Abstract
Introduction
Gastric cancer is the fourth commonest malignancy and the second leading cause of cancer-related death. Although gastric carcinoma is less common throughout Africa than in Europe, there are considerable variations in its incidence and pattern. It accounts for about 5% of cancer-related death. It is characterized with significant morbidity and mortality mainly because of late presentation in developing and poor countries. Previous studies on gastric cancer in Ibadan and other West African centres demonstrated the preponderance of distal (pyloric antrum) gastric lesions when compared to proximal (cardia, fundus) lesions. Nevertheless, recent studies in developed nations show that distal gastric lesions are on the decline while there is an increase in the proportion of proximal gastric lesions.
Objective
The objective of this study is to review the pattern of presentation of patients with gastric carcinoma managed in our surgical division over a 5-year period and to determine changes in the trend in our environment.
Methodology
A retrospective study of all patients with gastric carcinoma between November 2004 and October 2009 was carried out. Simple descriptive analysis was used to characterize the patients’ demographic parameters, symptomatology, clinical and investigative findings along with treatment and outcome modalities.
Results
There were 49 cases managed by the division over the period under review. The male to female ratio was 1.45:1 with a mean age of 56 years at presentation. Duration of symptom was less than 5 months (20 weeks) in 47.9% of the patients. Dysphagia was present in 12.2% while 52.6% had a history of suspected peptic ulcer disease. There was electrolyte derangement in 31.7% of the patients while 52.6% had anaemia at presentation. Proximal tumours of the gastro-oesophageal region, cardia and the body constituted 51% of the cases; 51.4% of the patients were blood group O as opposed to 28.6% and 20%, respectively, with blood A and B. Thirty-six patients (73.5%) had a histological diagnosis of adenocarcinoma, five patients (10%) had signet ring variant of adenocarcinoma carcinoma, while three patients (6.1%) were each had gastrointestinal stromal tumours or lymphomas.
Discussion
Our review shows a peak age in the sixth and seventh decades at presentation. There is a significant increase in the proportion of proximal gastric lesions and a predominance of blood group O. Gastrointestinal stromal tumour and lymphoma should be considered as differential diagnosis. Patients still present late with advanced diseases, and curative treatment is often impossible.
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References
Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics 2001. CA Cancer J Clin. 2001;51:15–36.
Aoki K, Kurihara M, Hayakawa N, et al., editors. Death rates for malignant neoplasms for selected sites by sex and five-year age group in 33 Countries 1953–57 to 1983–87. Nagoya: University of Nagoya Coop Press; 1992.
Balint GA. Gastric and colorectal cancer in the tropical part of Africa. Acta Med Hung. 1990;47:91–8.
Parkin DM, Bray FI, Davesa SS. Cancer burden in the year 2000. The global picture. Eur J Cancer. 2001;37 Suppl 8:S4–S66.
Parkin DM, Whelan SL, Ferlay J, et al., editors. Cancer incidence in five continents, volume VII. IARC scientific publications no. 143. Lyon: International Agency for Research on Cancer; 1997.
Brown LM, Daves SS. Epidemiologic trends in oesophageal and gastric cancer in the United States. Surg Oncol Clin N Am. 2002;11:235–56.
Sharara AI, Abdul-Baki H, ElHajj I, Kreidieh N, Kfoury Baz EM. Association of gastroduodenal disease phenotype with ABO blood group and Helicobacter pylori virulence-specific serotypes. Dig Liver Dis. 2006;38:829–33.
Takyi HK. A review of cancer of the stomach as seen in Korle Bu Teaching Hospital (1966–1969). Ghana Med J. 1972;11:133–6.
Alatise OI, Lawal OO, Adesunkanmi AK, et al. Clinical pattern and management of gastric cancer in Ile-Ife. Nigeria Arab J Gastroenterol. 2007;8(4):123–6.
Olurin EO, Itayemi SO. Carcinoma of the stomach: a study of 122 cases. J Niger Med Assoc. 1971;1:42–7.
Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24(14):2137–50.
Balint GA. Selected gastrointestinal pathologies in tropical sub-Saharan Africa. Bull World Health Organ. 1998;76(2):207–12.
Naomi U, Shiro O, Soichiro Y, Nobutoshi M, Shuji Y, Michio Y, et al. Helicobacter pylori infection and development of gastric cancer. N Engl J Med. 2001;345(11):784–9.
Beckman L, Angquist K. On the mechanism behind the association between ABO blood group and gastric carcinomas. Hum Hered. 1987;37:140–3.
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Afuwape, O.O., Irabor, D.O., Ladipo, J.K. et al. A Review of the Current Profile of Gastric Cancer Presentation in the University College Hospital Ibadan, a Tertiary Health Care Institution in the Tropics. J Gastrointest Canc 43, 177–180 (2012). https://doi.org/10.1007/s12029-011-9259-z
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DOI: https://doi.org/10.1007/s12029-011-9259-z