[Verse 1]
H. pylori carving ulcers in the antrum every night
Nitrosamines in the salted fish, smoked meat ignite
Atrophic gastritis, intestinal metaplasia chain
Lauren's intestinal type climbing from that acid terrain
Diffuse type scattered, signet cells no gland to claim
CDH1 mutation, hereditary diffuse by name
Japan and Korea screening with their scopes at forty-plus
Catching early lesions while the West still makes a fuss
[Chorus]
Stage it with EUS, CT scanning every phase
PET for distant spread, laparoscopy for the haze
Cytology from washing if the peritoneum's grey
Siewert one two three — the junction marks the play
D2 dissection, fifteen nodes to count and weigh
FLOT perioperative, four cycles either way
Mnemonic locked: EMR-ESD-D2-FLOT today
[Verse 2]
Early gastric cancer, mucosa or submucosa bound
ESD expands the criteria, absolute and expanded ground
Absolute: two centimetres, elevated, differentiated, clear
Expanded: ulcerated, three centimetres, still resectable here
eCura system scores the risk when margins start to blur
Subtotal gastrectomy for distal tumours that occur
Five-centimetre proximal margin for intestinal type
Diffuse requires more distance, so total is your gripe
Proximal gastrectomy with double-tract reconstruction kept
For proximal early lesions, oesophageal function's swept
[Chorus]
Stage it with EUS, CT scanning every phase
PET for distant spread, laparoscopy for the haze
Cytology from washing if the peritoneum's grey
Siewert one two three — the junction marks the play
D2 dissection, fifteen nodes to count and weigh
FLOT perioperative, four cycles either way
Mnemonic locked: EMR-ESD-D2-FLOT today
[Bridge]
Dutch trial showed D2 survival matched at fifteen years
Splenectomy and pancreatectomy add complication fears
MRC confirmed the Western surgeons need the volume trained
JCOG trials proved laparoscopic D2 can be sustained
KLASS and CLASS and robotic platforms closing gaps
Billroth one anastomosis, Billroth two with Braun perhaps
Roux-en-Y diverts the bile, jejunal pouch adds volume back
Intergroup zero-one-sixteen chemoradiation on the rack
CLASSIC capecitabine oxaliplatin adjuvant East
ACTS-GC S-one in Japan, recurrence is decreased
HER2 positive, add trastuzumab, survival blooms
CheckMate six-four-nine nivolumab fills those rooms
[Verse 3]
CDH1 germline mutation prophylactic total gut
Counsel at twenty-five, no scope can catch the signet cut
Palliative stenting for obstruction, bypass when it fails
Palliative gastrectomy for bleeding that derails
Surveillance CT every six to twelve months post-resection
Peritoneal recurrence commonest direction
Siewert one treated like oesophageal with Ivor-Lewis flair
Siewert three handled gastric-style, total with D2 care