In the setting of FAP, colonic interposition is not an option given the 100% risk for colonic adenomatous polyps and malignant transformation, necessitating total colectomy (5). Roux-en-Y gastrojejunostomy could be considered, however our patient had pre-operative symptoms of early satiety; secondarily due to the significant polyp burden in his stomach, a total gastrectomy was

felt to be the best therapeutic option. The jejunal interposition flap has several advantages including low perioperative risk, good motor activity Inhibitors,research,lifescience,medical of the flap and lower incidence of intrinsic disease compared with other forms of reconstruction (6). Conclusions FAP is associated with gastric polyposis, which is typically asymptomatic. In the setting of symptomatic

gastric polyposis, total gastrectomy with isoperistaltic jejunal interposition is a viable therapeutic option. Acknowledgements Disclosure: The authors declare no conflict of interest.
Treatment of advanced gastric cancer, traditionally with double or triple cytotoxic chemotherapy regimens, involves an advantage in Inhibitors,research,lifescience,medical overall survival of about 7-11 months compared to best supportive care (1). Though some data have emerged from a recent meta-analysis (2), there is currently no standard of treatment in the gastric cancer first-line setting. Again, Inhibitors,research,lifescience,medical at the time we were deciding how to treat our patient one was unable to use trastuzumab in metastatic gastric or gastroesophageal junction Inhibitors,research,lifescience,medical (GEJ) cancer HER2 positive, resulting later in a significant benefit in combination with cisplatin and 5-FU or capecitabine vs. chemotherapy alone (3). Starting from gene expression tumor profiling, and given the presence of epidermal growth factor (EGF) in 25-30% of gastric cancer as well as the positive experience obtained in the metastatic colorectal cancer (mCRC) setting Inhibitors,research,lifescience,medical (4), we were prompted to investigate anti-EGFR therapy in gastric and GEJ cancer. Epidermal growth factor receptor (EGFR) is over expressed in 18-81% of gastric cancer, representing an unfavorable prognostic marker in multivariate data, typically associated with older age,

more aggressive histology, higher stage disease and shorter survival. Tumors exhibiting EGF and EGFR simultaneously show a greater degree of local invasion and lymph node metastasis. Case Dacomitinib report A 52-year old woman with recurrent epigastric pain and significant weight loss underwent esophagogastroduodenoscopy which revealed a large ulcerated lesion in the gastric antrum-body. Pre-operative radiological investigations did not show any metastatic disease. In November 2003, the patient underwent total gastrectomy with omentectomy and D2 lymphadenectomy, mechanical end-to-side anastomosis of the jejunal loop excluded by Roux. The antral region proved to have a macroscopic ulcerative vegetating lesion of about 6 cm infiltrating the wall and extending to the sierosa and adipose perigastric tissue.