ackground : Gastric cancer associated with pregnancy is rare. Because of the similarity of symptoms between gastric cancer and preganancy, limitation in diagnostic approaches and difficulties in saving both mother and fetus, the prognosis is
poor.
Therefore, we analyzed the clinical features of gastric cancer associatied with pragnancy, appropriated diagnostic approaches and practical guidliness for treatment.
Method : We collected 23 cases of gastric cancer detected during pregnancy or within 12
months after delivery from January, 1980 to June, 1992. And age of patients, approaches of
diagnosis, stage of cancer, predominant histological features, results of surgical and obstetric
treatment, and prognosis were analyzed according to the stage of pregnancy.
Results :
1) Mean age of the patients at the time of diagnosis of the gastric cancer was 29.0±3.0
years old. Age range was 20-29 years old in 14 cases and 30-39 years in 9 cases.
2) The common presenting symptoms and signs were vomiting (52.2%), nausea (47.8%)
and epigastric pain (47.8%). Mean duration from symptom onset to diagnosis was 6.5±7.8
months.
3) The percentages of patients diagnosed by endoscopic examination and barium study
was 91.3% and 8.7%, respectively. In 5 cases, the distant metastases were found incidentally
and then the primary focus was diagnosed by endoscopic examination or barium study.
4) Early gastric cancer was detected in 13.0% and advanced gastric cancer in 87.0%. In
early gastric cancer, one case was found during pregnancy.
5) The histological features of gastrc cancer were adenocardinoma in all cases and the
types were poorly differentiated cell type (38.1%) and signet ring cell type (69.1%).
6) The treatment for gastric cancer was performed by surgery only in 21.7% and by
combined surgery and chemotherapy in 21.7%.
7) The obstetric outcomes in patients diagnosed during pregnancy were normal
spontaneous delivery in one case, preterm vaginal delivery in two cases, induced abortion in
four cases and spontaneous abortion in one case.
Conclusion : As the results show most of the gastric cancers associated with pregnancy
was found in advanced state and their prognosis were grave. But some cases were early
gastric cancers and in some cases complete resection was possible. Therefore, in order to
improve the prognosis of gastric cancer associated with pregnancy, early diagnosis by
endoscopy and appropriate treatment are emphasized.
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