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Gastric cancer

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<p><strong>Gastric cancer</strong> can develop in any part of the <a title="Stomach" href="/wiki/Stomach"><font color="#002bb8">stomach</font></a> and may spread throughout the stomach and to other organs; particularly the <a title="Esophagus" href="/wiki/Esophagus"><font color="#002bb8">esophagus</font></a>, <a class="mw-redirect" title="Lungs" href="/wiki/Lungs"><font color="#002bb8">lungs</font></a> and the <a title="Liver" href="/wiki/Liver"><font color="#002bb8">liver</font></a>. Stomach cancer causes about 800,000 deaths worldwide per year.<sup id="cite_ref-WHO_0-0" class="reference"><a href="#cite_note-WHO-0"><font size="2"><font color="#002bb8"><span>[</span>1<span>]</span></font></font></a></sup></p>
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<h2>Contents</h2>
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<li class="toclevel-1 tocsection-1"><a href="#Signs_and_symptoms"><font color="#002bb8"><span class="tocnumber">1</span> <span class="toctext">Signs and symptoms</span></font></a> </li>
<li class="toclevel-1 tocsection-2"><a href="#Causes"><font color="#002bb8"><span class="tocnumber">2</span> <span class="toctext">Causes</span></font></a> </li>
<li class="toclevel-1 tocsection-3"><a href="#Diagnosis"><font color="#002bb8"><span class="tocnumber">3</span> <span class="toctext">Diagnosis</span></font></a>
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<li class="toclevel-2 tocsection-4"><a href="#Histopathology"><font color="#002bb8"><span class="tocnumber">3.1</span> <span class="toctext">Histopathology</span></font></a> </li>
<li class="toclevel-2 tocsection-5"><a href="#Staging"><font color="#002bb8"><span class="tocnumber">3.2</span> <span class="toctext">Staging</span></font></a> </li>
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<li class="toclevel-1 tocsection-6"><a href="#Management"><font color="#002bb8"><span class="tocnumber">4</span> <span class="toctext">Management</span></font></a>
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<li class="toclevel-2 tocsection-7"><a href="#Surgery"><font color="#002bb8"><span class="tocnumber">4.1</span> <span class="toctext">Surgery</span></font></a> </li>
<li class="toclevel-2 tocsection-8"><a href="#Chemotherapy"><font color="#002bb8"><span class="tocnumber">4.2</span> <span class="toctext">Chemotherapy</span></font></a> </li>
<li class="toclevel-2 tocsection-9"><a href="#Radiation_therapy"><font color="#002bb8"><span class="tocnumber">4.3</span> <span class="toctext">Radiation therapy</span></font></a> </li>
<li class="toclevel-2 tocsection-10"><a href="#Multimodality_therapy"><font color="#002bb8"><span class="tocnumber">4.4</span> <span class="toctext">Multimodality therapy</span></font></a> </li>
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<li class="toclevel-1 tocsection-11"><a href="#Epidemiology"><font color="#002bb8"><span class="tocnumber">5</span> <span class="toctext">Epidemiology</span></font></a> </li>
<li class="toclevel-1 tocsection-12"><a href="#References"><font color="#002bb8"><span class="tocnumber">6</span> <span class="toctext">References</span></font></a> </li>
<li class="toclevel-1 tocsection-13"><a href="#External_links"><font color="#002bb8"><span class="tocnumber">7</span> <span class="toctext">External links</span></font></a> </li>
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<h2><span id="Signs_and_symptoms" class="mw-headline">Signs and symptoms</span></h2>
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<div style="WIDTH: 182px" class="thumbinner"><a class="image" href="/wiki/File:Linitis_plastica_2.jpg"><img class="thumbimage" alt="" width="180" height="165" src="http://upload.wikimedia.org/wikipedia/commons/thumb/9/94/Linitis_plastica_2.jpg/180px-Linitis_plastica_2.jpg" width="180" height="165" /></a>
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Endoscopic image of <a title="Linitis plastica" href="/wiki/Linitis_plastica"><font color="#002bb8">linitis plastica</font></a>, a type of stomach cancer where the entire <a title="Stomach" href="/wiki/Stomach"><font color="#002bb8">stomach</font></a> is invaded, leading to a leather bottle-like appearance with <a title="Bleeding" href="/wiki/Bleeding"><font color="#002bb8">blood</font></a> coming out of it.</div>
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<h3><span id="Histopathology" class="mw-headline">Histopathology</span></h3>
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<div style="WIDTH: 182px" class="thumbinner"><a class="image" href="/wiki/File:Adenocarcinoma_low_differentiated_(stomach)_H%26E_magn_400x.jpg"><img class="thumbimage" alt="" width="180" height="144" src="http://upload.wikimedia.org/wikipedia/commons/thumb/8/85/Adenocarcinoma_low_differentiated_%28stomach%29_H%26E_magn_400x.jpg/180px-Adenocarcinoma_low_differentiated_%28stomach%29_H%26E_magn_400x.jpg" width="180" height="144" /></a>
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Poor to moderately differentiated adenocarcinoma of the stomach. <a title="H&amp;E stain" href="/wiki/H%26E_stain"><font color="#002bb8">H&amp;E stain</font></a>.</div>
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<div style="WIDTH: 182px" class="thumbinner"><a class="image" href="/wiki/File:Gastric_signet_ring_cell_carcinoma_histopatholgy_(1).jpg"><img class="thumbimage" alt="" width="180" height="135" src="http://upload.wikimedia.org/wikipedia/commons/thumb/1/11/Gastric_signet_ring_cell_carcinoma_histopatholgy_%281%29.jpg/180px-Gastric_signet_ring_cell_carcinoma_histopatholgy_%281%29.jpg" width="180" height="135" /></a>
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Gastric signet ring cell carcinoma. <a title="H&amp;E stain" href="/wiki/H%26E_stain"><font color="#002bb8">H&amp;E stain</font></a>.</div>
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<div style="WIDTH: 182px" class="thumbinner"><a class="image" href="/wiki/File:Gastric_adenocarcinoma.jpg"><img class="thumbimage" alt="" width="180" height="135" src="http://upload.wikimedia.org/wikipedia/commons/thumb/5/56/Gastric_adenocarcinoma.jpg/180px-Gastric_adenocarcinoma.jpg" width="180" height="135" /></a>
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Adenocarcinoma of the stomach and <a title="Intestinal metaplasia" href="/wiki/Intestinal_metaplasia"><font color="#002bb8">intestinal metaplasia</font></a>. <a title="H&amp;E stain" href="/wiki/H%26E_stain"><font color="#002bb8">H&amp;E stain</font></a>.</div>
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<h2><span id="Epidemiology" class="mw-headline">Epidemiology</span></h2>
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<div style="WIDTH: 182px" class="thumbinner"><a class="image" href="/wiki/File:Stomach_cancer_world_map_-_Death_-_WHO2004.svg"><img class="thumbimage" alt="" width="180" height="79" src="http://upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Stomach_cancer_world_map_-_Death_-_WHO2004.svg/180px-Stomach_cancer_world_map_-_Death_-_WHO2004.svg.png" width="180" height="79" /></a>
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<div class="magnify"><a class="internal" title="Enlarge" href="/wiki/File:Stomach_cancer_world_map_-_Death_-_WHO2004.svg"><img alt="" width="15" height="11" src="http://bits.wikimedia.org/skins-1.5/common/images/magnify-clip.png" width="15" height="11" /></a></div>
<a title="Age adjustment" href="/wiki/Age_adjustment"><font color="#002bb8">Age-standardized</font></a> death from stomach cancer per 100,000&nbsp;inhabitants in 2004.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><font size="1"><font color="#002bb8"><span>[</span>14<span>]</span></font></font></a></sup>
<div style="-moz-column-count: 3; column-count: 3" class="references-small"><span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #b3b3b3 1px solid; BORDER-LEFT: #b3b3b3 1px solid; BACKGROUND-COLOR: #b3b3b3; COLOR: #b3b3b3; BORDER-TOP: #b3b3b3 1px solid; BORDER-RIGHT: #b3b3b3 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;no data</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ffff65 1px solid; BORDER-LEFT: #ffff65 1px solid; BACKGROUND-COLOR: #ffff65; COLOR: #ffff65; BORDER-TOP: #ffff65 1px solid; BORDER-RIGHT: #ffff65 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;less than 3.5</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #fff200 1px solid; BORDER-LEFT: #fff200 1px solid; BACKGROUND-COLOR: #fff200; COLOR: #fff200; BORDER-TOP: #fff200 1px solid; BORDER-RIGHT: #fff200 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;3.5-8</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ffdc00 1px solid; BORDER-LEFT: #ffdc00 1px solid; BACKGROUND-COLOR: #ffdc00; COLOR: #ffdc00; BORDER-TOP: #ffdc00 1px solid; BORDER-RIGHT: #ffdc00 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;8-12.5</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ffc600 1px solid; BORDER-LEFT: #ffc600 1px solid; BACKGROUND-COLOR: #ffc600; COLOR: #ffc600; BORDER-TOP: #ffc600 1px solid; BORDER-RIGHT: #ffc600 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;12.5-17</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ffb000 1px solid; BORDER-LEFT: #ffb000 1px solid; BACKGROUND-COLOR: #ffb000; COLOR: #ffb000; BORDER-TOP: #ffb000 1px solid; BORDER-RIGHT: #ffb000 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;17-21.5</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ff9a00 1px solid; BORDER-LEFT: #ff9a00 1px solid; BACKGROUND-COLOR: #ff9a00; COLOR: #ff9a00; BORDER-TOP: #ff9a00 1px solid; BORDER-RIGHT: #ff9a00 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;21.5-26</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ff8400 1px solid; BORDER-LEFT: #ff8400 1px solid; BACKGROUND-COLOR: #ff8400; COLOR: #ff8400; BORDER-TOP: #ff8400 1px solid; BORDER-RIGHT: #ff8400 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;26-30.5</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ff6e00 1px solid; BORDER-LEFT: #ff6e00 1px solid; BACKGROUND-COLOR: #ff6e00; COLOR: #ff6e00; BORDER-TOP: #ff6e00 1px solid; BORDER-RIGHT: #ff6e00 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;30.5-35</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ff5800 1px solid; BORDER-LEFT: #ff5800 1px solid; BACKGROUND-COLOR: #ff5800; COLOR: #ff5800; BORDER-TOP: #ff5800 1px solid; BORDER-RIGHT: #ff5800 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;35-40</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ff4200 1px solid; BORDER-LEFT: #ff4200 1px solid; BACKGROUND-COLOR: #ff4200; COLOR: #ff4200; BORDER-TOP: #ff4200 1px solid; BORDER-RIGHT: #ff4200 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;40-45</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #ff2c00 1px solid; BORDER-LEFT: #ff2c00 1px solid; BACKGROUND-COLOR: #ff2c00; COLOR: #ff2c00; BORDER-TOP: #ff2c00 1px solid; BORDER-RIGHT: #ff2c00 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;45-50</span> <span style="PADDING-BOTTOM: 1px; MARGIN: 0px; DISPLAY: block; FONT-SIZE: 90%"><span style="BORDER-BOTTOM: #cb0000 1px solid; BORDER-LEFT: #cb0000 1px solid; BACKGROUND-COLOR: #cb0000; COLOR: #cb0000; BORDER-TOP: #cb0000 1px solid; BORDER-RIGHT: #cb0000 1px solid">&nbsp;&nbsp;&nbsp;&nbsp;</span>&nbsp;more than 50</span></div>
<div style="-moz-column-count: 2; column-count: 2" class="references-small references-column-count references-column-count-2">
<ol class="references">
<li id="cite_note-WHO-0">^ <a href="#cite_ref-WHO_0-0 <li id="cite_note-WHO-0">^ <a href="#cite_ref-WHO_0-0
</ol>
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<h2><span id="External_links" class="mw-headline">External links</span></h2>
<ul>
<li><a title="National Cancer Institute" href="/wiki/National_Cancer_Institute"><font color="#002bb8">National Cancer Institute</font></a> <a class="external text" rel="nofollow" href="http://www.cancer.gov/cancertopics/pdq/treatment/gastric/HealthProfessional/page1" rel="nofollow"><font color="#3366bb">Gastric cancer treatment guidelines</font></a> </li> <li><a class="external text" rel="nofollow" href="http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&amp;part=hgc" rel="nofollow"><font color="#3366bb">GeneReview/NIH/UW entry on Hereditary Diffuse Gastric Cancer</font></a> </li> <li><a class="external text" rel="nofollow" href="http://www.nostomachforcancer.org" rel="nofollow"><font color="#3366bb">No Stomach For Cancer | Be Strong Hearted</font></a> is a source of information and support for Hereditary Diffuse Gastric Cancer and carriers of the CDH1 gene mutation and their families/friends. </li> <li><span class="citation web"><a class="external text" rel="nofollow" href="http://web.tiscali.it/iodio/" rel="nofollow"><font color="#3366bb">&quot;Stomach Cancer. In: Iodine Deficiency: studies by dr. Sebastiano Venturi (Italy)&quot;</font></a><span class="printonly">. <a class="external free" rel="nofollow" href="http://web.tiscali.it/iodio/" rel="nofollow"><font color="#3366bb">http://web.tiscali.it/iodio/</font></a></span><span class="reference-accessdate">. Retrieved 2008-05-15</span>.</span><span class="Z3988" title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=bookitem&amp;rft.btitle=Stomach+Cancer.+In%3A+Iodine+Deficiency%3A+studies+by+dr.+Sebastiano+Venturi+%28Italy%29&amp;rft.atitle=&amp;rft_id=http%3A%2F%2Fweb.tiscali.it%2Fiodio%2F&amp;rfr_id=info:sid/en.wikipedia.org:Stomach_cancer"><span style="DISPLAY: none">&nbsp;</span></span> </li>
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