Esophageal carcinoma and gastric cancer Flashcards Preview

Clin Med 2 > Esophageal carcinoma and gastric cancer > Flashcards

Flashcards in Esophageal carcinoma and gastric cancer Deck (13):
1

RF esophageal carcinoma

- Etoh
- Tobacco
- GERD→Barretts esophagus (metaplasia)→Adenocarcinoma
- Obesity vitamin deficiency (ie China)
- Familial Hx

2

Clinical esophageal carcinoma

- Dysphagia*- Progression from solid food to liquids; Rapid
- Weight loss >50%
- Regurgitate food- Epigastric pain/retrosternal pain/bone pain from mets
- Chronic cough
- Hoarseness/dysphonia
- Virschow node- lymph node in left supraclavicular fossa
- Cachectic

3

Dx esophageal carcinoma

Endoscopy with biopsy

4

How to stage esophageal carcinoma

EUS
CT
Broncoscopy
PET scan
Laproscopic staging

5

Tx esophageal carcinoma

Surgery- Esophagectomy
- for N2 and greater
Chemo and XRT for everyone else
-5-FU, Cisplatin, Paclitaxel, Anthracyclines

6

Prevent esophageal carcinoma

STOP GERD
Discontinue alcohol and smoking

7

MC cause gastric cancer

adenocarcinoma

8

Areas where gastric cancer MC

Asia and S. America

9

Cause gastric cancer

- Inherited predisposition
- H. Pylori*- Strongest RF as also associated w/ chronic atrophic gastritis
- Smoking
- Pernicious anemia
- Previous gastric surgery
- Obesity
- Diet- Pickled veggies, salted fish, smoked meats, salt
- Adenomatous polyps
- Radiation exposure

10

Clinical gastric cancer

- Insidious presentation
- Indigestion
- Nausea/Vomiting
- Dysphagia
- Early satiety/Anorexia
- Weight loss
- Melena/Hematemesis
- Local spread to omenta, pancreas, diaphragm, mesocolon, transverse colon, duodenum
- GOO- gastric outlet obstruction
- SBO
- Palpable enlarged stomach
- Hematogenous spread liver
- Sister Mary Joseph Node- periumbilical lymph node
- Virchow Node- supraclavicular node
- Hepatomegaly

11

Dx gastric cancer

EGD with bx

12

What blood levels elevated in gastric cancer

CEA : carcinoembryonic antigen
CA 19-9

13

Tx gastric cancer

Surgery- mainstay tx
- Total gastrectomy
- Esophagogastrectomy- Tumor @ GEJ and Cardia
- Subtotal gastrectomy- Tumors of distal stomach
Adjuvant chemoradiotherapy
o Post-operatively = std of care in US
o 5-FU and Leucovorin