer 6

-Older age
-Male
-H.Pylori
-Overweight & Obesity
-Food contaminated by Fungal toxin esp Aflatoxin
-Stomach Polyp
-Pernicious anaemia reaulting from poor vitamin B12 absorption
-Alcohol Abuse

Question 7

What pre-malignant condition is associated with gastric cancer?

Answer 7

Chronic atrophic gastritis and adenomatous polyps

Question 8

What percentage of gastric cancers present with perforation?

Answer 8

4% of cases present with perforation

Question 9

Why is the prognosis of gastric cancer generally poor?

Answer 9

Early spread of tumor and late appearance of symptoms

Question 10

What is the main symptom seen in gastric cancer?

Answer 10

Dyspepsia

Question 11

What is the primary imaging investigation for suspected gastric cancer?

Answer 11

Oesophago-gastro-duodenoscopy

Question 12

What does T1 stage indicate in gastric cancer?

Answer 12

Invasion of mucosa or submucosa

Question 13

What does N2 staging indicate in gastric cancer?

Answer 13

Nodes more than 3cm of tumour involved

Question 14

What does M1 indicate in gastric cancer staging?

Answer 14

Distant metastasis is present

Question 15

What percentage of gastric cancers involve the body of the stomach?

Answer 15

25% in the body

Question 16

What is the definition of Tis in gastric cancer staging?

Answer 16

Pre-invasive carcinoma

Question 17

What are the three main treatment options for gastric cancer?

Answer 17

Chemotherapy (adjuvant/neo-adjuvant)
Surgery (Resection)
Palliative Care

Question 18

What common type of anemia is associated with gastric cancer?

Answer 18

Pernicious anemia

Question 19

What is the main surgical treatment for gastric cancer?

Answer 19

Resection

Question 20

What lifestyle factor is a significant risk for gastric cancer?

Answer 20

Alcohol abuse

Question 21

What type of food contamination is associated with gastric cancer risk?

Answer 21

Food contaminated by fungal toxins (Aflatoxins)

Question 22

What is the most common presenting symptom of gastric cancer?

Answer 22

Dyspepsia

Question 23

What percentage of cases present with acute bleeding?

Answer 23

10% present with acute bleeding

Question 24

What imaging test is used after initial endoscopy?

Answer 24

Contrast-enhanced CT scan

Question 25

What investigation are done in gastric cancer?

Answer 25

1. Oesophago-gastro-duodenoscopy 2. Barium meal 3. Endoscopic ultrasonography 4. Ultrasound and contrast-enhanced CT scan 5. Laparoscopy 6. Hemoglobin

Question 26

What is dumping syndrome in post-gastric cancer patients?

Answer 26

Rapid movement of food from stomach to duodenum

Question 27

What factors affect the prognosis?

Answer 27

Gastric wall invasion 1. Nodal involvement 2. Distance metastases 3. Duration of symptoms 4. Degree of cellular differentiation

Question 28

What are the modes of spread pattern in gastric cancer?

Answer 28

Lymphatic, Local, blood, Trans-peritoneal, Extra-abdominal

Question 29

What are the microscopic/histologic types of Adenocarcinoma?

Answer 29

Diffuse (50%), Intestinal & Mixed type

Question 30

How does T4 staging differ from T3?

Answer 30

T4 involves invasion of adjacent structures while T3 involves invasion of serosa

Question 31

What are the symptoms of gastric cancer?

Answer 31

-Dyspepsia -Weight-loss -Anemia -Lump

Question 32

Complications of gastric cancer

Answer 32

-Gastric Outlet Obstruction -Perforation -Bleeding -Iron deficiency anemia (Breathlessness & Pallor)

Question 33

TNM staging of gastric cancer

Answer 33

T (Tumor - Depth of Invasion) Tis—Pre-invasive Carcinoma T1—Tumor invades lamina propria, muscularis mucosae, or submucosa T2—Tumor invades muscularis propria T3—Tumor invades subserosa T4—Tumor invades serosa (T4a) or adjacent organs (T4b) N (Lymph Node Involvement) N0—No lymph node involvement N1—Nodes within 3cm of tumor involved N2—Nodes more than 3cm of tumour involved N3—Distant nodal nvolvement M (Metastasis - Spread to Distant Sites) M0—No distant metastasis M1—Distant metastasis present (e.g., liver, peritoneum, distant lymph nodes)

Question 34

What is seen on examination of gastric cancer?

Answer 34

Examination of the patient may reveal; - A palpable mass in the epigastrium (25%) - Jaundice - Hepatomegaly (10%) - Ascites - Abdominal masses (Sister Mary-Joseph nodule) /enlarged supraclavicular lymph nodes. - Weight loss is evident. Examination may, however, be negative.

Question 35

Aetiology of Gastric cancer

Answer 35

- Genetics - Pre-malignant conditions like chronic atrophic gastritis & Adenomatous polyp - Diet - Nitrosamine