A prospective analysis of management of carcinoma stomach

Abstract

Background:Gastric carcinoma is a malignant epithelial tumour of the gastric mucosa with glandular differentiation. It applies to tumours arising in the distal stomach, body stomach and tumours arising in the proximal 5 cm, but not crossing the esophago-gastric junction. It is the fourth most common cancer and the second leading cause of cancer death. Its incidence is increasing and is especially prevalent in Asia. Its prevalence is four times higher in South India than North India. The objective of this study was to study the aetiology, clinical features, evaluation of carcinoma stomach, surgical management and post-operative complications of carcinoma stomach.Methods: This was a prospective study of patients with gastric carcinoma who were surgically managed at Victoria Hospital, Bangalore, India between September 2013 and April 2016.Results:The age group with the maximum incidence of gastric carcinoma was between the ages of 51-60. 61.54% of the patients followed a mixed diet and the rest were vegetarians. 50% of the patients were smokers only, 19.23% gave history of only alcohol consumption and 15.38% of the patients had history of both alcohol consumption and smoking. 55.77% of the patients presented with T3 disease and 19.23% of the patients had M1 disease. 42.31% of the patients had N1 disease, 34.62% of the patients had N2 disease, 19.23% of the patients had N3 disease and the rest had N0 disease. 75% of the patients underwent resection with a curative intent and the rest 25% had palliative procedures. On follow-up, 19.51% of the patients who underwent a curative resection expired and 80.48% are surviving. 81.48% of the patients who underwent a palliative procedure expired and 18.51% are surviving.Conclusions:Diet plays an important role in carcinoma of the stomach. A high index of suspicion is important in the diagnosis. Surgery is the only potentially curative form of treatment and the prognosis after curative surgery for early gastric cancer has been excellent. There is a need for early diagnosis so that the disease can be treated adequately which directly translates into an improved survival.