Prophylactic gastrectomy seems to extend life of patients with a family history of stomach cancer

Patients with a hereditary predisposition to stomach cancer may benefit from prophylactic total gastrectomy, according to recent case reports. A multinational group of clinicians have reported in the latest issue of the New England Journal of Medicine the results of genetic testing, prophylactic gastrectomies, and pathological examination of the removed stomachs in five asymptomatic members of two families affected by familial diffuse gastric cancer (2001;344:1904-9). The clinicians were led by Dr David Hunstman and colleagues from the British Columbia Cancer Agency's hereditary cancer programme in Vancouver, British Columbia, and Dr Carlos Caldas from Addenbrooke's Hospital at the University of Cambridge in England. All five patients carried germline mutations for familial diffuse gastric cancer but were asymptomatic when they decided to undergo the radical surgery. In addition, conventional imaging studies and periodic endoscopic biopsies were repeatedly negative …