Stomach path

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Last updated 7:53 PM on 9/12/26
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15 Terms

1
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anatomy

  • left hypochondrium and epigastrium

  • muscular organ; inner mucosa and outer serosa

  • blood vessels, lymphatics, CT

  • simple columnar epithelial cells


2
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lymphatics

gastric, gastropancreatic, celiac axis, periaortic

3
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epidemiology

  • #7 cancer death in US

  • 1.5:1 M/F ratio

  • 50 y/o median age

  • Chile, CR, Russia, Japan

  • white - proximal, black - pyloric & antral lesions


4
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etiology

  • diet (smoked & salty)

  • environmental & occupational exposure (coal, rubber, nickel)

  • h. pylori

  • genetics


5
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pathology

  • 95% adenocarcinoma

  • lymphomas, leiomyosarcoma, SCC


6
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signs & symptoms

  • vague epigastric discomfort (90%)

  • weight loss (80%), anorexia

  • jaundice


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detection & diagnosis

fecal occult blood test, UGI, endoscopy, CT CXR laparotomy

8
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routes of spread

pancreas, liver, lung, bone

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tx tehcniques

surgery, chemo, RT

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chemo

5-FU in combo w/ others; for unresectable tumors or mets

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RT

tx nodes, post op

  • 45 gy to primary tumor & regional nodes

  • does not improve survival

  • AP/PA ports


12
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OARs

  • kidney: 23

  • liver: 30

  • small bowel: 45

  • spinal cord: 47

  • spleen


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acute reactions

N/V, esophagitis, gastritis

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chronic reactions

gastric ulcers, nephritis (if kidney in field)

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5 year survival rate

  • limited 50%

  • mets 8%

  • over all 16%