Preoperative CA 125 is significant indicator of curative resection in gastric cancer patients

AIM: To investigate the correlation among tumor markers, curative resection, and recurrence in gastric cancer.METHODS: The patients with preoperative tumormakers [Carcinoembryonic antigen, Carbohydrate antigen(CA) 19-9, and CA 125] and elective gastrectomy between January 2000 and December 2009 at Chungbuk National University Hospital were enrolled in this study. We analyzed the relationship among the tumor makers, curative resection and recurrence, retrospectively.RESULTS: Among the 679 patients with gastric cancer, curative resection was 93.6%(n = 636) and noncurative resection was 6.4%(n = 43). The independent risk factors for the non-curative resection were tumor location and the positivity of preoperative serum CA 19-9 and CA 125 levels. After curative resection, the independent prognostic risk factors for recurrence in curative resection were gender, stage, and preoperative increased serum CA 125 level(HR = 2.431, P =0.020), in a multivariate analysis. CONCLUSION: Preoperative CA 125 is a useful predictive biomarker for curative resection and prognostic biomarker for recurrence in gastric cancer patients.

Long-term survival after gastrectomy and metastasectomy for gastric cancer with synchronous bone metastasis

Bone metastasis is a rare event in patients with gastric cancer, but pathologic fracture, paralysis, pain and hematological disorders associated with the bone metastasis may influence the quality of life. We report herein the case of a 53-year-old man who presented with primary remnant gastric cancer with bone metastasis. The patient requested further investigations after detection of a metastatic lesion in the 2 nd lumbar vertebra during evaluation for back pain that had persisted for 3 mo. No other metastatic lesions were detected. He underwent total gastrectomy and palliative metastasectomy to aid in reduction of symptoms, and he received combination chemotherapy with tegafur(S-1) and cisplatin. The patient survived for about 60 mo after surgery. Currently, there is no treatment guideline for gastric cancer with bone metastasis, and we believe that gastrectomy plus metastasectomy may be an effective therapeutic option for improving qualityof life and survival in patients with resectable primary gastric cancer and bone metastasis.

Endoluminal closure of an unrecognized penetrating stab wound of the duodenum with endoscopic band ligation: A case report

BACKGROUND A penetrating injury of a hollow viscus is an obvious indication for an exploratory laparotomy,but is not typically an indication for endoscopic treatment.CASE SUMMARY A 27-year-old man visited the emergency department with a self-inflicted abdominal stab wound.Injuries to the colon and ileum were detected,but an injury to the second portion of the duodenum was missed.On the day following admission to our institution,the patient became hemodynamically unstable with massive hematochezia,although there was no evidence of bleeding in the Levin tube or Jackson-Pratt drain.We thus performed an upper gastrointestinal endoscopy and discovered a missed duodenal injury that was actively bleeding.An endoscopic band ligation was performed for hemostasis and closure of the perforation.The patient was subsequently discharged without any complications.CONCLUSION A penetrating injury of the duodenum can be overlooked,so careful abdominal exploration is very important.If a missed duodenal injury is suspected,a cautious endoscopic approach may be helpful.