P-0036 Gastric Linitis Plastica: Experience of a Moroccan Medical Oncology Unit

Abstract

IntroductionGastric linitis plastica is a very particular malignant gastric tumor different from the usual gastric carcinoma. It refers to the diffuse proliferation of connective tissue, resulting in tissue thickening so that the stomach is constricted and rigid. MethodsIn this retrospective study, we reviewed the records of 34 patients diagnosed with gastric linitis between January 2008 and January 2012. The aim of this study is to identify the clinical, diagnostic and therapeutic features of this type of gastric cancer in Moroccan patients. ResultsThe mean age at the diagnosis was 42.6 years ranged from 25 to 69 years, 22 patients were female. The clinical symptoms were mainly vomiting (73 %), epigastric pain (79 %) and deterioration of Performance Status (94 %). In all of the cases, endoscopy has revealed rigid and thickening stomach. 68 % (n=23) of the patients were metastatic at the diagnosis, sites of metastasis were: peritoneum (71 %), lymphatic nodes (53 %), lung (32 %), liver (24 %) and the ovary (6 %). Among the 34 patients, 32 % (n=11) were treated with curative strategy by total gastrectomy followed by adjuvant concomitant chemo radiotherapy (n=5), adjuvant chemotherapy (n=4) or perioperative chemotherapy (n=2). For the metastatic patients chemotherapy regimens were distributed as following: ECC (Epirubicin 50 mg/m2, Cisplatin 60 mg/m2, Capecitabine 625 mg/m2/12h) was administered to 56 % of the cases, combination of cisplatin and 5 fluorouracil (cisplatin at the dose of 75 mg/m2 and 5 fluorouracil at 300 mg/m2 for 3 days) to 22 % of the cases, capecitabine as monotherapy for 14 %, and FUFOL Mayo Clinic regimen for 4 % of metastatic patients. While 4 % of the cases received supportive care because of deterioration of the performance status and liver blood tests. [Display omitted] [Display omitted] ConclusionThe gastric linitis plastica represent an entity with specific characteristics, which tends more toward tumor invasion depth, with nodal and peritoneal metastases. A multidisciplinary approach including cancer surgery and chemotherapy is recommended to improve the prognosis of patients with this disease.