Epidemiology and overall survival of gastric carcinoma patients (about 210 cases) experience of medical oncology department of CHU Hassan II Fez
Authors: H. Erraichi, Z. Benbrahim, S. Berrad, K. Darif, L. Nouikh, L. Amaadour, K. Oualla, F. Lmrabet, S. Arifi, N. Mellas
Journal: Annals of Oncology (2018)

Introduction: Gastric cancer is the second leading cause of cancer mortality in men and the fourth on women, due to its aggressiveness it represents a challenging oncology session. It is usually late-onset discovery, which leads to poor prognosis despite advances in surgery and therapeutic oncology. Methods: Through retrospective study held in the medical oncology department of the Hassan II CHU in Fez, involving 210 patients with gastric cancer during a period of 5 years from January 2013 to January 2018. The aim of our study is to determine the epidemiological, paraclinical, and therapeutic aspects and especially the overall survival of these patients. The survival analysis was performed according to the Kaplan-Meier method and the comparison of the different survival rates according to the Log-Rank test. Results: A clear male predominance was found with a rate of 62.5% and a sex ratio of 1.6. The median age was 59, 25 years (range, 20 to 86 yo) with a standard deviation of 13.46 yo. family history of cancer was found in 3.9%. Alcohol-toxic intoxication was noted in 31.3% of patients. The clinical symptomatology was dominated by epigastric pain (93.02%), impairment of general health (89.2%), vomiting (45.73%) and gastrointestinal bleeding (29.8%). Regarding endoscopic aspects, distal location was predominant in 62.7% and ulceroburging was the most common in 58% of cases. Histologically, adenocarcinoma was the most common sub type with 65.7% of cases followed by signet ring cell carcinoma ring. Moderately differentiated adenocarcinoma was found in 49% of cases. The extension investigation has assessed a metastatic disease in 38%. The peritoneal localisation was predominant with 47.6% of cases followed by liver and lung localization in 35.8% and 34.8% respectively. 52% of the patients who received a first line chemotherapy based on ECX or EOX with an average number of 4 cures, 36, 8% of the cases received a chemotherapy based on fluoropyrimidines in combination with oxaliplatin with an average number of 3 cures, and 11.2% who received exclusively 5FU due to their general condition. Surgery was indicated in only 30.8% of patients, including 54.5% of patients who received adjuvant chemotherapy with a median of 5 courses. Chemoradiation based FUFOL was administered in 27.3% of patients. The overall median survival is 6.1 months with a 95% confidence interval (CI 95%) ranging from 2.1 to 10 months. The median survival depending on the stage of the disease was 30 months in the localized stage, 4.26 month in the locally advanced stage and only 3 months in the metastatic disease with a statically significant difference (p < 0.001). Conclusion: Gastric cancer remains a common cancer and has a poor prognosis. In our study, the stage of the disease has been identified as a factor influencing the overall survival of our patients, hence the interest of an early screening which be used to improve the prognosis.