History, Pathogenesis, and Management of Familial Gastric Cancer: Original Study of John XXIII's Family

Table 1

Clinicopathological approach to John XXIII’s gastric illness (Vatican City 1962-1963). As shown in this table, we considered four clinical phases.

Features	September-October 1962; Phase 1	November-December 1962; Phase 2	January–April 1963; Phase 3	May-June 1963; Phase 4
Clinical symptoms/signs	Dyspepsia, vomits, weight loss (5 kg in 4 years)	Epigastric pain, palpable mass in right hypocondrium, anemia, severe postprandial pain, nocturnal epigastric pain, insomnia, acute haemorrhage, severe anemia	Persistent epigastric pain, anorexia	Chronic epigastric pain with frequent exacerbations, multiple episodes of vomits and bleeding, melenas, strong widespread pain, anemia
Examinations/procedures	X-ray: tumour narrowing the antral region of the stomach, pyloric stenosis Ulceration	Blood and plasma transfusions, B12 vitamin, batroxobine cyclophosphamide, bicarbonate	Clinical followup	Ascites (5 litres), blood transfusion
Diagnosis/pathogenesis/evolutions	Family history	Advanced gastric cancer, cT4bN2 (IV stage), Intestinal histotype?	Unresectable gastric carcinoma	Tumour perforation, peritonitis, fever, coma, death