Management of patients with pregnancy-associated gastric cancer in Japan: a mini-review

Int J Clin Oncol. 2009 Oct;14(5):392-6. doi: 10.1007/s10147-009-0903-6. Epub 2009 Oct 25.

Abstract

Gastric cancer associated with pregnancy is quite rare, and is most often diagnosed at an advanced stage. Furthermore, physicians are confronted with two conflicting issues in this condition: the need for early treatment of the maternal gastric cancer and the continuation of the pregnancy. To clarify the characteristics of pregnancy-associated gastric cancer and to obtain useful information that would help us choose the best treatment strategy for pregnancy-associated gastric cancer, we reviewed the existing literature, using the key words "pregnancy" and "gastric cancer". We were able to accumulate 136 cases, including 100 cases reported previously in Japan, and 1 case that we report here. We analyzed a total of 137 cases in the present study. With respect to the stage of gastric cancer, 92.5% of the patients studied had advanced gastric cancer, and only 45.3% of the patients underwent gastrectomy, including incomplete resection. Accordingly, the prognosis was very poor; the 1- and 2-year survival rates were 18.0% and 15.1%, respectively. However, the number of patients found to have early gastric cancer by endoscopic examination has been increasing recently. An endoscopic examination should be conducted immediately in pregnant patients presenting with persistent gastrointestinal symptoms for the differential diagnosis of hyperemesis gravidarum. When an endoscopic examination reveals that pregnant patients have gastric cancer, a therapeutic plan should be promptly formulated, in accordance with the number of weeks of gestation, by a medical team consisting of specialists in perinatal obstetrics and gastric cancer specialists.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Asian People*
  • Cesarean Section*
  • Chemotherapy, Adjuvant
  • Fatal Outcome
  • Female
  • Gastrectomy*
  • Gastroscopy
  • Gestational Age
  • Humans
  • Japan / epidemiology
  • Live Birth
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Neoplasm Staging
  • Patient Care Team
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / secondary
  • Pregnancy
  • Pregnancy Complications, Neoplastic / diagnosis
  • Pregnancy Complications, Neoplastic / ethnology
  • Pregnancy Complications, Neoplastic / therapy*
  • Splenectomy
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / ethnology
  • Stomach Neoplasms / secondary
  • Stomach Neoplasms / therapy*
  • Treatment Outcome