Linitis plastica natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

If left untreated, patients with linitis plastica may progress to develop symptoms associated with decreased peristalsis of the stomach. This may include dyspepsia, dysphagia, nausea, vomiting, increased satiety, and regurgitation. Linitis plastica has an insidious onset and can remain clinicslly silent until its advanced stages. At this point, the prognosis is poor. The presence of metastasis or signet ring cells is associated with a particularly poor prognosis. Linitis plastica is associated with a 5-year survival rate of approximately 3-10% in Japan and Europe.

Natural History

  • Diffuse gastric adenocarcinoma or linitis plastica remains asymptomatic for a long time before diagnosis. Therefore, when a patient presents with symptoms, the disease is usually in an advanced stage.[1][2]
  • If left untreated, patients with linitis plastica may progress to develop symptoms of decreased peristalsis of the stomach including, dyspepsia, dysphagia, nausea, vomiting, increased satiety, and regurgitation.

Complications

Patients with linitis plastica may progress to develop gastric outlet obstruction from the rigid stomach wall that limits the process of digestion.[3]

Prognosis

  • Depending upon the stage of linitis plastica at the time of diagnosis, the prognosis may vary.[2]
  • The presence of metastasis is associated with a particularly poor prognosis among patients with linitis plastica because of the rapid peritoneal and lymphatic spread of the disease.
  • Linitis plastica is associated with a 5-year survival rate of approximately 3-10% in Japan and Europe.

References

  1. Jafferbhoy S, Shiwani H, Rustum Q (2013). "Managing Gastric Linitis Plastica: Keep the scalpel sheathed". Sultan Qaboos Univ Med J. 13 (3): 451–3. PMC 3749031. PMID 23984032.
  2. 2.0 2.1 Gastric linitis plastica. Orphanet. http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=36273 Accessed on November 19, 2015.
  3. Shiver SA, Blaivas M (2004). "Gastric outlet obstruction secondary to linitis plastica of the stomach as shown on transabdominal sonography". J Ultrasound Med. 23 (7): 989–92. PMID 15292571.



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