Gastric carcinoma: 5 year experience of a single institute

Gastric cancer (GC) is the most common cause of cancer death registered in cancer institute. Background clinical information is important for cancer prevention and therefore we here present characteristics and outcome of GC patients, more than half coming from northern parts of Iran.

we retrospectively studied records patients with pathologic diagnosis of GC referred to the Medical Oncology Department of the Cancer Institute from 1998 to 2003.

Four hundred and thirteen patients were registered with GC with the average age of 58 and a male to female ratio of 3/1. Tumor stage based on AJCC was stage 2(12.5%), stage 3(22%), stage 4(63%) and 2% unknown. Most common site of involvement was cardia (43%). Median survival time of all patients (with or without treatment) was 10 months overall. Gastrectomy was performed for 214 patients(39% with positive surgical margins), and 175 of the gastrectomised patients received chemotherapy. Median survival with surgery only was 7 months but 20 months with both surgery and chemotherapy. Only 21 patients received neoadjuvant chemotherapy. Median survival of patients who had response to preoperative chemotherapy was 30 months. By multivariate analysis lower extent of disease (p=0.0024), free surgical margin (p=0.0017), and chemotherapy (p=0.001) were associated with better prognosis.

Only curative resection with free margins was associated with a survival benefit in this study. More than 80% of patients were diagnosed in locally advanced or metastatic stage of disease and even with neoadjuvant chemotherapy and salvage surgery the outcome was poor. Clearly more efforts need to be given to early detection of lesions to allow a better cure rate.