## Anatomical Sites of Gastric Cancer **Key Point:** The antrum and pyloric region are the most common sites of gastric cancer, accounting for approximately 50–60% of cases. This is followed by the body and cardia. ### Frequency Distribution by Site | Anatomical Site | Frequency (%) | Clinical Notes | |-----------------|---------------|----------------| | **Antrum/Pylorus** | 50–60 | Most common; often ulcerating type | | **Body** | 20–25 | Intermediate frequency | | **Cardia/GE junction** | 10–15 | Often associated with Barrett's oesophagus in Western patients; adenocarcinoma | | **Fundus** | 5–10 | Least common | | **Greater curvature** | Variable (part of body/antrum) | Not a primary site classification | **High-Yield:** The antrum is the most common site because: 1. It has the longest residence time for carcinogens and H. pylori colonization 2. Chronic gastritis and intestinal metaplasia are most prevalent here 3. The mucosa is more susceptible to malignant transformation ### Clinical Pearl Tumours of the antrum tend to present as ulcerating or fungating lesions and may cause gastric outlet obstruction. Tumours of the cardia may present with dysphagia if they extend proximally into the oesophagus. ### Mnemonic **ANTRUM = Adenocarcinoma, Antral site, Atrophic gastritis (H. pylori-induced)** — the antrum is the prime site for gastric cancer due to chronic H. pylori-related changes.
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