A five-year retrospective analysis of clinical, pathological and treatment aspects on stomach cancer from a regional cancer centre in north east India
Keywords:Antrum, Gastric outlet obstruction, Metastasis, Palliative, Stomach cancer
Background: Stomach cancer is the fifth most common cancer in the world, which generally presents in advanced stage and have poor prognosis.
Methods: Retrospective study including 101 cases was done at the Regional Cancer Centre in North East India from January, 2018 to December, 2022 on the clinical, pathological and treatment aspects of stomach cancer.
Results: Median age of diagnosis was 59 years, with high male: female ratio. Most common risk factor was tobacco smoking and chewing. Most common symptom was pain abdomen followed by nausea or vomiting. Antrum was the most common tumor location, and gastric outlet obstruction was present in 10.9% patients. Histologically, all patients had adenocarcinoma, with metastasis found in 47 patients. Out of the 101 patients enrolled in the study, 50 patients were treated with curative intent and the remaining 51 patients were treated with palliative intent. Patients were treated with surgery, preoperative/ adjuvant/ palliative chemotherapy and/or curative/ palliative radiotherapy.
Conclusions: This study showed tobacco use as an important risk factor for stomach cancer. Majority of our patients were diagnosed at an advanced stage, thus having poor prognosis. Hence, avoidance of risk factors, early detection of signs and symptoms, and aggressive treatment with surgery, chemotherapy, and/ or radiotherapy is required for management of stomach cancer.
Global Burden of Disease Cancer Collaboration; Fitzmaurice C, Allen C, Barber EM, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systemic analysis for the global burden of disease study. JAMA Oncol 2017;3(4):524-48.
Tan YE, Wang PL, Yin SC, Zhang C, Hou WB, Xu HM. Thirty-year trends in clinicopathologic characteristics and prognosis after gastrectomy for gastric cancer: a single institution in Northern China. J Cancer 2020; 11:1056-62.
Thrift AP, El-Serag HB. Burden of gastric cancer. Clin Gastroenterol Hepatol. 2020;18(3):534-42.
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA: a cancer J clini. 2011;61(2):69-90.
Forman D, Burley VJ. Gastric cancer: global pattern of the disease and an overview of environmental risk factors. Best Pract Res Clin Gastroenterol. 2006;20(4):633-49.
Phukan RK, Zomawia E, Narain K, Hazarika NC, Mahanta J.. Tobacco use and stomach cancer in Mizoram, India. Cancer Epidemiol Biomarkers Prev. 2005;14(8):1892-6.
Hirohata T, Kono S. Diet/nutrition and stomach cancer in Japan. Int J Cancer. 1997;71(S10):34-6.
Elmajjaoui S, Ismaili N, Zaidi H, Elkacemi H, Hassouni K, Kebdani T, et al. Epidemiological, clinical, pathological, and therapeutic aspects of gastric cancer in Morocco. Clin Cancer Investig J. 2014;3(1):3-8.
Tuyns AJ, Quenum C. Registre des cancers au Sénégal. In: Parkin DM, editor. Cancer in Africa. Epidemiology and Prevention. vol. 153. Lyon: IARC Scientific Publications; 2003.
Barad AK, Mandal SK, Harsha HS, Sharma BM, Singh TS. Gastric cancer- a clinicopathological study in a tertiary care center of North-eastern India. Journal of Gastrointestinal Oncol. 2014;5(2):142-7.
Dekker W, Tytgat GN. Diagnostic accuracy of fiberendoscopy in the detection of upper intestinal malignancy. A follow-up analysis. Gastroenterol. 1977;73(4):710-4.
Cherian JV, Sivaraman R, Muthusamy AK, Venkataraman J. Stomach carcinoma in the Indian subcontinent: a 16-year trend. Saudi J Gastroent. 2007;13(3):114-7.
Riihimäki M, Hemminki A, Sundquist K, Sundquist J, Hemminki K. Metastatic spread in patients with gastric cancer. Oncotarget. 2016;7(32):52307.
Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345(10):725-30.
Jin P, Ji X, Kang W, Li Y, Liu H, Ma F, et al. Artificial intelligence in gastric cancer: a systematic review. J Cancer Res Clin Oncol. 2020;146:2339-50.
Joshi SS, Badgwell BD. Current treatment and recent progress in gastric cancer. CA Cancer J Clin. 2021;71(3):264-79.