( ate-of-the-art tumor-staging method fro...)Napoleon's mysterious death unmasked, UT Southwestern researcher says

ate-of-the-art tumor-staging method from 21st century pathology and determined that Napoleon had at least T3N1M0, or Stage IIIA, gastric cancer, which is very severe. The method grades severity on a 1 to 4 scale, with 4 being the worst case. The "T" designates cancer size; the "N" designates the presence of lymph nodes, which are associated with tumors; and the "M" designates metastasis of the cancer to other organs. The autopsy and other accounts indicate that the cancer was large, lymph nodes were present around the stomach and there were no tumors in other organs. Only 20 percent of patients with Stage IIIA gastric cancer survive five years if treated with modern surgery and chemotherapy.

But what might have caused Napoleon's cancer?

Risk factors for gastric cancer include male gender, genetic susceptibility, chronic gastritis and infection by the bacteria Helicobacter pylori.

Although genetic susceptibility is a possible cause, it's not likely, Dr. Genta said. That's because the autopsy of Napoleon's father described a tumor that might have been something other than gastric cancer. And because autopsies were not performed on other Bonaparte family members, their causes of death can only be speculated upon based on symptoms or medical reports.

Instead, the ulcerated lesion on the emperor's stomach suggests a history of chronic H. pylori gastritis, which might have increased his risk of gastric cancer, Dr. Genta said. The risk might have been further increased by his diet full of salt-preserved foods but sparse in fruits and vegetables ?common fare for long military campaigns.

"Even if treated today, he'd have been dead within a year," he said.

Dr. Genta completed some of the work for this report while at the University of Geneva. Researchers from the Aarau Cantonal Hospital and the Institute of Pathology at the University Hospital of Basel, both in Switzerland, and McGill University in
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Source:UT Southwestern Medical Center

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