Gastric cancer at a university teaching hospital in northwestern Tanzania: a retrospective review of 232 cases

World Journal of Surgical Oncology

Research

Mheta Koy¹  Hyasinta Jaka¹  Nestory Masalu²  Peter F Rambau³  Joseph B Mabula⁴  Phillipo L Chalya⁴  Mabula D Mchembe⁵  Fabian Massaga⁶ 

[1] Department of Internal Medicine, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;Department of Oncology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania;Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania;Department of Surgery, University of Dodoma, Dodoma, Tanzania;

关键词: Gastric cancer;    Clinicopathological pattern;    Treatment outcome;    Tanzania;   

DOI  :  10.1186/1477-7819-10-257

 received in 2012-08-26, accepted in 2012-10-31,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundDespite marked decreases in its incidence, particularly in developed countries, gastric cancer is still the second most common tumor worldwide. There is a paucity of information regarding gastric cancer in northwestern Tanzania. This study was undertaken to describe our experience, in our local setting, on the management of gastric cancer, outlining the clinicopathological and treatment outcome of these patients and suggesting ways to improve the treatment outcome.MethodsThis was a retrospective study of histologically confirmed cases of gastric cancer seen at Bugando Medical Centre between January 2007 and December 2011. Data were retrieved from patients’ files and analyzed using SPSS computer software version 17.0.ResultsA total of 232 gastric cancer patients were enrolled in the study, representing 4.5% of all malignancies. The male to female ratio was 2.9:1. The median age of patients was 52 years. The majority of the patients (92.1%) presented late with advanced gastric cancer (Stages III and IV). Lymph node and distant metastasis at the time of diagnosis was recorded in 31.9% and 29.3% of cases, respectively. The antrum was the most frequent anatomical site (56.5%) involved and gastric adenocarcinoma (95.1%) was the most common histopathological type. Out of 232 patients, 223 (96.1%) patients underwent surgical procedures for gastric cancer of which gastro-jejunostomy was the most frequent performed surgical procedure, accounting for 53.8% of cases. The use of chemotherapy and radiotherapy was documented in 56 (24.1%) and 12 (5.1%) patients, respectively. Postoperative complication and mortality rates were 37.1% and 18.1%, respectively. According to multivariate logistic regression analysis, preoperative co-morbidity, histological grade and stage of the tumor, presence of metastases at the time of diagnosis was the main predictors of death (P <0.001). At the end of five years, only 76 (32.8%) patients were available for follow-up and the overall five-year survival rate was 6.9%. Evidence of cancer recurrence was reported in 45 (19.4%) patients. Positive resection margins, stage of the tumor and presence of metastasis at the time of diagnosis were the main predictors of local recurrence (P <0.001).ConclusionsGastric cancer in this region shows a trend towards relative young age at diagnosis and the majority of patients present late with an advanced stage. Lack of awareness of the disease, poor accessibility to health care facilities and lack of screening programs in this region may contribute to advanced disease at the time of diagnosis. There is a need for early detection, adequate treatment and proper follow-up to improve treatment outcome.

【 授权许可】

Unknown   
© Mabula et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.