Marbun Vania Myralda Giamour, Putranto Agi Satria
Digestive Division of General Surgery Department, Faculty of Medicine, Universitas Indonesia, General Surgery Department, Cipto Mangunkusumo Hospital, Jalan Diponegoro #71, Senen, Central Jakarta, Indonesia.
Int J Surg Case Rep. 2020;75:338-344. doi: 10.1016/j.ijscr.2020.09.109. Epub 2020 Sep 21.
Gastric cancer in pregnancy is a very rare case with an incidence of 0.016% and is mostly detected in a locally advanced or advanced stage due to misinterpretation of non-specific signs and symptoms. Management of gastric cancer in pregnancy should emphasize mother and fetal survival. Currently, there is no diagnostic and management guidance for gastric cancer in pregnancy. The purpose of this study is to ascertain how to diagnose and manage gastric cancer in pregnancy.
This study is an evidence-based case report performed in Digestive Division of Department of Surgery in Cipto Mangunkusumo hospital in September-October 2017. Literature search on databases such as Cochrane, PubMed, ScienceDirect, and Scholar Google used keywords like "gastric cancer" AND "pregnant" OR "pregnancy" with inclusion criteria which are systematic review, randomized-clinical trial (RCT), cohort study, case report, or case series, performed in human and published in the last 10 years in English language. Critical appraisal is done according to Oxford Centre For Evidence-Based Medicine 2011. This work is reported in line with the SCARE criteria.
There are 9 case-report studies and 1 case-control study. Radiology examination includes endoscopy, MRI, and CT scan. Management is given according to cancer stage which is; surgery, surgery with adjuvant therapy, and palliative chemotherapy.
Radiology examinations with a lower risk of adverse effects are endoscopy and MRI. CT scan may be performed when the benefits exceed the risk. Surgery and chemoradiation have the lowest rate of adverse effects when done in the second and third trimester.
妊娠期胃癌是一种非常罕见的病例，发病率为0.016%，由于对非特异性体征和症状的误解，大多在局部晚期或晚期被发现。妊娠期胃癌的治疗应强调母婴生存。目前，尚无针对妊娠期胃癌的诊断和治疗指南。本研究的目的是确定如何诊断和治疗妊娠期胃癌。
本研究是一项基于证据的病例报告，于2017年9月至10月在西爪哇省勿加泗市西托·曼贡库苏莫医院外科消化科进行。在Cochrane、PubMed、ScienceDirect和谷歌学术等数据库上进行文献检索，使用“胃癌”和“怀孕”或“妊娠”等关键词，纳入标准为系统评价、随机临床试验（RCT）、队列研究、病例报告或病例系列，研究对象为人类，且在过去10年以英文发表。根据牛津循证医学中心2011年的标准进行严格评价。本研究按照SCARE标准报告。
有9项病例报告研究和1项病例对照研究。影像学检查包括内镜检查、MRI和CT扫描。根据癌症分期进行治疗，即手术、辅助治疗手术和姑息化疗。
不良反应风险较低的影像学检查是内镜检查和MRI。当益处超过风险时可进行CT扫描。在妊娠中期和晚期进行手术和放化疗时，不良反应发生率最低。
