DOCSLIB.ORG

Comparison of Survival and Prognostic Factors in Patients with Gastric Adenocarcinoma in T2 and T3 Original Article377

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Comparison of Survival and Prognostic Factors in Patients with Gastric Adenocarcinoma in T2 and T3 Original Article377 Jucá Comparison of survival and prognostic factors in patients with gastric adenocarcinoma in T2 and T3 Original Article377 Comparison of survival and prognostic factors in patients with gastric adenocarcinoma in T2 and T3 Comparação da sobrevivência e dos fatores prognósticos em pacientes com adenocarcinoma gástrico T2 e T3 PATRÍCIA CAMPOS JUCÁ – ACBC-RJ1; LAERCIO LOURENÇO – TCBC-SP2; RUBENS KESLEY – TCBC-RJ1; EDUARDO LINHARES RIELLO DE MELLO – TCBC-RJ1; IVANIR MARTINS DE OLIVEIRA 3; JOSÉ HUMBERTO SIMÕES CORREA – TCBC-RJ1 ABSTRACT Objective: To compare the survival and prognosis after surgical treatment of patients with gastric adenocarcinoma which extends to the muscular layer (T2), and patients whose tumor invades the subserosa (T3). Methods: This was a retrospective study of 122 patients with gastric cancer invading the muscularis propria and subserosa, undergoing surgical treatment from January 1997 to December 2008 and followed-up until December 2010. We analyzed demographic, surgical and pathological variables. Results: Of the 122 patients, 22 (18%) were excluded from the final analysis because they showed: positive margin or less than 15 lymph nodes in the surgical specimen, early postoperative mortality and second primary tumors. Among the 100 patients included, 75 had tumors inveding the muscularis propria (T2) and 25 with extension to the subserosa (T3). Overall survival was 83.8%, and 90.6% for T2 and 52.1% or T3. Univariate analysis showed statistical significance in: lymph node metastasis (p = 0.02), tumor size (p = 0.000), tumor pathological stage (p = 0.000), lymph node pathologic stage (p = 0.000) and staging by classification of groups TNM-UICC/AJCC, 2010 (p = 0.000). In multivariate analysis, independent prognostic factors were tumor size and lymph node pathological staging (pN). Conclusion: The lymph node status and tumor size are independent prognostic factors in tumors with invasion of the muscularis propria and in tumors with invasion of subserosa. T2 lesions have smaller size, lower rate of lymph node metastasis and therefore better prognosis than T3. Key words: Prognosis. Neoplasms. Stomach neoplasms. Adenocarcinoma. Survival rate. INTRODUCTION adjacent structures. Surgical treatment remains the only curative treatment modality3,4 and the extent of resection he incidence of gastric cancer (GC) is decreasing depends on pre and intraoperative localization of the tu- Tworldwide since 1950. However, its aggressiveness, mor, the degree of penetration of the tumor in the stomach malignancy and, consequently, its prognosis remains wall, invasion of adjacent organs and lymph node unchanged, representing the second leading cause of cancer metastasis5 ,6. death, with 628,000 (12.1%) deaths per year1. In Brazil, The identification of prognostic factors in GA according to the National Cancer Institute2 (INCA), the is important to establish the staging and determining estimated incidence of GC for the year 2011 pointed to therapeutic strategies. The tumor that invades the mucosa 21,500 new cases of the disease, 13,820 being in men and submucosa layers (T1), independent of lymph node (64.3%) and 7,680 in women (35, 7%), corresponding to status, is classified as early gastric cancer (EGC), with an estimated risk of 14 new cases per 100,000 men and five-year survival of 93.5% of operated patients, 72.8% eight for every 100,000 women, consolidating its position being in those with positive nodes and 95.6% for those as the fifth malignant tumor in incidence, the second of with no lymph node metastases. When the tumor goes the gastrointestinal tract. beyond the submucosal layer and invades the muscularis Gastric adenocarcinoma (GA) is the most propria (T2), it is classified as advanced gastric cancer common histological type (95%), originating in the (AGC), but it is considered an intermediate stage of tu- epithelium of the gastric mucosa and progressively mor progression between the AGC and EGC, with better involving the entire stomach wall to reach the serosa and prognosis and survival in five years7-14. This category (T2), From the PostGraduate Program in Interdisciplinary Surgical Science, Master’s Degree level, Federal University of São Paulo, São Paulo Medical School, São Paulo State – SP, Brazil. 1. Staff Surgeon, National Cancer Institute – INCA, Rio de Janeiro; 2. Associate Professor, Department of Surgery, Federal University of São Paulo; 3. Head, Pathology Service, National Cancer Institute – INCA, Rio de Janeiro. Rev. Col. Bras. Cir. 2012; 39(5): 377-384 Jucá 378 Comparison of survival and prognostic factors in patients with gastric adenocarcinoma in T2 and T3 infrequent, represents 8% to 18% of resected GCs in METHODS Japan13. The TNM classification of the 2010 American We studied 122 patients with GA, with Joint Committee on Cancer (AJCC) establishes criteria for invasion of the muscularis propria (T2) and invasion of staging based on tumor invasion of the gastric wall, lymph subserosa (T3). All patients were treated at the node invasion and distant metastases. Tumors are grouped Department of Abdominopelvic Surgery, Cancer Hos- into categories according to the stomach wall invasion pital I, INCA, between January 1997 and December (T), number of positive lymph nodes (N) and presence of 2008, and followed up until December 2010. The study distant metastases (M). In 1998, the College of American was approved by the Ethics in Research Committee of Pathologists recommended the subclassification of T2 into the National Cancer Institute, registration number 69/ T2a “ invasion of the muscularis propria, and T2b “ 2009, and of the Federal University of São Paulo under invasion of the subserosa, to allow for better prognostic the record 1484/2009. and survival evaluation in these patients15. In the beginning Of the 122 patients, 22 were excluded from the of this study, we used the sixth edition of the classification final analysis: one due to margins compromised by neoplasia TNM-UICC/AJCC16, which defined this subdivision, in the final histopathology (0.8%); four died in the first 30 recommended by the College of American Pathologists postoperative days (3.2%); four had a second primary tu- for T2, however, with no change in the staging of the mor (3.2%); and 13 had fewer than 15 resected lymph groups that include T2 lesions (stages IB, II and IIIA), ie nodes (10.6%). pT2aN0 and pT2bN0 stage I and pT2aN1 and pT2bN1 Of the 100 patients included, 75 had tumors with stage II. Only lymph node commitment determined the invasion of the muscularis propria (T2), and 25, with invasion change of stage16. of subserosa (T3), according to the seventh edition of the In 2010 the seventh edition of the classification TNM-UICC/AJCC, 201017. The radical surgical classification TNM-UICC/AJCC17 was published, which treatment followed the criteria of the Japanese Gastric separated tumors restricted to the muscularis propria Cancer Association (JGCA)5 according to tumor site. A and those invading the subserosa, T2 and T3, subtotal gastrectomy (STG) was performed in tumors of respectively, into different categories and stages. The the distal stomach, and a total gastrectomy (TG) in tumors T2a remains in the T2 category and T2b passes to of the proximal third. Tumors in the middle third underwent category T3. The nodal pathologic stage (pN) was also STG or GT depending on the distance from the proximal modified, N1 comprising one to two lymph nodes, N2 edge of the tumor to the GEJ. three to six, N3a seven to 15 and N3b 16 or more Lymphadenectomy was performed based on the lymph nodes. In staging by groups, categories T2 and location of the tumor in the stomach, including the lymph T3 were separated, T2N0 becoming stage IB, T3N0 nodes of level I and / or II, according to the report of the and T2N1 stage IIA, T3N1 and T2N2 stage IIB, T3N2 surgeon and the criteria of the Japanese classification5, and T2N3 stage IIIA and T3N3 stage IIIB. This current being considered adequate the sampling of at least 15 classification excludes tumors of the esophagogastric resected lymph nodes. The resection was considered curative junction (EGJ) or that originate in the stomach less (R0) in the absence of macroscopic or microscopic residual than 5cm to the EGJ and invade it. These tumors, of tumor, with margins, proximal and distal, free of neoplasia poor prognosis, are now staged as esophageal at pathology exam during surgery, and in the absence of adenocarcinomas17. This separation of T2 and T3 in distant disease6. different groups of patients confirms that T2 GC has a The demographic variables studied were age and different prognosis from T3. The identification of gender. Patients were divided into two age groups, with prognostic factors related to T2 is important because, 60 years or less and more than 60 years, determined by in this intermediate stage, the cancer may be curable the median and average age. with an appropriate surgical procedure that includes Variables included the type of surgical D2 lymphadenectomy. gastrectomy, total or subtotal, and the extent of There are few published studies evaluating lymphadenectomy performed, level 1 (D1) and level 1 and the prognostic factors in patients with T28,10,13,14. 2 (D2), described by the surgeon. Several studies suggest a favorable prognosis for The macroscopic pathologic variables analyzed survival with T2 in five years, close to T18,18-21. Other according to the mean and median found were tumor size series report that the subclassification of T2 (T2/T3) (d” 5 cm or> 5 cm) and the number of lymph nodes resected has no value in the presence of metastatic lymph (d” 33 lymph nodes and> 33 lymph nodes). The macroscopic nodes, since these latter are the determinants of appearance of tumors was analyzed according to the prognosis10,22. classification of Borrmann23 for AGC, including the zero This study aims to compare survival and prognosis category according to the Japanese classification for EGC of patients with T2 and T3 gastric adenocarcinoma after (JGCA)5, when the macroscopic appearance of tumors surgical treatment.
Load more

Recommended publications
  • Appendiceal GCC and LAMN Navigating the Alphabet Soup in the Appendix
    2018 Park City AP Update Appendiceal GCC and LAMN Navigating the Alphabet Soup in the Appendix Sanjay Kakar, MD University of California, San Francisco Appendiceal tumors Low grade appendiceal mucinous neoplasm • Peritoneal spread, chemotherapy • But not called ‘adenocarcinoma’ Goblet cell carcinoid • Not a neuroendocrine tumor • Staged and treated like adenocarcinoma • But called ‘carcinoid’ Outline • Appendiceal LAMN • Peritoneal involvement by mucinous neoplasms • Goblet cell carcinoid -Terminology -Grading and staging -Important elements for reporting LAMN WHO 2010: Low grade carcinoma • Low grade • ‘Pushing invasion’ LAMN vs. adenoma LAMN Appendiceal adenoma Low grade cytologic atypia Low grade cytologic atypia At minimum, muscularis Muscularis mucosa is mucosa is obliterated intact Can extend through the Confined to lumen wall Appendiceal adenoma: intact muscularis mucosa LAMN: Pushing invasion, obliteration of m mucosa LAMN vs adenocarcinoma LAMN Mucinous adenocarcinoma Low grade High grade Pushing invasion Destructive invasion -No desmoplasia or -Complex growth pattern destructive invasion -Angulated infiltrative glands or single cells -Desmoplasia -Tumor cells floating in mucin WHO 2010 Davison, Mod Pathol 2014 Carr, AJSP 2016 Complex growth pattern Complex growth pattern Angulated infiltrative glands, desmoplasia Tumor cells in extracellular mucin Few floating cells common in LAMN Few floating cells common in LAMN Implications of diagnosis LAMN Mucinous adenocarcinoma LN metastasis Rare Common Hematogenous Rare Can occur spread
    [Show full text]
  • Crohn's Disease of the Colon
    Gut, 1968, 9, 164-176 Gut: first published as 10.1136/gut.9.2.164 on 1 April 1968. Downloaded from Crohn's disease of the colon V. J. McGOVERN AND S. J. M. GOULSTON From the Royal Prince Alfred Hospital, Sydney, Australia The fact that Crohn's disease may involve the colon never affected unless there had been surgical inter- either initially or in association with small bowel ference. There was no overt manifestation of mal- disease is now firmly established due largely to the absorption in any of these patients. evidence presented by Lockhart-Mummery and In 18 cases the colon alone was involved. Five had Morson (1960, 1964) and Marshak, Lindner, and universal involvement, five total involvement with Janowitz (1966). This entity is clearly distinct from sparing of the rectum, two involvement of the ulcerative colitis and other forms of colonic disease. descending colon only, two the transverse colon only, Our own experience with this disorder reveals many and in the other four there was variable involvement similarities with that published from the U.K. and of areas of large bowel (Fig. 2). the U.S.A. Thirty patients with Crohn's disease involving the large bowel were seen at the Royal CLINICAL FEATURES Prince Alfred Hospital during the last decade, the majority during the past five years. The criteria for The age incidence varied from 6 to 69 years when the inclusion were based on histological examination of patient was first seen, the majority being between the operative specimens in 28 and on clinical and radio- ages of 11 and 50.
    [Show full text]
  • Nomina Histologica Veterinaria, First Edition
    NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria.
    [Show full text]
  • Small Intestine Cancer Early Detection, Diagnosis, and Staging Detection and Diagnosis
    cancer.org | 1.800.227.2345 Small Intestine Cancer Early Detection, Diagnosis, and Staging Detection and Diagnosis Catching cancer early often allows for more treatment options. Some early cancers may have signs and symptoms that can be noticed, but that is not always the case. ● Can Small Intestine Cancer (Adenocarcinoma) Be Found Early? ● Signs and Symptoms of Small Intestine Cancer (Adenocarcinoma) ● Tests for Small Intestine Cancer (Adenocarcinoma) Stages and Outlook (Prognosis) After a cancer diagnosis, staging provides important information about the extent of cancer in the body and anticipated response to treatment. ● Small Intestine Cancer (Adenocarcinoma) Stages ● Survival Rates for Small Intestine Cancer (Adenocarcinoma) Questions to Ask About Small Intestine Cancer Get some questions you can ask your cancer care team to help you better understand your cancer diagnosis and treatment options. ● Questions to Ask Your Doctor About Small Intestine Cancer 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Can Small Intestine Cancer (Adenocarcinoma) Be Found Early? (Note: This information is about small intestine cancers called adenocarcinomas. To learn about other types of cancer that can start in the small intestine, see Gastrointestinal Carcinoid Tumors1, Gastrointestinal Stromal Tumors2, or Non-Hodgkin Lymphoma3.) Screening is testing for diseases like cancer in people who do not have any symptoms. Screening tests can find some types of cancer early, when treatment is most likely to be effective. But small intestine adenocarcinomas are rare, and no effective screening tests have been found for these cancers, so routine testing for people without any symptoms is not recommended. For people at high risk For people with certain inherited genetic syndromes4 who are at increased risk of small intestine cancer, doctors might recommend regular tests to look for cancer early, especially in the duodenum (the first part of the small intestine).
    [Show full text]
  • Digestive System
    Digestive system Dr. Anna L. Kiss Department of Anatomy, Histology and Embryology Semmelweis University Budapest 2019 The gastrointestinal tract (GI tract): digestion and excretion Upper gastrointestinal tract The upper GI tract consists of the mouth, pharynx, esophagus, and stomach. The lower GI tract. small intestine, which has three parts: -duodenum -jejunum -ileum large intestine, which has three parts: -cecum (the vermiform appendix is attached to the cecum). -colon (ascending colon, transverse colon, descending colon and sigmoid flexure) -rectum Primitive Gut Tube Coeliac trunk Superior mesenteric artery Inferior mesenteric artery Vitelline duct Umbilical loop Umbilical artery Final Position of Parts of Gut Tube Abdominal esophagus Thoracic esophagus Liver Stomach Gall bladder & bile duct Duodenum Pancreas 2.) Transverse colon Jejunum & ileum 1.) Ascending colon 3.) Descending colon Cecum Appendix 4.) Sigmoid colon Final Position of Parts of Gut Tube Stomach: left hypochondric region (intraperitoneal) Duodenum: right side (partly retroperitoneal) Jejunum, ileum: umbilical + iliac region (intraperitoneal) Appendix: right side (Mc Burney point) (intraperitoneal) Ascending colon: right iliac region Transverse colon: middle position (intraperitoneal) Descending colon: left iliac region Sigmoid colon: sacral and pelvic region (intraperitoneal) highly acidic environment due to gastric acid production The stomach lies between the esophagus and the duodenum It is on the left side of the abdominal cavity. Stomach fundus cardia rugae!! lesser curvature body pylorus greater curvature Diaphragm Fundus pyloric antrum Corpus superior part body (duodenum) Greater curvature descending part (duodenum) ascending part Jejunum horizontal part Histology of the gut Mucosa: • epithelium: simple columnar (goblet cells) • propria (lymphoreticular connective tissue): glands (Lieberkhün crypts) • muscularis mucosae (2 layered smooth muscle) Submucosa: loose connective tissue (submucosus plexus; glands, lymphatic follicles) External muscle layer (t.
    [Show full text]
  • SPLANCHNOLOGY Part I. Digestive System (Пищеварительная Система)
    КАЗАНСКИЙ ФЕДЕРАЛЬНЫЙ УНИВЕРСИТЕТ ИНСТИТУТ ФУНДАМЕНТАЛЬНОЙ МЕДИЦИНЫ И БИОЛОГИИ Кафедра морфологии и общей патологии А.А. Гумерова, С.Р. Абдулхаков, А.П. Киясов, Д.И. Андреева SPLANCHNOLOGY Part I. Digestive system (Пищеварительная система) Учебно-методическое пособие на английском языке Казань – 2015 УДК 611.71 ББК 28.706 Принято на заседании кафедры морфологии и общей патологии Протокол № 9 от 18 апреля 2015 года Рецензенты: кандидат медицинских наук, доцент каф. топографической анатомии и оперативной хирургии КГМУ С.А. Обыдённов; кандидат медицинских наук, доцент каф. топографической анатомии и оперативной хирургии КГМУ Ф.Г. Биккинеев Гумерова А.А., Абдулхаков С.Р., Киясов А.П., Андреева Д.И. SPLANCHNOLOGY. Part I. Digestive system / А.А. Гумерова, С.Р. Абдулхаков, А.П. Киясов, Д.И. Андреева. – Казань: Казан. ун-т, 2015. – 53 с. Учебно-методическое пособие адресовано студентам первого курса медицинских специальностей, проходящим обучение на английском языке, для самостоятельного изучения нормальной анатомии человека. Пособие посвящено Спланхнологии (науке о внутренних органах). В данной первой части пособия рассматривается анатомическое строение и функции системы в целом и отдельных органов, таких как полость рта, пищевод, желудок, тонкий и толстый кишечник, железы пищеварительной системы, а также расположение органов в брюшной полости и их взаимоотношения с брюшиной. Учебно-методическое пособие содержит в себе необходимые термины и объём информации, достаточный для сдачи модуля по данному разделу. © Гумерова А.А., Абдулхаков С.Р., Киясов А.П., Андреева Д.И., 2015 © Казанский университет, 2015 2 THE ALIMENTARY SYSTEM (systema alimentarium/digestorium) The alimentary system is a complex of organs with the function of mechanical and chemical treatment of food, absorption of the treated nutrients, and excretion of undigested remnants.
    [Show full text]
  • Carcinoma of the Small Intestine Staging Diagram
    CARCINOMA OF THE SMALL INTESTINE STAGING DIAGRAM SITE: Duodenum (C17.0) Ileum (C17.2) (excludes ileocaecal valve C 18.0) Jejunum (C17.1) Small Intestine, NOS (C17.9) HISTOLOGY: New Recurrent Disease Referred for Follow up Definitive treatment already received. Previously treated and followed Referred as part of definitive treatment Referred at recurrence. elsewhere before referral. (initial treatment of disease). Staged at initial diagnosis. Staged at initial diagnosis. TNM 2009 T X 0 is 1 1a 1b 2 3 4 Clinical N X 0 1 2 3 M 0 1 TNM 2009 T X 0 is 1 1a 1b 2 3 4 Pathological N X 0 1 2 M 1 Completed by: Date: (dd/mm/yy) Diagnosis/Stage Amended to: Reason: By: Date: (dd/mm/yy) NOTIFY DATA QUALITY & REGISTRY IF STAGE/DIAGNOSIS IS AMENDED FORM #TH-90 Revised August 2010 Photocopy Form as Required CARCINOMA OF THE SMALL INTESTINE STAGING DIAGRAM AJCC 7th Edition for Diagnosis Date > 01 January 2010 Definitions for T, N, and M Descriptors PRIMARY TUMOUR (T)1 TX Primary tumour cannot be assessed T0 No evidence of primary tumour Tis Carcinoma in situ T1 Tumour invades lamina propria, muscularis mucosae or submucosa T1a Tumour invades lamina propria or muscularis mucosae T1b Tumour invades submucosa T2 Tumour invades muscularis propria T3 Tumour invades subserosa or non-peritonealized perimuscular tissue (mesentery or retroperitoneum2) with extension 2 cm or less T4 Tumour perforates visceral peritoneum or directly invades other organs or structures (includes other loops of small intestine, mesentery, or retroperitoneum more than 2 cm and abdominal wall by way of serosa; for duodenum only, invasion of pancreas) Note1: This classification does not apply to carcinomas of the ampulla of Vater (see Pancreas/Ampulla of Vater staging diagram).
    [Show full text]
  • Summary Stage 2018 Coding Manual 1 We Would Also Like to Give a Special Thanks to the Following Individuals at Information Management Services, Inc
    SUMMARY STAGE 2018 GENERAL CODING INSTRUCTIONS APRIL 2018 Effective with cases diagnosed January 1, 2018 and forward Prepared by Data Quality, Analysis and Interpretation Branch Surveillance Research Program Division of Cancer Control and Population Sciences National Cancer Institute U.S. Department of Health and Human Services Public Health Service National Institutes of Health Editors Jennifer Ruhl, MSHCA, RHIT, CCS, CTR, NCI SEER Carolyn Callaghan, CTR (SEER Seattle Registry) Annette Hurlbut, RHIT, CTR (Contractor) Lynn Ries, MS (Contractor) Nicki Schussler, BS (IMS) Suggested Citation: Ruhl JL, Callaghan C, Hurlbut, A, Ries LAG, Adamo P, Dickie L, Schussler N (eds.) Summary Stage 2018: Codes and Coding Instructions, National Cancer Institute, Bethesda, MD, 2018 NCI SEER Peggy Adamo, BS, AAS, RHIT, CTR Lois Dickie, CTR Serban Negoita, MD, PhD, CTR Others Bethany Fotumale, BS, CTR (SEER Utah Registry) Jennifer Hafterson, CTR (SEER Seattle Registry) Denise Harrison, BS, CTR (Santa Barbara City College) Stephanie M. Hill, MPH, CTR (SEER New Jersey Registry) Loretta Huston, BS, CTR (SEER Utah Registry) Tiffany Janes, CTR (SEER Seattle Registry) Bobbi Jo Matt, BS, RHIT, CTR (SEER Iowa Registry) Mary Mroszczyk, CTR (Massachusetts Registry) Patrick Nicolin, BA, CTR (SEER Detroit Registry) Lisa A. Pareti, BS, RHIT, CTR (SEER Louisiana Tumor Registry) Cathryn Phillips, BA, CTR (SEER Connecticut Registry) Mary Potts, RHIA, CPA, CTR (SEER Seattle Registry) Elizabeth (Liz) Ramirez-Valdez, CTR (SEER New Mexico Registry) Nancy Rold, CTR (Missouri Registry) Debbi Romney, CTR (SEER Utah Registry) Winny Roshala, BA CTR (SEER Greater California Registry) Christina Schwarz, CTR (SEER Greater Bay Area Cancer Registry) Kacey Wigren, RHIT, CTR (SEER Utah Registry) Copyright information: All material in this report may be reproduced or copied without permission; citation as to source, however, is appreciated.
    [Show full text]
  • GI Tract Anatomy
    SHRI Video Training Series 2018 dx and forward Recorded 1/2020 Colorectal Introduction & Anatomy Presented by Lori Somers, RN 1 Iowa Cancer Registry 2020 Mouth GI Tract Pharynx Anatomy Esophagus Diaphragm Liver Stomach Gallbladder Pancreas Large Small Intestine Intestine (COLON) 2 Anal Canal 1 Colorectal Anatomy Primary Site ICD-O Codes for Colon and Rectum Transverse Hep. Flex C18.4 Splen. Flex C18.3 C18.5 Ascending Large Descending C18.2 Intestine, C18.6 NOS C18.9 Cecum C18.0 Sigmoid C18.7 Appendix C18.1 Rectum C20.9 Rectosigmoid C19.9 3 ILEOCECAL JUNCTION ILEUM Ileocecal sphincter Opening of appendix APPENDIX 4 2 Rectum, Rectosigmoid and Anus Rectosigmoid junction Sigmoid colon Peritoneal Rectum reflection Dentate line Anus 5 Anal verge Peritoneum: serous membrane lining the interior of the abdominal cavity and covers the abdominal organs. Rectum is “extraperitoneal” Rectum lies below the peritoneal reflection and outside of peritoneal cavity 6 3 Greater Omentum Liver Stomach Vessels Ligament Greater Omentum: (reflected upward) Gallbladder Greater Greater Omentum Omentum Transverse colon coils of jejunum Ascending Descending colon colon Appendix Cecum coils of ileum slide 9 slide 10 7 Mesentery (Mesenteries): folds of peritoneum- these attach the colon to the posterior abdominal wall. Visceral peritoneum: = Serosa covering of colon (organs) Parietal peritoneum: = Serosa covering of ABD cavity (body cavities) 8 4 Colon & Rectum Wall Anatomy Lumen Mucosa Submucosa Muscularis propria Subserosa Serosa Peritoneum 9 Layers of Colon Wall
    [Show full text]
  • Ta2, Part Iii
    TERMINOLOGIA ANATOMICA Second Edition (2.06) International Anatomical Terminology FIPAT The Federative International Programme for Anatomical Terminology A programme of the International Federation of Associations of Anatomists (IFAA) TA2, PART III Contents: Systemata visceralia Visceral systems Caput V: Systema digestorium Chapter 5: Digestive system Caput VI: Systema respiratorium Chapter 6: Respiratory system Caput VII: Cavitas thoracis Chapter 7: Thoracic cavity Caput VIII: Systema urinarium Chapter 8: Urinary system Caput IX: Systemata genitalia Chapter 9: Genital systems Caput X: Cavitas abdominopelvica Chapter 10: Abdominopelvic cavity Bibliographic Reference Citation: FIPAT. Terminologia Anatomica. 2nd ed. FIPAT.library.dal.ca. Federative International Programme for Anatomical Terminology, 2019 Published pending approval by the General Assembly at the next Congress of IFAA (2019) Creative Commons License: The publication of Terminologia Anatomica is under a Creative Commons Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0) license The individual terms in this terminology are within the public domain. Statements about terms being part of this international standard terminology should use the above bibliographic reference to cite this terminology. The unaltered PDF files of this terminology may be freely copied and distributed by users. IFAA member societies are authorized to publish translations of this terminology. Authors of other works that might be considered derivative should write to the Chair of FIPAT for permission to publish a derivative work. Caput V: SYSTEMA DIGESTORIUM Chapter 5: DIGESTIVE SYSTEM Latin term Latin synonym UK English US English English synonym Other 2772 Systemata visceralia Visceral systems Visceral systems Splanchnologia 2773 Systema digestorium Systema alimentarium Digestive system Digestive system Alimentary system Apparatus digestorius; Gastrointestinal system 2774 Stoma Ostium orale; Os Mouth Mouth 2775 Labia oris Lips Lips See Anatomia generalis (Ch.
    [Show full text]
  • Pocket Atlas of Human Anatomy
    Pocket Atlas of Human Anatomy Founded by Heinz Feneis Bearbeitet von Wolfgang Dauber Neuausgabe 2006. Taschenbuch. 568 S. Paperback ISBN 978 3 13 511205 3 Format (B x L): 12,5 x 19 cm Weitere Fachgebiete > Medizin > Vorklinische Medizin: Grundlagenfächer > Anatomie Zu Inhaltsverzeichnis schnell und portofrei erhältlich bei Die Online-Fachbuchhandlung beck-shop.de ist spezialisiert auf Fachbücher, insbesondere Recht, Steuern und Wirtschaft. Im Sortiment finden Sie alle Medien (Bücher, Zeitschriften, CDs, eBooks, etc.) aller Verlage. Ergänzt wird das Programm durch Services wie Neuerscheinungsdienst oder Zusammenstellungen von Büchern zu Sonderpreisen. Der Shop führt mehr als 8 Millionen Produkte. 148 Alimentary System Stomach and Small Intestine 149 1 Serosa; Serous coat. Peritoneal covering con- 21 Circular layer; Short pitch helicoidal layer. sisting of simple squamous epithelium. B Inner circular muscle layer. Its cells are coiled 2 Subserosa; Subserous layer. Connective tissue tightly in a helicoidal form. F underlying the serosa. B 22 Circular folds. (Kerckring’s valves). Up to 8 mm 12 3 Muscular layer; Muscular coat. Muscular coat high permanent folds containing submucosa 13 of stomach composed of muscle fibers running that extend transversely to the intestinal axis, 3 encircling around two-thirds of the intestinal in three directions. A B 7 14 lumen. E F 4 Longitudinal layer. External layer of longitu- 23 Submucosa. Sliding layer between the muscu- dinal muscle fibers mainly at the lesser and 9 greater curvatures of stomach. A B laris mucosae and the muscular coat consisting mainly of collagenous connective tissue and 5 15 5 Circular layer. Middle layer consisting of containing vessels and nerves.
    [Show full text]
  • Morphologic Comparison of the Elastic Fibers Found in The
    TurkJMedSci 32(2002)201-205 ©TÜB‹TAK AhmetKALAYCIO⁄LU1 2 MorphologicComparisonoftheElasticFibers MithatKerimARSLAN FoundintheSubmucosalLayerinDifferent PortionsoftheStomach Received:August24,2000 Abstract: Thisstudywascarriedouton30 pylorusthanthoseinthecorpusandthe humanstomachs(fromcadavers)obtained antrum.Anotherfeatureofthisstudyisthe fromdifferentmedicalfaculties.Theelastic useofthevizopanmicroscop,whichisusedin fibersinthesubmucosallayerinthepylorus, thefieldofforestryengineeringfor corpusandantrumwerestudiedand measurements. comparedintermsoftheirlength,and 1 2 Departmentsof Anatomy, GeneralSurgery, densityperunitarea.Thesubmucosallayer FacultyofMedicine,KaradenizTechnical containingelasticfiberswaslongerandtheir KeyWords: Tunicasubmucosa,elasticfibers, University,Trabzon-Turkey densitiesperunitareaweregreaterinthe pylorus. Introduction importantroleofthepylorussphincteristheprevention Inthehumandigestivetract,thefunctionsofthe ofthereturnofthechymeintothestomachfromthe stomachdependonitsmorphology.However,theexact duodenum(7,8).Anymorphologicdisorderinthe roleofthemorphologyofthestomachwallintermsof muscularornervoustissuesofthepylorusresultsin itsfunctionisnotknown.Thestomachwallconsistsof reflux.Insomepeople,eventhoughnoneuromuscular tunicaserosa-subserosa,tunicamuscularis,tunica morpholgydisorderexists,refluxhasbeenseento submucosaandtunicamucosalayersfromexteriorto developduetotheinsufficiencyofthesphincter.Some interiorrespectively.Thetunicaserosa-subserosaand authorsreportedindogsthatelongatedligamentsmay tunicasubmucosalayerscontainelasticfibers(1).
    [Show full text]