Clinicopathological Features of Gastric Cancer in a Cohort of Gulf Council Countries’ Patients: A Cross-Sectional Study of 96 Cases

Abstract

Objective: This cross-sectional study aims to report the clinicopathological features of Gulf Cooperation Council (GCC) patients with Gastric Cancer (GC). Patients and Methods: This cross-sectional study evaluated patients from GCC countries presenting with GC, treated at the University of Texas MD Anderson Cancer Center, Houston, Texas from 1981 to 2015. After obtaining an Institutional Review Board (IRB) approval to conduct this cross-sectional study, the data were collected from the charts of 96 consecutive GCC patients diagnosed with GC according to electronic and paper medical records (for cases prior to the implementation of the electronic medical records): The charts were reviewed for demographic data, clinical data, diagnostic tools, endoscopic location of the tumour and clinicopathological features of the GC. Statistical analyses were performed by using SPSS version 20. Numerical data were presented as mean +/- standard deviation (SD) (For normally distributed data); median and range (For not normally distributed data). Nominal data were expressed by percentages. Results: 96 patients identified with histologically confirmed gastric carcinoma from Saudi Arabia (KSA) (40%), UAE (26%), Qatar (16%) Kuwait (10%), Oman (3%) and Bahrain (2%). The median age was 54.5 years and 40 patients (42%) were less than 50 years of age. 61% of the patients were of male gender and 39% were female. Intestinal type was the most common histological type in 61% of cases, 30% had signet cell histology. The aggressive signet ring histology is the most common (71.4%) in younger patients (Age < 50) in this cohort. Out of those 28 patients tested for HER-2 amplification, 6 (20%) were found to be amplified. Finally, 76% of the patients presented with stage IV disease. Conclusion: GC tends to present in advanced stages in GCC population with median duration from first symptoms to diagnosis was 9.3 months (2 to 18 months). GC in patients from GCC countries is diagnosed at 10 years earlier than in Western population. Intestinal‐type histology is most common similar to the western population, yet aggressive histology (signet ring) is high in younger population. HER-2 amplification rate is similar to Western populations. This is the first study to report these findings in GCC population with gastric cancer. Further collaboration and research are needed across the GCC countries to better characterize GC in this region and to understand the early onset pattern of GC observed in this report.