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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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