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4 - Upper gastrointestinal series in the diagnosis of gastric cancer

Published online by Cambridge University Press:  31 March 2010

By
Marc S. Levine
Edited by
Richard M. Gore
Richard M. Gore
Affiliation:
Northwestern University Medical School, Illinois
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Summary

Introduction

Although the incidence of gastric carcinoma has declined since the 1960s, it continues to be a deadly disease, with overall 5-year survival rates of less than 20%. There also has been a gradual shift in the distribution of gastric cancer from the antrum proximally to the fundus and cardia during this same period. As many as 40% of all gastric cancers are now located in the fundus or cardiac region. This changing pattern of disease has major implications for the radiologic diagnosis of gastric cancer, as the gastric cardia and fundus must be carefully evaluated in all patients with suspected gastric tumors. The double-contrast barium study is a valuable technique for detection of tumors in the fundus that are inaccessible to manual palpation as well as scirrhous tumors encasing the wall of the stomach. Double-contrast studies are also particularly useful for the detection of early cancers, which have a much better prognosis than advanced cancers. This chapter reviews the role of barium studies in the diagnosis of gastric cancer.

Early gastric cancer

Early gastric cancers are defined histologically as tumors limited to the mucosa or submucosa, regardless of the presence or absence of regional lymph node metastases (which does not substantially affect the prognosis). Unlike advanced carcinomas, which have a dismal prognosis, early gastric cancers are curable lesions, with 5-year survival rates of 90%–95%.

Type
Chapter
Information
Gastric Cancer , pp. 62 - 82
Publisher: Cambridge University Press
Print publication year: 2009

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References

Devesa, SS and Silverman, DT.Cancer incidence and mortality trends in the United States: 1935–74. J Natl Cancer Inst 1978; 60: 545–71.CrossRefGoogle ScholarPubMed
Howson, CP, Hiyama, T, and Wynder, EL.The decline in gastric cancer: epidemiology of an unplanned triumph. Epidemiol Rev 1986; 8: 1–27.CrossRefGoogle ScholarPubMed
McBride, CM and Boddie, AW.Adenocarcinoma of the stomach: are we making any progress?South Med J 1987; 80: 283–6.CrossRefGoogle ScholarPubMed
Cady, B, Rossi, RL, Silverman, ML, Piccione, W, and Heck, TA.Gastric adenocarcinoma: a disease in transition. Arch Surg 1989; 124: 303–8.CrossRefGoogle ScholarPubMed
Meyers, WC, Damiano, RJ, Rotolo, FS, and Postlethwait, RW.Adenocarcinoma of the stomach: changing patterns over the last 4 decades. Ann Surg 1987; 205: 1–8.CrossRefGoogle ScholarPubMed
Antonioli, DA and Goldman, H.Changes in the location and type of gastric adenocarcinoma. Cancer 1982; 50: 775–81.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Kaneko, E, Nakamura, T, Umeda, N, Fujino, M, and Niwa, H.Outcome of gastric carcinoma detected by gastric mass survey in Japan. Gut 1977; 18: 626–30.CrossRefGoogle ScholarPubMed
Okui, K and Tejima, H.Evaluation of gastric mass survey. Acta Chir Scand 1980; 146: 185–7.Google ScholarPubMed
Green, PH, O'Toole, KM, Slonim, D, Wang, T, and Weg, A.Increasing incidence and excellent survival of patients with early gastric cancer: experience in a United States medical center. Am J Med 1988; 85: 658–61.CrossRefGoogle Scholar
White, RM, Levine, MS, Enterline, HT, and Laufer, I.Early gastric cancer: recent experience. Radiology 1985; 155: 25–7.CrossRefGoogle ScholarPubMed
Murakami, T. Pathomorphological diagnosis. In Murakami, T ed., Early Gastric Cancer. Tokyo: University of Tokyo Press, 1971; pp. 53–5.Google Scholar
Levine, MS and Laufer, I. Tumors of the stomach. In Levine, MS, Rubesin, SE and Laufer, I eds., Double Contrast Gastrointestinal Radiology, 3rd edn. Philadelphia, PA: WB Saunders, 2000; pp. 204–38.Google Scholar
Levine, MS, Megibow, AJ, and Kochman, ML. Carcinoma of the stomach and duodenum. In Gore, RM and Levine, MS eds., Textbook of Gastrointestinal Radiology, 3rd edn. Philadelphia, PA: WB Saunders, 2008; pp. 619–43.Google Scholar
Koga, M, Nakata, H, Kiyonari, H, Inakura, M, and Tanaka, M.Roentgen features of the superficial depressed type of early gastric carcinoma. Radiology 1975; 115: 289–92.CrossRefGoogle ScholarPubMed
Olearchyk, AS.Gastric carcinoma. A critical review of 243 cases. Am J Gastroenterol 1978; 70: 25–45.Google ScholarPubMed
Thomas, RL and Rice, RP.Calcifying mucinous adenocarcinoma of the stomach. Radiology 1967; 878: 1002–3.CrossRefGoogle Scholar
Low, VH, Levine, MS, Rubesin, SE, Laufer, I, and Herlinger, H.Diagnosis of gastric carcinoma: sensitivity of double-contrast barium studies. AJR Am J Roentgenol 1994; 162: 329–34.CrossRefGoogle ScholarPubMed
Wolf, BS.Observations on roentgen features of benign and malignant gastric ulcers. Semin Roentgenol 1971; 6: 140–50.CrossRefGoogle ScholarPubMed
Rubesin, SE, Levine, MS, and Laufer, I.Double-contrast upper gastrointestinal radiography: a pattern approach for diseases of the stomach. Radiology 2008; 246: 33–48.CrossRefGoogle ScholarPubMed
Thompson, G, Somers, S, and Stevenson, GW.Benign gastric ulcer: a reliable radiologic diagnosis?AJR Am J Roentgenol 1983; 141: 331–3.CrossRefGoogle ScholarPubMed
Levine, MS, Creteur, V, Kressel, HY, Laufer, I, and Herlinger, H.Benign gastric ulcers: diagnosis and follow-up with double-contrast radiography. Radiology 1987; 164: 9–13.CrossRefGoogle ScholarPubMed
Carman, RD.A new roentgen-ray sign of ulcerating gastric cancer. J Am Med Assoc 1921; 77: 990–2.Google Scholar
Kirklin, BR.The value of the meniscus sign in the roentgenologic diagnosis of ulcerating gastric carcinoma. Radiology 1934; 22: 131–5.CrossRefGoogle Scholar
Smith, DL, Dockerty, MB, and Black, BM.Gastrocolic fistulas of malignant origin. Surg Gynecol Obstet 1972; 134: 829–32.Google ScholarPubMed
Levine, MS, Kelly, MR, Laufer, I, Rubesin, SE, and Herlinger, H.Gastrocolic fistulas: the increasing role of aspirin. Radiology 1993; 187: 359–61.CrossRefGoogle ScholarPubMed
Cho, KC, Baker, SR, Alterman, DD, Fusco, JM, and Cho, S.Transpyloric spread of gastric tumors: comparison of adenocarcinoma and lymphoma. AJR Am J Roentgenol 1996; 167: 467–9.CrossRefGoogle ScholarPubMed
Raskin, MM.Some specific radiological findings and consideration of linitis plastica of the gastrointestinal tract. CRC Crit Rev Clin Radiol Nucl Med 1976; 8: 87–106.Google ScholarPubMed
Marshak, RH, Lindner, AE, and Maklansky, D. Carcinoma of the stomach. In Marshak, RH, Lindner, AE and Maklansky, D eds., Radiology of the Stomach. Philadelphia, PA: WB Saunders, 1983; pp. 108–46.Google Scholar
Balthazar, EJ, Rosenberg, H, and Davidian, MM.Scirrhous carcinoma of the pyloric channel and distal antrum. AJR Am J Roentgenol 1980; 134: 669–73.CrossRefGoogle ScholarPubMed
Levine, MS, Kong, V, Rubesin, SE, Laufer, I, and Herlinger, H.Scirrhous carcinoma of the stomach: radiologic and endoscopic diagnosis. Radiology 1990; 175: 151–4.CrossRefGoogle ScholarPubMed
Winawer, SJ, Posner, G, Lightdale, CJ, Sherlock, P, Melamed, M, and Fortner, JG.Endoscopic diagnosis of advanced gastric cancer. Factors influencing yield. Gastroenterology 1975; 69: 1183–7.Google ScholarPubMed
Evans, E, Harris, O, Dickey, D, and Hartley, L.Difficulties in the endoscopic diagnosis of gastric and oesophageal cancer. Aust N Z J Surg 1985; 55: 541–4.CrossRefGoogle ScholarPubMed
Joffe, N.Metastatic involvement of the stomach secondary to breast carcinoma. AJR Am J Roentgenol 1975; 123: 512–21.CrossRefGoogle ScholarPubMed
Cormier, WJ, Gaffey, TA, Welch, JM, Welch, JS, and Edmonson, JH.Linitis plastica caused by metastatic lobular carcinoma of the breast. Mayo Clin Proc 1980; 55: 747–53.Google ScholarPubMed
Sherrick, DW, Hodgson, JR, and Dockerty, MB.The roentgenologic diagnosis of primary gastric lymphoma. Radiology 1965; 84: 925–32.CrossRefGoogle ScholarPubMed
Menuck, LS.Gastric lymphoma: a radiologic diagnosis. Gastrointest Radiol 1976; 1: 157–61.CrossRefGoogle ScholarPubMed
Levine, MS, Pantongrag-Brown, L, Aguilera, NS, Buck, JL and Buetow, PC.Non-Hodgkin lymphoma of the stomach: a cause of linitis plastica. Radiology 1996; 201: 375–8.CrossRefGoogle ScholarPubMed
MacDonald, WC.Clinical and pathologic features of adenocarcinoma of the gastric cardia. Cancer 1972; 29: 724–32.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Freeny, PC.Double-contrast gastrography of the fundus and cardia: normal landmarks and their pathologic changes. AJR Am J Roentgenol 1979; 133: 481–7.CrossRefGoogle ScholarPubMed
Herlinger, H, Grossman, R, Laufer, I, Kressel, HY, and Ochs, RH.The gastric cardia in double-contrast study: its dynamic image. AJR Am J Roentgenol 1980; 135: 21–9.CrossRefGoogle ScholarPubMed
Freeny, PC and Marks, WM.Adenocarcinoma of the gastroesophageal junction: barium and CT examination. AJR Am J Roentgenol 1982; 138: 1077–84.CrossRefGoogle ScholarPubMed
Levine, MS, Laufer, I, and Thompson, JJ.Carcinoma of the gastric cardia in young people. AJR Am J Roentgenol 1983; 140: 69–72.CrossRefGoogle ScholarPubMed
Balthazar, EJ, Goldfine, S, and Davidian, MM.Carcinoma of the esophagogastric junction. Am J Gastroenterol 1980; 74: 237–43.Google ScholarPubMed
Woodfield, CA, Levine, MS, Rubesin, SE, Langlotz, CP, and Laufer, I.Diagnosis of primary versus secondary achalasia: reassessment of clinical and radiographic criteria. AJR Am J Roentgenol 2000; 175: 727–31.CrossRefGoogle ScholarPubMed
Levine, MS, Caroline, DF, Thompson, JJ, Kressel, HY, Laufer, I, and Herlinger, H.Adenocarcinoma of the esophagus: relationship to Barrett mucosa. Radiology 1984; 150: 305–9.CrossRefGoogle ScholarPubMed

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