Gastric cancer during pregnancy

Area of Science:

• Oncology
• Gastroenterology
• Obstetrics & Gynecology

Background:

• Gastric cancer is a significant global health concern.
• Pregnancy-associated gastric cancer (PAGC) is exceptionally rare, posing diagnostic and therapeutic challenges.
• Limited data exists on the management and outcomes of PAGC.

Purpose of the Study:

• To report on the incidence and outcomes of gastric cancer diagnosed during pregnancy.
• To review the management strategies for patients with PAGC.
• To highlight the potential for successful treatment combining oncologic surgery and obstetric delivery.

Main Methods:

• Retrospective analysis of gastric cancer patients admitted between 1966 and 1993.
• Identification of cases where gastric cancer was diagnosed concurrently with pregnancy.
• Review of treatment modalities and patient outcomes, including survival and disease progression.

Main Results:

• Out of 3,256 gastric cancer patients, only 3 (0.1%) cases were associated with pregnancy.
• Two patients with stage IVb gastric cancer experienced peritoneal metastasis, with one succumbing before surgery and the other 12 months post-palliative gastrectomy.
• One patient with stage IIIb gastric cancer underwent successful synchronous extended total gastrectomy and cesarean section, remaining well at follow-up, as was her child.

Conclusions:

• Pregnancy-associated gastric cancer is a rare clinical entity with a generally poor prognosis, particularly in advanced stages.
• Aggressive surgical management, including synchronous gastrectomy and cesarean section, may offer a viable treatment option for selected patients with early-stage disease.
• Further research is warranted to establish optimal management protocols for PAGC, balancing maternal oncologic needs with fetal well-being.