Gastric cancer treatment in Brazil: a multicenter study of the Brazilian Gastric Cancer Association

Gastric cancer (GC) has distinct characteristics and management according to the region of the world, and the objective of our study was to evaluate how it is being managed in Brazil.

This is a multicenter study that involved 18 oncology referral centers. Data were collected using the REDCap platform and compiled at the end of one year.

All Brazilian regions were represented, and 635 patients were included. Most patients were from the Southeast (40.6%) and Northeast (29.6%) regions. The mean age was 62 years, with a predominance of males. Most patients (84.6%) had good performance status, with an ECOG score of 1-2. Less than 10% of patients were covered by medical insurance. A quarter of the patients underwent diagnostic laparoscopy, but endoscopic ultrasound and PET scans were rarely performed. The cT3 category was the most common (40.6%), lymph node involvement was described in 48.9%, and distant metastases, in 14.4% of the staging exams. The final cTNM staging was III (29.4%), II (26%), I (24.2%) and IV (20.5%). Most patients underwent surgery with curative intent (74.4%) and open access (82.8%). Preoperative chemotherapy was performed in 37.2% of cases, and the most common surgical procedures were subtotal gastrectomy (45.3%) and total gastrectomy (33.1%).

The present study allowed us to evaluate the current panorama of surgical treatment of Gastric Cancer, representing all regions of Brazil. Stage III, distal, and diffuse tumors continue to be prevalent in Brazil, and there has been relevant use of diagnostic laparoscopy, preoperative chemotherapy, and minimally invasive surgery.