Gastric cancer staging comparism and role of EUS

The tumor stage of gastric cancer in the preoperative period must be evaluated to choose the type of therapy so the preoperative imaging diagnosis is the basis for a tumor-stage -adapted therapy of each patient. Is to compare between the preoperative staging of gastric cancer which includes the ultrasound scan, CT scan and EUS findings and the postoperative staging which include the histopathological finding and to assess the efficacy of EUS in determining the tumor and lymph node stage of tumor. Prospective study of 32 patients with gastric cancer admitted to the surgical word in the gastroenterology and hepatology teaching hospital, medical city, Baghdad over the period from Nov. 2005 to Nov. 2007 who underwent gastric resection, all the cases were proved to be gastric cancer by endoscopic biopsy or by histopathological examination of the gastric specimen after operative resection, and all the cases radiologically investigated in the preoperative period by abdominal ultrasound, endoluminal ultrasound and abdominal CT scan. Show that there is increase in the staging in 18 [56.25%] cases and same staging in 8 [25%] cases and decrease staging in 6 [18.75%] cases. Endoluminal ultrasound is most accurate preoperative investigation to determine staging of gastric malignancy. Ultrasound and CT scan although it is important in the assessment but they downstage the tumor in about half of cases. So we recommend that EUS is done for all patients with gastric cancer for accurate planning for surgery

Colorectal carcinoma presentation and management

Colorectal carcinoma is the most common gastrointestinal tract cancer worldwide. In men, it is the third cancer after lung and prostate cancer, while in women; it is the third common cancer after lung and breast cancer. Despite the clear relationship with aging, colorectal carcinoma is not strictly a disease of elderly and 6-8% of cases occur in patients below 40 years of age. Colorectal cancers are of favorable prognosis provided they are diagnosed and treated in early stage. This study aims to assess the patterns of presentation, distribution, and management of colorectal carcinoma in Gastroenterology and Hepatology Teaching Hospital. From November 2005 to November 2007, 80 patients with colorectal carcinoma 50 males and 30 females were admitted to the Gastroenterology and hepatology center. The age, sex, presentation, modes of investigation, stage of the cancer, treatments as well as complications have been described. Male: female ratio about 1.6:1 with peak age of incidence is 60-69 year age group, 17.5% of cases are below age of 40 most of them were with worse histopathological types and advanced stage. The main presenting symptom was bleeding per rectum 63%.The mean period between onset of presenting symptoms and final diagnosis was 7 months The most common sites were rectum 35%, Fiftythree percent were moderately differentiated, 47.5% were Dukes-C. The study highlights the distribution of colorectal carcinoma, presenting symptoms, modalities of treatment, keeping in mind the increasing incidence of colorectal carcinoma in younger age groups