Metastasis of gastric cancer spreads through the lymphatic ways, but in rare cases - through the circulatory( portal or gastric veins).Also, the cancer can germinate into the remaining organs( transversal and pancreas, abdominal wall or liver).
Peritoneal metastases are small and can extend to large areas of the parietal and visceral peritoneum. Often they are associated with ascites.
The main attention is paid to the analysis of the development of cancer metastases along the lymphatic pathways. There are 3 major lymphatic drainages, where the lymph flows away from the stomach:
- is the 1st lymphatic drainage. Performs the function of removing lymph from the right side of the stomach through the vessels( anterior and posterior adjacent walls of the stomach) through vessels carrying lymph to the regional nodes of small curvature to the cardia. Because this form of cancer is a frequent localization, it is of great importance to eliminate the regional nodes of the 1st collector;
- 2nd lymphatic flow. Carries out the removal of lymph from the lower part of the stomach through the lymphatic vessels to the lymph nodes in the gastrointestinal ligament. The operation involves cutting the ligament or removing a large omentum;
- The third lymph flow( collector) diverts from the prepyloric region of small curvature of the organ lymph. The first nodes are located at the top in the corner of the 12-colon. Metastases are easily removed.
Metastasis of stomach cancer, how many live?
If metastases of stomach cancer are detected, how many live such patients? This question is difficult to answer. Basically, the prognosis is related to the stage of the disease, the presence of distant metastases, the therapy used and the state of the patient's health.
In the early study of stomach cancer( at the zero or the first stage), cancer cells are based only on the wall and mucous membrane of the stomach. With the timely treatment of cancer, a large percentage of survival is observed.
At the second stage of the disease, malignant cells of the serous membrane( the outer shell covering the stomach) are affected. Approximately 50% of patients have a radical operation, and their recovery is observed. With impossible removal of the tumor, people die due to metastases and relapse within 2 years after surgery.
Cancer cells grow in the body, metastasizing to other organs. At the third stage of the cancer metastases appear in the lymph nodes, and in about 5 years about 40% of the patients survive. At the fourth stage of the disease, the entire lymphatic system is affected, metastases spread to the kidneys, liver and other internal organs. According to statistics, people with 3.4 stages of the disease die within 6 months from the diagnosis.
Remote gastric cancer metastases
The spread of metastases in gastric cancer is carried out lymphogenically, but they can spread by imputation, contact and hematogenous pathways. First, damage to the regional lymph nodes in the gastric ligaments is observed, after which the abdominal organs and retroperitoneal lymph nodes are affected.
The main distant metastases of stomach cancer( referred to by the authors) are Virchow metastases( to the navel, above the clavicle), Schnitzler( to the pelvis bottom), Crookenberg( ovaries).Often from distant organs, the cancer metastasizes into the liver, adrenal glands, lungs.
Metastases of stomach cancer in the liver, lungs, brain, navel
Metastases of stomach cancer spread to the liver, lungs, brain, navel, mainly by hematogenous way. Among them, the most significant are metastases to the navel, the ovaries, the left supraclavicular fossa and the Douglas space.
Basically metastasis of stomach cancer to the liver proceeds without symptoms. Only when the tumor spreads do patients feel heaviness in the right hypochondrium. Even in this situation, surgical treatment will play an important role. With the help of modern diagnostics, cancer can be identified in the early stages( ultrasound tomography, MRI, positron emission and computed tomography).
Metastases to the lungs manifest together with the alveolitis. In this case, tumor cells are formed in subperural and peribronchial lymph nodes. They show hemoptysis, coughing, and shortness of breath. Determined by fluoroscopy, computed tomography. Chemotherapy and radiation therapy are used for treatment.
Metastases in the brain are determined more often than in the primary tumor. Secondary formations in the brain rarely appear( about 10%) and are mainly formed in lung cancer.
In the late stages of the disease, small nodules with a dense structure are probed in the navel. They are dense, uneven and painless.
Metastases of stomach cancer in the bone, spine.
Only in 20% of cases of gastric cancer metastases spread to the bone or spine. This is mainly observed in breast, prostate, lung, bladder, kidney, thyroid, and other cancers.
In the bone, metastasis is carried out by the hematogenous way. Malignant neoplasms also grow into bones. Metastases can grow without symptoms, form pain, pinching of the spinal nerves, swelling, pathological fractures or myelophysis. Secondary foci can occur in any area of the skeleton( humerus, ribs, skull), but mostly - near the vertebrae. The disease is determined by scintigraphy of the skeleton, radiology.
Tumor formation rarely appears in the spine. After primary resection of the tumor, but no chemotherapy or radiotherapy, particles of cancer cells can enter the spine. Usually, metastases are manifested by neurologic pains( radiculitis), which, with an increase in the tumor, lead to paresis of the limbs.