Patient case (clinical description): A 63-year-old man comes to the clinic for recent unintentional weight loss. The patient also has epigastric discomfort after meals. He has no known medical problems and takes no medications. His blood pressure is 130/75 and pulse rate is 88/min. He is not febrile. Upper endoscopy shows a lesion in the stomach that shows typical features of diffuse-type adenocarcinoma presenting with signet ring cells that do not form glands.

Patient's own account: I went to the clinic because I had been losing so much weight that it was concerning. I'm a 63-year-old guy, and it is something rather unusual. I'm always suffering from stomachache after every meal. I've never been sick, and I don't take any medicine. The doctor took my blood pressure and told me it was 130/75, and my pulse rate was 88/min. I'm not febrile! I also had to do an endoscopy, and they found a lesion in my stomach that shows typical features of stomach cancer. I'm totally devastated...

Clinical trial: Laparoscopic Spleen-Preserving No. 10 Lymph Node Dissection for AGC

Eligibility criteria:
Inclusion Criteria:

          -  Patients age older than 18 years (including 18 years old);

          -  The primary lesion is located in the upper or middle third of the stomach, including
             Siewert II type and Siewert III type adenocarcinoma of the esophagogastric junction;

          -  Pathologically confirmed primary gastric adenocarcinoma by endoscopic biopsy
             (including papillary, tubular, mucinous, signet ring cell and poorly differentiated
             adenocarcinoma);

          -  Preoperative cancer stage cT2-4aN0-3M0 (according to AJCC-7th TNM staging);

          -  The Eastern Cooperative Oncology Group performance status of 0 or 1;

          -  The American Society of Anesthesiology classes of I, II or III;

          -  Signed Informed consent.

        Exclusion Criteria:

          -  Pregnant or lactating women;

          -  Suffering from severe mental disorder;

          -  Previous gastrectomy, including endoscopic submucosal dissection and endoscopic
             mucosal resection;

          -  Integrated or enlarged lymph node with maximum diameter larger than 3 cm according to
             preoperative imaging, including significantly enlarged or bulky No. 10 lymph nodes;

          -  Siewert I type adenocarcinoma of the esophagogastric junction;

          -  Other malignant diseases (within 5 years);

          -  Other illnesses needed operation concurrently;

          -  Complications (bleeding, perforation or obstruction) required emergency surgery due to
             primary gastric malignancy;

          -  Pulmonary function tests FEV1 less than 50% of predicted value;

          -  Patient suffered from bleeding tendency disease such as hemophilia or took
             anti-coagulant medication due to deep vein thrombosis.

          -  Patients with obvious tumor infiltration in the spleen and splenic vessels which
             require splenectomy.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Entailment