Publication:

Management and outcomes of carcinoma stomach in Central India: a prospective cross-sectional study

Background Adenocarcinoma of the stomach is one of the leading causes of cancer-related deaths worldwide. Cancer rates in India are rising with increase in life expectancy and changes in lifestyles. Although the incidence of gastric cancer has decreased, number of newly diagnosed cases of proximal gastric and esophago-gastric junction adenocarcinomas has increased markedly. It is necessary to identify the population and risk factors along with malignancy characteristics in Central India.

Methods A prospective observational study of 84 histopathological proven cases of gastric malignancy were analysed and evaluated. Treatment for the same was categorised after staging. Surgical resection, therapeutic and palliative chemotherapy was employed in the treatment protocols. A follow-up of 6 months was taken to observe the early complications.

Results Eighty-four patients were analysed and evaluated. The mean age was 54.1 year with male predominance (1.54:1). Hypertension was commonest comorbidity, while smoking was commonest associated risk factor observed. Majority (56%) of patients underwent palliative chemotherapy while 34% underwent curative surgery. Subtotal gastrectomy with Billiroth II gastrojejunostomy was commonest performed operation (34%). Postoperative wound infection was commonest complication. Mean follow-up period of 11.3 months was observed where one patient expired of ARDS and one was readmitted for anastomotic site stricture.

Conclusions There was high incidence of gastric malignancy patients presenting in stage IV in 5th decade of life with weight loss as main feature. Palliative chemotherapy is commonly followed because of advanced disease. The rates of inoperability are high and unfavourable histopathological variety occur frequently in older patients.