Napoleon Bonaparte's gastric cancer: A clinicopathologic approach to staging, pathogenesis, and etiology

Alessandro Lugli, Inti Zlobec, Gad Singer, Andrea Kopp Lugli, Luigi M. Terracciano, Robert M. Genta

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background: Numerous hypotheses on the cause of Napoleon Bonaparte's death have been proposed, including hereditary gastric cancer, arsenic poisoning, and inappropriate medical treatment. We aimed to determine the etiology and pathogenesis of Napoleon's illness by a comparison of historical information with current clinicopathologic knowledge. Investigations: Evaluation of Napoleon's clinical history, original autopsy reports, and of historical documents. The clinicopathologic data from 135 gastric cancer patients were used for comparison with the data available on Napoleon. Diagnosis: At least T3N1M0 (stage IIIA) gastric cancer. Napoleon's tumor extended from the cardia to the pylorus (>10 cm) without infiltration of adjacent structures, which provides strong evidence for at least stage T3. The N1 stage was determined by the presence of several enlarged and hardened regional (perigastric) lymph nodes, and the M0 stage by the absence of distant metastasis. Analysis of the available historical documents indicates that Napoleon's main risk factor might have been Helicobacter pylori infection rather than a familial predisposition. Conclusions: Our analysis suggests that Napoleon's illness was a sporadic gastric carcinoma of advanced stage. Patients with such tumors have a notoriously poor prognosis.

Original languageEnglish (US)
Pages (from-to)52-57
Number of pages6
JournalNature Clinical Practice Gastroenterology and Hepatology
Volume4
Issue number1
DOIs
StatePublished - Jan 1 2007

Keywords

  • Gastric cancer
  • Helicobacter pylori infection
  • Hereditary gastric cancer syndrome
  • Napoleon Bonaparte
  • TNM stage

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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