Gastric carcinoma--a big challenge in a poor economy

Gastric carcinoma is usually characterized with significant morbidity and mortality mainly because of late presentation. Late presentation of gastric carcinoma is a prominent feature in developing and poor countries.

The purpose of this study is to present our experience with the pattern and outcome of gastric tumors at the University of Benin Teaching Hospital, Benin City, Nigeria; with emphasis on late presentation of the patients.

The case files of the patients that were managed at the University of Benin Teaching Hospital for gastric tumors over a 5-year period (January 2004 to December 2006) were analyzed for biodata, symptoms and signs of disease, findings at operation, treatment offered, and outcome of treatment.

The male/female ratio was 2.3:1, with the youngest patient being 38 years while the oldest patient was 76 years old. Upper abdominal pain and a palpable mass per abdomen were the commonest symptoms and signs, respectively. Alcohol ingestion was the commonest identifiable risk factor. Only 30.4% of the patients presented within a year of the onset of symptoms. The gastric antrum was affected in over 78% of the cases, and adenocarcinoma was found in about 90% of the patients. Partial gastrectomy with gastrojejunostomy was the commonest procedure carried out. The mortality rate was 39.1%, and of the patients that died, 66.7% occurred within a year from time of diagnosis.

Most of the cases of gastric carcinoma presented in this study presented late with associated significant mortality. Health education is advised with a view to encouraging early presentation.